European heart journal. Imaging methods and practice最新文献

{"title":"Myocardial extracellular volume fraction by computed tomography vs. cardiovascular magnetic resonance imaging in patients with stable chest pain.","authors":"Bunny Saberwal, Kush Patel, Ernst Klotz, Anna Herrey, Andreas Seraphim, Sebastian Vandermolen, George D Thornton, Mohammed Y Khanji, Thomas A Treibel, Francesca Pugliese","doi":"10.1093/ehjimp/qyaf019","DOIUrl":"10.1093/ehjimp/qyaf019","url":null,"abstract":"<p><strong>Aims: </strong>Computed tomography (CT) is increasingly being recognized as a diagnostic modality across a range of cardiovascular conditions. Myocardial late enhancement imaging has shown value as an imaging biomarker for the identification and prognostication of disease. The objective of this study was to compare extracellular volume fraction by CT (ECVCT) against cardiovascular magnetic resonance (ECVCMR), the latter considered as reference standard for this study.</p><p><strong>Methods and results: </strong>Consecutive patients with an index history of cardiac chest pain referred for invasive angiography were prospectively recruited. In addition to late gadolinium enhancement (LGE) imaging, patients underwent 1.5 T CMR with T1-mapping [by MOdified Look-Locker Inversion (MOLLI) recovery]. Pre- and post-contrast CT was performed for whole-heart ECVCT quantification. Averaged and segmental ECVCT was compared in patients with and without LGE, as well as between mid-ventricular averaged ECVCT and ECVCMR. Bland-Altman analysis was used to determine limits of agreement and identify differences between ECVCT and ECVCMR. A total of 88 participants (74% male, mean age 59.8 ± 9.1 years) underwent ECVCT and LGE; 49 of these also underwent mid-ventricular ECVCMR. For these, the CMR and CTECV fractions were 27.6 ± 2.4 and 26.8 ± 2.2, respectively. Patients with LGE findings on CMR (<i>n</i> = 24) had a significantly higher ECVCT than those without (<i>n</i> = 64): 27.2 [25.8, 28.7] vs. 26.1 [25.0, 27.7] (<i>P</i> = 0.02). Segments with LGE demonstrated a consistently higher ECV: 30.8 [25.7, 35.9] (<i>P</i> = 0.008) (endocardial LGE) and 30.9 [27.9, 33.1] (<i>P</i> = 0.0001) (transmural LGE) vs. 26.1 [25.0, 27.4].</p><p><strong>Conclusion: </strong>ECVCT obtained from 5 min post-contrast CT protocols shows good agreement with CMR in a stable chest pain cohort. Such a protocol could be seamlessly introduced into a CT workflow for the identification of significant secondary pathologies.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf019"},"PeriodicalIF":0.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of respiratory motion compensation in intracardiac 4D flow magnetic resonance imaging on left ventricular flow dynamics, multicomponent particle tracing, and valve tracking.","authors":"Paul R Roos, Thomas In de Braekt, Hildo J Lamb, Jos J M Westenberg","doi":"10.1093/ehjimp/qyaf020","DOIUrl":"10.1093/ehjimp/qyaf020","url":null,"abstract":"<p><strong>Aims: </strong>4D flow magnetic resonance imaging (MRI) has enabled evaluation of intracardiac flow dynamics by particle tracing for visualizing and quantifying complex flow patterns. The aim of this study was to assess the impact of respiratory motion compensation on 4D flow MRI-based left ventricular four-component particle tracing, valve tracking, and haemodynamics.</p><p><strong>Methods and results: </strong>In this prospective cohort study, 4D flow MRI with and without respiratory motion compensation was performed in 15 healthy volunteers. Intracardiac particle tracing considered four components: direct flow, delayed ejection flow (DEF), retained inflow (RI), and residual volume. Data quality was assessed by comparing DEF and RI components. Particle tracing, valve tracking, kinetic energy (KE), and vorticity were compared between scan methods. Paired sample <i>t</i>-tests and intraclass correlation analysis were performed with an alpha of 0.05. DEF, RI, ejection fraction, and stroke volume were different between scan methods. Five participants showed DEF-RI mismatch > 10%. After excluding these, differences in flow fractions were non-significant. Differences in stroke volume, ejection fraction, and valvular flow mismatch between scan methods remained. Valve tracking was comparable between scan methods and correlated well with particle tracing. Absolute mismatch between particle tracing- and valve tracking-based mitral flow, and KE and vorticity at A-peak, was higher for non-compensated MRI.</p><p><strong>Conclusion: </strong>Respiratory motion compensation can improve accuracy of intracardiac particle tracing based on 4D flow MRI by decreasing mismatch to retrospective valve tracking. For intracardiac particle tracing, respiratory motion compensation is advised. Robust data quality assessment for particle tracing-based analyses is equally crucial.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf020"},"PeriodicalIF":0.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accurate fully automated assessment of left ventricle, left atrium, and left atrial appendage function from computed tomography using deep learning.","authors":"Lee Jollans, Mariana Bustamante, Lilian Henriksson, Anders Persson, Tino Ebbers","doi":"10.1093/ehjimp/qyaf011","DOIUrl":"10.1093/ehjimp/qyaf011","url":null,"abstract":"<p><strong>Aims: </strong>Assessment of cardiac function is essential for diagnosis and treatment planning in cardiovascular disease. Volume of cardiac regions and the derived measures of stroke volume (SV) and ejection fraction (EF) are most accurately calculated from imaging. This study aims to develop a fully automatic deep learning approach for calculation of cardiac function from computed tomography (CT).</p><p><strong>Methods and results: </strong>Time-resolved CT data sets from 39 patients were used to train segmentation models for the left side of the heart including the left ventricle (LV), left atrium (LA), and left atrial appendage (LAA). We compared nnU-Net, 3D TransUNet, and UNETR. Dice Similarity Scores (DSS) were similar between nnU-Net (average DSS = 0.91) and 3D TransUNet (DSS = 0.89) while UNETR performed less well (DSS = 0.69). Intra-class correlation analysis showed nnU-Net and 3D TransUNet both accurately estimated LVSV (ICC_nnU-Net = 0.95; ICC_3DTransUNet = 0.94), LVEF (ICC_nnU-Net = 1.00; ICC_3DTransUNet = 1.00), LASV (ICC_nnU-Net = 0.91; ICC_3DTransUNet = 0.80), LAEF (ICC_nnU-Net = 0.95; ICC_3DTransUNet = 0.81), and LAASV (ICC_nnU-Net = 0.79; ICC_3DTransUNet = 0.81). Only nnU-Net significantly predicted LAAEF (ICC_nnU-Net = 0.68). UNETR was not able to accurately estimate cardiac function. Time to convergence during training and time needed for inference were both faster for 3D TransUNet than for nnU-Net.</p><p><strong>Conclusion: </strong>nnU-Net outperformed two different vision transformer architectures for the segmentation and calculation of function parameters for the LV, LA, and LAA. Fully automatic calculation of cardiac function parameters from CT using deep learning is fast and reliable.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"2 4","pages":"qyaf011"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging small dynamic lesions using positron emission tomography and computed tomography: an ¹⁸F-sodium fluoride valvular phantom study.","authors":"Anna K Barton, Jacek Kwiecinski, Hidenobu Hashimoto, Mark Hyun, Keiichiro Kuronuma, Aditya Killekar, Aakriti Gupta, Nipun Manral, John Moore, Marc R Dweck, David E Newby, Daniel S Berman, Damini Dey, Piotr Slomka","doi":"10.1093/ehjimp/qyaf013","DOIUrl":"10.1093/ehjimp/qyaf013","url":null,"abstract":"<p><strong>Aims: </strong>¹⁸F-sodium fluoride (¹⁸F-NaF) positron emission tomography (PET) detects active microcalcification and predicts adverse outcomes including bioprosthetic valve deterioration. However, measuring small areas of ¹⁸F-NaF uptake within moving structures remains challenging, requiring further optimization. We developed a representative cardiac phantom to optimize ¹⁸F-NaF imaging of bioprosthetic valves.</p><p><strong>Methods and results: </strong>We placed a bioprosthetic valve with two pockets sutured to the leaflets mimicking valvular lesions and a subvalvular ring mimicking the valve remnant into the phantom and injected each with ¹⁸F-radionuclide (1 μCi pockets, 4 μCi ring). We injected the cardiac chambers with iohexol and ¹⁸F-radionuclide (0.176 mCi) for background activity. PET and computed tomography (CT) images were acquired using a Siemens Biograph Vision high-resolution digital PET/CT scanner. We analysed target-to-background ratio (TBR) and signal-to-noise ratio (SNR) and subjective measures of image quality. We compared results with a human case of transcatheter aortic valve replacement. Initially the SNR and TBR in the phantom greatly exceeded those from human imaging. We reduced the scan duration used for reconstruction to 30 and 15 s, achieving comparable results (30 s vs. 15 s vs. patient: SNR 45.6 vs. 13.9 vs. 44.3, TBR_max 6.5 vs. 5.4 vs. 4.1, noise 10.2% vs. 8.8% vs. 12.0%). With motion correction, SNR and image quality improved in the phantom (30 s 135.8 vs. 45.6, 15 s 32.9 vs. 13.9) but remained similar in the human case (47.3 vs. 44.3).</p><p><strong>Conclusion: </strong>A cardiac phantom can mimic clinical ¹⁸F-NaF valve bioprosthesis imaging, providing an opportunity to explore acquisition, reconstruction, and post-processing of ¹⁸F-NaF PET/CT for small mobile cardiac structures.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf013"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143559838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent locally uncontrolled infection in endocarditis, a fearful complication.","authors":"Axel Abel Rodriguez-Mendez, Hugo Gerardo Rodriguez-Zanella, Ana Maria Coeto-Cano, David Jacobo Sanchez-Amaya, Daniel Manzur-Sandoval","doi":"10.1093/ehjimp/qyae117","DOIUrl":"https://doi.org/10.1093/ehjimp/qyae117","url":null,"abstract":"","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyae117"},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of loading, heart rate, and short episodes of ischaemia on myocardial stiffness assessed using shear wave elastography in an open-chest animal model.","authors":"Eric Saloux, Christophe Simard, Pauline Ruello, Adrien Lemaitre, Amir Hodzic, Alexandre Lebrun, Pierre-Antoine Dupont, Christophe Tribouilloy, Hélène Eltchaninoff, Morgane Le Garec, Christophe Fraschini, Vladimir Saplacan, Alain Manrique","doi":"10.1093/ehjimp/qyaf015","DOIUrl":"10.1093/ehjimp/qyaf015","url":null,"abstract":"<p><strong>Aims: </strong>Shear wave elastography (SWE) is a new promising ultrasound modality that enables non-invasive measurement of the dynamic myocardial stiffness. The impact of varying physiological conditions on SWE measurement of left ventricular (LV) myocardial stiffness remains poorly investigated.</p><p><strong>Methods and results: </strong>Nineteen sheep were evaluated during open-chest surgery. Epicardial multiframe SWE acquisitions were performed in short-axis view simultaneously with haemodynamic acquisitions during inferior vena cava occlusion, aortic clamping, atrial pacing, and ischaemia-reperfusion. The cyclic variation in the median value of LV myocardial stiffness ranged from 1.1 m/s in diastole (C_min) to 2.4 m/s in systole (C_max). At steady state, intra-animal reproducibility was good for C_min [intraclass correlation coefficient ICC = 0.77 (0.54, 0.90), <i>P</i> < 0.001] and C_max [ICC = 0.92 (0.84, 0.96), <i>P</i> < 0.001]. C_min was independent of loading conditions, heart rate, and short 15-minute episodes of ischaemia and reperfusion. C_max was independent of loading conditions and moderate increase in heart rate but decreased significantly during ischaemia and reperfusion. Compared with baseline, percentage changes in C_max was correlated to percentage changes in dP/dt_max (<i>R</i> = 0.47, <i>P</i> = 0.001) and in LV systolic pressure (<i>R</i> = 0.35, <i>P</i> = 0.013) and SW (<i>R</i> = 0.31, <i>P</i> = 0.026).</p><p><strong>Conclusion: </strong>In this study, LV diastolic myocardial stiffness C_min assessed using SWE demonstrated the characteristics of a potentially useful clinical marker of LV diastolic function linked to the intrinsic elastic properties of the myocardium, whereas C_max was an indicator of LV contractility.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf015"},"PeriodicalIF":0.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac imaging highlights from European Society of Cardiology 2024: the future is within our grasp!","authors":"Stefano Figliozzi, Erika Hutt, Alessia Gimelli, Wael A Jaber","doi":"10.1093/ehjimp/qyaf009","DOIUrl":"10.1093/ehjimp/qyaf009","url":null,"abstract":"<p><p>The European Society of Cardiology has held its annual Congress in London, UK, from 30 August to 2 September 2024. With a total of 31 800 participants, 5400 faculty and presenters, and many National Cardiac Societies and industry partners, the Congress has taken an enormous step forward to present and discuss the latest advances in cardiovascular medicine. The sizable intercontinental reach was proved by the fact that 5 of the 10 top countries, in terms of submission of abstracts, were from outside Europe: China, the USA, Japan, Korea, and Australia. This brought a great impetus for international collaboration and exchange of views, learning from different perspectives. Specifically, the field of cardiovascular imaging has been in the spotlight, remarking its growing, central, and transversal role in modern cardiovascular medicine. In this communication, we offer a summary of some notable advances in research, either in terms of novelty or clinical applicability, within the realm of four imaging modalities: echocardiography, cardiovascular magnetic resonance, computed tomography, and nuclear imaging.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf009"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of bicuspid valve morphology on the selection of transcatheter aortic valve implantation devices: an <i>in silico</i> study.","authors":"Benedetta Grossi, Giulia Luraghi, Sara Barati, Chiara Forte, Luca Gerosa, Ottavia Cozzi, Fabrizio D'Ascenzo, Gianluigi Condorelli, Francesco Migliavacca, Giulio Stefanini","doi":"10.1093/ehjimp/qyaf018","DOIUrl":"10.1093/ehjimp/qyaf018","url":null,"abstract":"<p><strong>Aims: </strong>Bicuspid aortic valve (BAV) represents a challenge for transcatheter aortic valve implantation (TAVI). Few data are reported about the procedural implications of BAV using different self-expandable devices. The aim of this study is to investigate how BAV and tricuspid aortic valve (TAV) morphologies influence device selection and their impact on the potential development of post-operative conduction disturbances, using a novel <i>in silico</i> approach.</p><p><strong>Methods and results: </strong>Five patients with BAV undergoing TAVI were enrolled. TAVs were virtually modelled within each BAV patient-specific anatomy, resulting in 10 virtual patients. Acurate Neo2 and Evolut R implantations were subsequently simulated across all cases. Post-implantation stresses exerted on both the stent and aortic root were measured, allowing a comparative analysis of the impact of the two valve morphologies. Comparing stent stresses between BAV and TAV configurations, the stress gap increased by 21.96 ± 5.35% (<i>P</i> = 0.01) in Acurate Neo2 cases (<i>n</i> = 6) compared with Evolut R cases (<i>n</i> = 4). The analysis of aortic root stresses showed no significant differences between BAV (<i>n</i> = 5) and TAV (<i>n</i> = 5) configurations, with a mean stress difference of 5.1 ± 8.17% (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>Our patient-specific model shows that high radial force devices, such as Evolut R, demonstrate consistent expansion regardless of valve morphology, without increasing the risk of post-implantation conduction disturbances, hence resulting more suitable for BAV cases. Incorporating this methodology into pre-operative planning could support clinicians in selecting the most suitable device with a patient-specific approach.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf018"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Segmental post-percutaneous coronary intervention physiological gradients using ultrasonic or optical flow ratio: insights from ASET JAPAN study.","authors":"Pruthvi C Revaiah, Kotaro Miyashita, Tsung-Ying Tsai, Retesh Bajaj, Nozomi Kotoku, Akihiro Tobe, Takashi Muramatsu, Kengo Tanabe, Ken Kozuma, Yukio Ozaki, Scot Garg, Shengxian Tu, Jouke Dijkstra, Christos V Bourantas, Yoshinobu Onuma, Patrick W Serruys","doi":"10.1093/ehjimp/qyaf017","DOIUrl":"10.1093/ehjimp/qyaf017","url":null,"abstract":"<p><strong>Aims: </strong>Segmental pressure gradients post-percutaneous coronary intervention (PCI) can detect residual disease and optimization targets. Ultrasonic flow ratio (UFR) or optical flow ratio (OFR) offer simultaneous physiological and morphological assessment using a single imaging catheter. This study evaluated the utility of UFR and OFR in identifying residual disease post-PCI.</p><p><strong>Methods and results: </strong>The study include patients from the Acetyl Salicylic Elimination Trial JAPAN Pilot study with complete intravascular imaging pullback data, where UFR or OFR was obtained post-PCI. Anatomical focal lesions distal and proximal to the stent were analysed in segments ≥5 mm long. UFR or OFR virtual pullback curves assessed intra-stent pressure gradients, defining physiological focal or diffuse by segmental pressure drops ≥0.05 over lengths <10 or ≥10 mm, respectively. The median post-PCI UFR/OFR was 0.93 (0.88-0.96) with 35.4% (69/195) vessels having a UFR/OFR < 0.91. There were significantly more focal lesions, both anatomical and physiological, proximal and distal to the stent in vessels with UFR/OFR < 0.91 compared with those ≥0.91. Agreement between anatomical and physiological focal lesions was moderate proximally (kappa = 0.553, <i>P</i> < 0.001) and fair distally (kappa = 0.219, <i>P</i> = 0.002). The in-stent gradient poorly predicted significant stent under-expansion. However, the virtual fractional flow reserve gradient performed well in detecting proximal or distal focal disease (area under the curve = 0.835 and 0.877, respectively).</p><p><strong>Conclusion: </strong>UFR/OFR effectively identifies sub-optimal vessel physiology post-PCI and locates precise anatomical issues, validated by intravascular imaging.</p><p><strong>Trial registration: </strong>The ASET JAPAN ClinicalTrials.gov reference: NCT05117866.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf017"},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of tricuspid regurgitation regression after mitral valve transcatheter edge-to-edge repair using three-dimensional transoesophageal echocardiography.","authors":"Makoto Takeuchi, Hiroto Utsunomiya, Kiyotaka Tohgi, Ayano Hamada, Yohei Hyodo, Akane Tsuchiya, Atsuo Mogami, Hajime Takemoto, Kanako Izumi, Kosuke Takahari, Yusuke Ueda, Kiho Itakura, Hiroki Ikenaga, Yukiko Nakano","doi":"10.1093/ehjimp/qyaf016","DOIUrl":"10.1093/ehjimp/qyaf016","url":null,"abstract":"<p><strong>Aims: </strong>We aimed to identify three-dimensional echocardiographic predictors of tricuspid regurgitation (TR) regression in patients with functional TR of moderate or greater severity undergoing mitral valve transcatheter edge-to-edge repair to optimize patient selection and improve clinical outcomes.</p><p><strong>Methods and results: </strong>This retrospective study analysed 61 patients (mean age 81.3 ± 7.6 years; 55.7% males) who underwent mitral valve transcatheter edge-to-edge repair. Two-dimensional transthoracic echocardiography was performed pre- and 1-month post-procedurally, while three-dimensional transoesophageal echocardiography was performed pre-procedurally. We collected data on clinical variables, medications, and detailed echocardiographic measurements to evaluate procedural outcomes. Tricuspid regurgitation severity was semiquantitatively assessed and categorized. At the 1-month follow-up, TR severity had regressed in 43% of patients. A lower prevalence of atrial fibrillation, smaller left atrial volume index, and smaller right atrial area were significantly associated with TR regression. Multivariate analysis revealed the tricuspid valve annulus perimeter, area, and area change as significant predictors of post-procedure TR regression; tricuspid valve annulus perimeter was the strongest predictor among the three indicators [area under the receiver operating characteristic curve, 0.84 (95% confidence interval: 0.75-0.94), <i>P</i> < 0.001]. Receiver operating characteristic curve analysis indicated that tricuspid valve annulus perimeter cut-off of ≤13.75 cm was the best predictor of post-procedure TR regression. Additionally, tricuspid valve annulus area ≤13.55 cm² and annulus area change ≥17.5% were predictors of post-procedure TR regression.</p><p><strong>Conclusion: </strong>In patients with relatively severe mitral regurgitation with a non-dilated tricuspid annulus and significant change in tricuspid valve annulus area, mitral valve transcatheter edge-to-edge repair may lead to TR regression.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf016"},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}