European heart journal. Imaging methods and practice最新文献

{"title":"Cardiovascular imaging in 2024: review of current research and innovations.","authors":"Andrea Barison, Ana Teresa Timoteo, Saloua El Messaoudi, Sonia Borodzicz-Jazdzyk, Sara Moscatelli, Giulia Elena Mandoli, Christina Luong, Eylem Levelt, Arti Anushka Ramkisoensing, Zahra Raisi-Estabragh, Alexios Antonopoulos, Sarah Moharem-Elgamal, Riccardo Liga, Gianluca Pontone, Danilo Neglia","doi":"10.1093/ehjimp/qyaf066","DOIUrl":"10.1093/ehjimp/qyaf066","url":null,"abstract":"<p><p>Cardiovascular imaging saw significant advancements in 2024, impacting technology, pathophysiology, and clinical applications. This review provides a comprehensive summary of the most impactful research in cardiovascular imaging published in 2024, highlighting technological advancements, as well as research on ischaemic heart disease, valvular heart disease, cardiomyopathies, and heart failure. It emphasizes the crucial role of artificial intelligence, large-scale studies, and technical improvements across echocardiography, cardiovascular magnetic resonance, computed tomography (CT), and nuclear medicine. In the context of ischaemic heart disease, non-invasive imaging strategies improve patient management and reduce invasive coronary angiograms and unnecessary follow-up testing. Computed tomography plaque characterization is a growing area of research, with potential for predicting disease severity, atherosclerosis progression, and clinical outcomes. In valvular heart disease, several imaging studies focused not only on transcatheter treatments for aortic stenosis, mitral regurgitation, and tricuspid regurgitation but also on specific conditions such as mitral valve prolapse and mitral annular disjunction. Finally, for heart failure and cardiomyopathies, imaging plays a vital role in early diagnosis and risk assessment, with newer techniques surpassing traditional methods in providing morpho-function characterization and in predicting long-term outcomes.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf066"},"PeriodicalIF":0.0,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228217","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":"Haemodynamic response of normal aortic valves to stress using invasive, non-invasive, and computational techniques.","authors":"Rob Eerdekens, Vijay Govindarajan, Nils P Johnson, Jesse P A Demandt, Mohamed El Farissi, Fabienne E Vervaat, Daniel T Johnson, Richard L Kirkeeide, Pim A L Tonino","doi":"10.1093/ehjimp/qyaf061","DOIUrl":"10.1093/ehjimp/qyaf061","url":null,"abstract":"<p><strong>Aims: </strong>The haemodynamic physiology of the aortic valve has attracted renewed attention after the introduction of transcatheter aortic valve implantation (TAVI). Understanding normal valve function, especially under stress conditions, permits identification of early pathology and quantification of the extent to which TAVI restores normalcy. We aimed to describe the haemodynamic behaviour of a normal aortic valve during stress via invasive, non-invasive, and computational techniques.</p><p><strong>Methods and results: </strong>Our cohort included subjects already undergoing invasive coronary angiography for clinical indications. Haemodynamic measurements were made invasively and non-invasively along with dobutamine infusion. Additionally, patient-specific anatomy from computed tomographic imaging served as input to a computational fluid dynamics model using fluid-structure interaction analysis. We studied 10 subjects with simultaneous invasive sensors and non-invasive echocardiography during dobutamine administration. The majority of normal valves (7 of 10) demonstrated a fall in the invasive gradient during stress, in contrast to the increase noted by Doppler assessment. The stress aortic valve index, a relative measure of pressure loss over the valve during ejection, uniformly exceeded 0.90 with median value of 0.96 and interquartile range 0.94-1.00. Simulation of increased transvalvular flow via faster heart rates produced a highly linear relationship (coefficient of determination <i>R</i> ² equal to 0.95) with the mean transvalvular pressure gradient.</p><p><strong>Conclusion: </strong>Normal aortic valves demonstrated minimal pressure loss even during the high transvalvular flow generated by dobutamine infusion. Computational simulation using anatomy from a normal aortic valve behaved like a resistor, since mean gradient scaled directly with transvalvular flow.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf061"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12127842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210654","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":"Study of cardiac structures and heart valves: analysing curvatures based on 3D ultrasound waves.","authors":"Mersedeh Karvandi, Saeed Ranjbar","doi":"10.1093/ehjimp/qyae120","DOIUrl":"10.1093/ehjimp/qyae120","url":null,"abstract":"<p><p>The geometry of the heart has been studied as a four-dimensional manifold allowing us to translate the 3D echocardiography images into different colours for distinguishing between regions and leaflets of heart valves that is the main objective of this article.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyae120"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096133","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":"Mechanical wave velocities in acute myocardial infarction: an exploratory study using three-dimensional high frame rate echocardiography.","authors":"Marlene Iversen Halvorsrød, Mohammad Mohajery, Torvald Espeland, Sebastien Salles, Asbjørn Støylen, Lasse Løvstakken, Bjørnar Grenne","doi":"10.1093/ehjimp/qyaf060","DOIUrl":"10.1093/ehjimp/qyaf060","url":null,"abstract":"<p><strong>Aims: </strong>High frame rate (HFR) echocardiography captures myocardial mechanical waves (MWs), reflecting critical tissue properties. The aim was to assess the feasibility of 3D HFR echocardiography for estimating MW velocities in acute myocardial infarction (AMI) patients and to compare MW velocities with those in controls.</p><p><strong>Methods and results: </strong>Twenty patients with ST-elevation AMI were included within 48 h of reperfusion therapy. 3D high-quality recordings (∼20 volumes/s) were acquired for myocardial segmentation and 3D HFR recordings (750 volumes/s) for measuring the atrial kick wave propagation velocity. MW velocities were compared with 20 controls. MW velocities were successfully measured in 93% of subjects (17 patients and 20 controls). The segmental feasibility was 97%. Global MW velocities were significantly higher in AMI patients than controls (2.1 ± 0.6 m/s vs. 1.5 ± 0.2 m/s, <i>P</i> < 0.001). Infarcted territories had higher velocities when compared with the corresponding territories in controls: right coronary artery: 1.9 ± 0.7 m/s vs. 1.4 ± 0.3 m/s, <i>P</i> < 0.05; circumflex artery: 3.1 ± 1.5 m/s vs. 1.7 ± 0.4 m/s, <i>P</i> < 0.01; and left anterior descending artery: 1.8 ± 0.5 m/s vs. 1.4 ± 0.2 m/s, <i>P</i> < 0.01. There was a strong correlation between global MW velocities and wall motion score index (<i>r</i> = 0.70, <i>P</i> < 0.001). MW velocities were higher in segments with wall motion abnormalities than in healthy segments (2.3 ± 1.1 vs. 1.6 ± 0.7 m/s, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Estimation of MW velocities using 3D HFR echocardiography had excellent feasibility. MW velocities were higher in patients with AMI than in controls, in infarcted compared with healthy territories, and in segments with wall motion abnormalities. Future work should evaluate the clinical value in larger populations.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf060"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144218086","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":"Valve type and post-dilation impact on transprosthetic gradients in patients undergoing transcatheter aortic valve-in-valve procedure.","authors":"Manuela Muratori, Laura Fusini, Gloria Tamborini, Paola Gripari, Sarah Ghulam Ali, Valentina Mantegazza, Anna Garlaschè, Francesco Doni, Andrea Baggiano, Francesco Cannata, Alberico Del Torto, Fabio Fazzari, Antonio Frappampina, Daniele Junod, Riccardo Maragna, Saima Mushtaq, Luigi Tassetti, Alessandra Volpe, Stefano Galli, Franco Fabbiocchi, Marco Gennari, Marco Agrifoglio, Antonio L Bartorelli, Federico De Marco, Mauro Pepi, Gianluca Pontone","doi":"10.1093/ehjimp/qyaf048","DOIUrl":"https://doi.org/10.1093/ehjimp/qyaf048","url":null,"abstract":"<p><strong>Aims: </strong>Valve-in-Valve transcatheter aortic valve replacement (ViV-TAVR) is an appealing treatment option for patients with degenerated aortic bioprosthetic valves. However, higher post-procedural transprosthetic gradients are more common after ViV-TAVR than after TAVR for native aortic valve stenosis. We sought to evaluate the impact of type of implanted valve and balloon post-dilation on echocardiographic results and mortality in ViV-TAVR patients.</p><p><strong>Methods and results: </strong>One hundred and eleven consecutive patients were enrolled. A balloon-expandable valve, a self-expandable valve without balloon post-dilation, and a self-expandable valve with balloon post-dilation were performed in 35 (Group 1), 39 (Group 2), and 37 (Group 3) patients, respectively. All patients underwent comprehensive transthoracic echocardiography at baseline, discharge, and 6-12 months follow-up. Successful ViV-TAVR was performed in 110 patients (99%). Baseline transprosthetic gradients, left ventricular volumes, ejection fraction, and pulmonary artery systolic pressure were similar among groups. All groups experienced a significant reduction in post-procedural gradients at discharge and during the 6-12 months follow-up compared with baseline. At discharge, the lowest mean gradient was observed in Group 3 (12 ± 7 mmHg) compared with both Group 1 (20 ± 9 mmHg) and Group 2 (17 ± 8 mmHg, <i>P</i> = 0.001). This result was confirmed at 6-12 months follow-up (<i>P</i> = 0.012). Similar 5-year all-cause mortality was observed among groups (34%, 36%, 14%, respectively, <i>P</i> = 0.056).</p><p><strong>Conclusion: </strong>In patients with failed surgical aortic prosthesis, ViV-TAVR is an effective treatment option associated with sustained improved haemodynamics regardless of transcatheter valve type and use of balloon post-dilation. However, self-expandable valves with balloon post-dilation showed lower transprosthetic gradients.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf048"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083130","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":"Cardiovascular magnetic resonance left ventricular 4D-flow: differences in flow components and kinetic energy across heart failure spectrum.","authors":"Hau Wai Wong, Haonan Wang, Chi Ting Kwan, Eponine Kate Wong, Yueyi Xu, Kwan Ho Leung, Jumatay Biekan, Jinyoung Jang, Kai-Hang Yiu, Hung-Fat Tse, Martin A Janich, David Montero, Andrew T Yan, Vanessa M Ferreira, Ming-Yen Ng","doi":"10.1093/ehjimp/qyaf059","DOIUrl":"10.1093/ehjimp/qyaf059","url":null,"abstract":"<p><strong>Aims: </strong>Cardiovascular magnetic resonance (CMR) 4-dimensional (4D) intraventricular flow analysis quantifies volume and kinetic energy (KE) of direct flow (DF), and residual volume (ReV) components, illustrating heart failure (HF) haemodynamic changes. Study aims were (1) compare volume and KE indexed (KEi) of DF and ReV between groups. (2) Assess relationship between 4D-flow parameters with CMR parameters.</p><p><strong>Methods and results: </strong>187 subjects (63.0 ± 17.1 years; 101 males) comprising 78 controls, 47 HF with preserved ejection fraction (HFpEF), 25 HF with mildly reduced ejection fraction (HFmrEF), 37 HF with reduced ejection fraction (HFrEF) were included. Volume and KEi of DF, and ReV were obtained from 4D flow CMR images. Controls had highest DF volume and systolic KEi (control 35.0% and 54.7 µJ/mL), followed by HFpEF (22.7% and 61.4 µJ/mL), HFmrEF (13.1% and 43.3 µJ/mL), HFrEF (5.2% and 33.1 µJ/mL) (<i>P</i> < 0.001). ReV and diastolic KEi were lowest in controls (26.0% and 7.9 µJ/mL), and higher across HFpEF (31.8% and 7.8 µJ/mL), HFmrEF (41.6% and 10.8 µJ/mL), HFrEF (49.5% and 11.5 µJ/mL) (<i>P</i> < 0.001). DF volume correlated positively with left ventricular ejection fraction (LVEF) (<i>r</i>  <i>=</i> 0.794), but negatively with LV-end-diastolic volume indexed (EDVi) (<i>r</i> = -0.563) (all <i>P</i> < 0.001). ReV correlated negatively with LVEF (<i>r</i>  <i>=</i> -0.737) but positively with LV-EDVi (<i>r</i> = 0.602) (all <i>P</i> < 0.001). Loss of two diastolic peaks in KE time curves for HF patients were shown.</p><p><strong>Conclusion: </strong>CMR 4D DF and ReV with their KEi showed haemodynamic changes and KEi time curve pattern distortions in HF.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf059"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164514","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":"Prognostic significance of myocardial ischaemia during exercise echocardiography in the absence of angiographic evidence of obstructive coronary disease.","authors":"Alaa Mabrouk Salem Omar, Robert Leber, Nitin Barman, Edgar Argulian","doi":"10.1093/ehjimp/qyaf055","DOIUrl":"10.1093/ehjimp/qyaf055","url":null,"abstract":"<p><strong>Aims: </strong>We studied the prognostic significance of myocardial ischaemia during exercise stress echocardiography (ExE) in the absence of angiographic evidence of obstructive coronary artery disease (CAD) in a contemporary cohort of patients.</p><p><strong>Methods and results: </strong>We retrospectively enrolled 84 patients who underwent ExE and had exercise-induced myocardial ischaemia followed by angiographic coronary evaluation. Fifty-one (61%) patients had non-obstructive CAD (iNOCAD), and 33 (39%) had normal coronaries (iNC). iNC and NOCAD patients were propensity matched to 99 and 153 patients with non-ischaemic ExE, respectively. Compared to iNOCAD, iNC patients were younger (60.9 ± 10.4 vs. 68 ± 8.9 years, <i>P</i> = 0.002) and predominantly women (76% vs. 47%, <i>P</i> = 0.009). Ejection fraction (57 ± 9.4 vs. 56.4 ± 6, <i>P</i> = 0.776) as well as other clinical and demographic variables were similar. During median follow-up of 3.2 years, there were 27 composite adverse cardiovascular events (1 death, 10 acute chest pain events, 2 strokes, and 21 cardiac hospitalizations). iNC was associated with a higher risk of acute chest pain (HR: 19.0, 95% CI: 3.7-93) and the composite adverse outcome (HR: 3.3, 95% CI: 1.7-6.6), compared to matched patients. Similarly, iNOCAD was associated with a higher risk of the composite outcome (HR: 2.2, 95% CI: 1.2-4.2).</p><p><strong>Conclusion: </strong>Ischaemic ExE in the absence of angiographically obstructive CAD carries an elevated risk of adverse cardiovascular events necessitating medical optimization and close follow-up for progression.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf055"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145389","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":"Contemporary review of the clinical features, multi-modality imaging, and management of coronary artery aneurysms.","authors":"Sharmeen Sorathia, Aro Daniela Arockiam, Ankit Agrawal, Elio Haroun, Rishabh Khurana, Abdelrahman Ahmed, Leslie Cho, Wael Jaber, Brian Griffin, Tom Kai Ming Wang","doi":"10.1093/ehjimp/qyaf054","DOIUrl":"10.1093/ehjimp/qyaf054","url":null,"abstract":"<p><p>Coronary artery aneurysm (CAA) is a rare, dilated segment of the coronary artery. Phenotypically, it can have different morphologies, patterns, content, and affected vessels, making multimodality invasive and noninvasive imaging play a significant role in its evaluation. In this review article, we discuss in depth the contemporary perspectives in pathophysiology, epidemiology, clinical presentation, multimodality imaging evaluation, treatment strategies (medical, percutaneous and surgical) and outcomes of CAA. CAA is predominantly associated with coronary atherosclerotic diseases and/or autoimmune vasculitis conditions including Kawasaki disease. It can present with various clinical manifestations, from an incidental finding to myocardial infarction and life-threatening complications. While coronary angiography has been the gold standard to detect CAA, noninvasive modalities including coronary computed tomography have increasingly been utilized given its high resolution for anatomical depiction of the vessels and relations to surrounding structures. We suggest a stepwise approach to the assessment and clinical decision-making in the management of CAA. Pharmacological strategies include risk factor control and secondary prevention. For obstructive ischaemic presenting aneurysms, percutaneous is pursued, while larger or multi-vessel obstructive lesions are typically managed with coronary surgery.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf054"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152987","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":"Machine learning-enabled screening for aortic stenosis with handheld ultrasound.","authors":"Samuel Karmiy, Zhe Huang, Divya Velury, Eileen Mai, Jing Li, Monica M Dehn, Dikran R Balian, Davinder Ramsingh, John Martin, Jacob Kantrowitz, Ayan R Patel, Michael C Hughes, Benjamin S Wessler","doi":"10.1093/ehjimp/qyaf051","DOIUrl":"10.1093/ehjimp/qyaf051","url":null,"abstract":"<p><strong>Aims: </strong>Neural network classifiers can detect aortic stenosis (AS) using limited cardiac ultrasound images. While networks perform very well using cart-based imaging, they have never been tested or fine-tuned for use with focused cardiac ultrasound (FoCUS) acquisitions obtained on handheld ultrasound devices.</p><p><strong>Methods and results: </strong>Prospective study performed at Tufts Medical Center. All patients ≥65 years of age referred for clinically indicated transthoracic echocardigraphy (TTE) were eligible for inclusion. Parasternal long axis and parasternal short axis imaging was acquired using a commercially available handheld ultrasound device. Our cart-based AS classifier (trained on ∼10 000 images) was tested on FoCUS imaging from 160 patients. The median age was 74 (inter-quartile range 69-80) years, 50% of patients were women. Thirty patients (18.8%) had some degree of AS. The area under the received operator curve (AUROC) of the cart-based model for detecting AS was 0.87 (95% CI 0.75-0.99) on the FoCUS test set. Last-layer fine-tuning on handheld data established a classifier with AUROC of 0.94 (0.91-0.97). AUROC during temporal external validation was 0.97 (95% CI 0.89-1.0). When performance of the fine-tuned AS classifier was modelled on potential screening environments (2 and 10% AS prevalence), the positive predictive value ranged from 0.72 (0.69-0.76) to 0.88 (0.81-0.97) and negative predictive value ranged from 0.94 (0.94-0.94) to 0.99 (0.99-0.99) respectively.</p><p><strong>Conclusion: </strong>Our cart-based machine-learning model for AS showed a drop in performance when tested on handheld ultrasound imaging collected by sonographers. Fine-tuning the AS classifier improved performance and demonstrates potential as a novel approach to detecting AS through automated interpretation of handheld imaging.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf051"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112385","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":"An echocardiographic prognostic risk stratification decision tree to determine adverse events in Anderson-Fabry disease.","authors":"Luke Stefani, Anita Boyd, Jennifer Pham, Matthew Zada, Peter Emerson, Kerry Devine, Michel Tchan, Liza Thomas","doi":"10.1093/ehjimp/qyaf032","DOIUrl":"https://doi.org/10.1093/ehjimp/qyaf032","url":null,"abstract":"<p><strong>Aims: </strong>Anderson-Fabry disease (AFD) is an X-linked disease, with cardiac involvement resulting in increased left ventricular (LV) wall thickness. Speckle tracking echocardiography analysis may be more sensitive in the assessment of myocardial impairment in AFD patients and have prognostic value. Our aim was to evaluate LV and left atrial (LA) dysfunction by traditional and strain parameters in AFD patients and evaluate prognostic utility.</p><p><strong>Methods and results: </strong>Fifty-six AFD patients were age- and sex-matched to 56 healthy controls. LV global longitudinal strain (GLS) and LA reservoir strain (LAS_R) were significantly lower in male (GLS: 19.38[3.21] vs. 17.8[7.0], <i>P</i> = 0.009; LAS_R: 38.07 ± 6.67 vs. 31.12 ± 6.76, <i>P</i> = 0.003) and female (GLS: 20.58 ± 1.63 vs. 19.29 ± 1.67, <i>P</i> = 0.003; LAS_R: 38.77 ± 7.43 vs. 33.13 ± 6.06, <i>P</i> < 0.001) AFD patients compared with controls. Reduced strain parameters were also seen in female AFD patients with normal wall thickness (GLS: 20.88 ± 1.74 vs. 19.72 ± 1.53, <i>P</i> = 0.037; LAS_R: 40.09 ± 7.15 vs. 34.79 ± 6.20, <i>P</i> = 0.004). 53/56 AFD patients had a median follow-up of 43[81] months; 11/53 experienced an adverse cardiovascular event (i.e. cardiac death, myocardial infarction, arrhythmias, stroke. and heart failure). LV wall thickness, LAVI_max, and LV GLS displayed good sensitivity and specificity for adverse cardiac events. A prognostic risk decision tree comprising of these parameters demonstrated good predictive value for adverse events (AUC = 0.910).</p><p><strong>Conclusion: </strong>We demonstrate differences in LV and LA echocardiographic parameters in AFD patients compared with healthy controls, including female AFD patients with normal LV wall thickness. A prognostic risk decision tree stratified AFD patients into three groups with the highest risk group demonstrating more AFD-related adverse events.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf032"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002939","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}