European heart journal. Imaging methods and practice最新文献

{"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":"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":"Simultaneous volumetric and functional right ventricular assessment by principal strain analysis in children with repaired tetralogy of Fallot.","authors":"Daisuke Matsubara, Ryusuke Numata, Renzo Calderon-Anyosa, Hunter L Kauffman, David M Biko, Gianni Pedrizzetti, Anirban Banerjee","doi":"10.1093/ehjimp/qyaf050","DOIUrl":"10.1093/ehjimp/qyaf050","url":null,"abstract":"<p><strong>Aims: </strong>Principal strain (PS) analysis using 3D speckle-tracking echocardiography enables us to simultaneously measure 3D ventricular volumes and strains. PS quantifies 3D deformation by defining not only amplitude but also direction of principal myocardial contraction (PS angle). This study aims (i) to validate volumetric and functional parameters using PS analysis in volume-overloaded right ventricle (RV) of repaired tetralogy of Fallot (rTOF) vs. cardiac magnetic resonance (CMR) and (ii) to describe PS analysis indices in patients undergoing pulmonary valve replacement (PVR).</p><p><strong>Methods and results: </strong>Sixty-four paediatric patients with rTOF (12.4 ± 5.2 years) and 58 age-matched healthy children (12.8 ± 3.7 years) were prospectively included. We calculated PS magnitude [global PS (GPS)] and angle, indexed RV end-diastolic and end-systolic volumes (EDVi and ESVi), RV ejection fraction (EF), and conventional strains. Among rTOF patients, 32 CMRs were available. First, we validated volumetric parameters obtained by PS analysis against CMR. Second, we compared these indices between rTOF patients and controls. Lastly, we evaluated the discriminative value of PS analysis in PVR. PS analysis and CMR measurements showed good correlations (EDVi, <i>r</i> = 0.80; ESVi, <i>r</i> = 0.74; and EF, <i>r</i> = 0.70, <i>P</i> < 0.001). GPS showed the highest correlation with 3D-EF (<i>r</i> = -0.84, <i>P</i> < 0.001). rTOF patients exhibited nearly doubled RV volume and significantly decreased 3D-EF and conventional strains. PS magnitude also decreased in rTOF patients, with altered PS angles in RV free wall. Volume measurements of RV showed the highest predictive value for discriminating PVR (+) by receiver operating characteristic analysis, followed by PS functional parameters.</p><p><strong>Conclusion: </strong>PS analysis is a reliable and reproducible method for both volumetric and functional analysis of volume-overloaded RV in rTOF, which can be of incremental value for defining the indications for PVR.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 3","pages":"qyaf050"},"PeriodicalIF":0.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144677124","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":"A deep learning model for classifying left ventricular enlargement for both transthoracic echocardiograms and handheld cardiac ultrasound.","authors":"Jeffrey G Malins, D M Anisuzzaman, John I Jackson, Eunjung Lee, Jwan A Naser, Jared G Bird, Paul A Friedman, Christie C Ngo, Jae K Oh, Gal Tsaban, Patricia A Pellikka, Jeremy J Thaden, Francisco Lopez-Jimenez, Zachi I Attia, Sorin V Pislaru, Garvan C Kane","doi":"10.1093/ehjimp/qyaf049","DOIUrl":"10.1093/ehjimp/qyaf049","url":null,"abstract":"<p><strong>Aims: </strong>To develop a deep learning model that: (i) utilizes transthoracic echocardiography (TTE) clips to detect left ventricular (LV) enlargement without being provided information regarding a patient's sex and body size; and (ii) can be accurately applied to clips acquired using either standard comprehensive TTE or handheld cardiac ultrasound (HCU).</p><p><strong>Methods and results: </strong>Using retrospective TTE data (training: 8722 patients; internal validation: 468 patients), we developed a deep learning model that estimates a patient's end-diastolic LV volume (indexed to body surface area and normalized across the sexes), and then thresholds this estimate to perform the following classifications: (1) normally sized LV vs. ≥ mild LV enlargement; (2) normal/mildly enlarged LV vs. ≥ moderate LV enlargement. For retrospective datasets, the model showed strong performance in TTE across three geographically distinct locations (Minnesota and Wisconsin: 1082 patients, AUC = 0.925 and 0.953 for classifications 1 and 2, respectively; Arizona: 1475 patients, AUC = 0.935 and 0.969; and Florida: 1481 patients, AUC = 0.934 and 0.970). Additionally, performance was strong for both TTE and HCU clips collected from a prospective cohort of 410 patients who underwent HCU immediately following TTE (TTE: AUC = 0.925 and 0.971; HCU: AUC = 0.874 and 0.902, for classifications 1 and 2, respectively).</p><p><strong>Conclusion: </strong>An automated deep learning model applied to TTE or HCU images accurately categorizes LV volumes. These results lay a foundation for future work aimed at optimizing clinical outcomes for heart failure patients by enabling early detection of LV enlargement across various point-of-care settings.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 3","pages":"qyaf049"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144677123","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":"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}

{"title":"Continuous three-dimensional transesophageal echocardiography and deep learning for perioperative monitoring of left ventricular longitudinal function.","authors":"Jinyang Yu, Anders Austlid Taskén, Erik Andreas Rye Berg, Tomas Dybos Tannvik, Katrine Hordnes Slagsvold, Idar Kirkeby-Garstad, Bjørnar Grenne, Gabriel Kiss, Svend Aakhus","doi":"10.1093/ehjimp/qyaf052","DOIUrl":"10.1093/ehjimp/qyaf052","url":null,"abstract":"<p><strong>Aims: </strong>Continuous monitoring of left ventricular (LV) function may improve cardiopulmonary management. Therefore, we have developed <i>3D autoMAPSE</i>, a novel method that combines 3D transesophageal echocardiography and deep learning to automatically measure mitral annular plane systolic excursion (MAPSE). We hypothesized that 3D autoMAPSE could provide continuous monitoring of LV function in perioperative patients.</p><p><strong>Methods and results: </strong>This prospective observational study included 50 adult intensive care patients after cardiac surgery. Single-beat full-volume 3D recordings were obtained every 5 min over a 120-min period using a hands-free method that simulated continuous monitoring with transesophageal echocardiography. Precision and agreement with manual MAPSE were determined by a test-retest study design during hemodynamic stability. Our results show that continuous monitoring by 3D autoMAPSE had excellent feasibility (99%). It analysed 10 cycles instantaneously (55 ± 15 s) with high precision (least significant change 1.6 mm). 3D autoMAPSE had adequate agreement with manual MAPSE (bias -1.4 mm, limits of agreement -4.0 to 1.2 mm). Continuous 3D autoMAPSE was associated with both N-terminal pro B-type natriuretic peptide (<i>rho</i> = -0.37, <i>P</i> = 0.008) and high-sensitivity troponin-T (<i>rho</i> = -0.28, <i>P</i> = 0.047). This association was slightly stronger than for LV ejection fraction or any other single echocardiographic measurement.</p><p><strong>Conclusion: </strong>3D autoMAPSE provided continuous monitoring of LV function in perioperative patients by obtaining highly feasible and precise measurements that agree with manual echocardiography and postoperative biomarkers. Thus, continuous 3D autoMAPSE may be an attractive complement to hemodynamic monitoring that can aid cardiopulmonary management.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf052"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121920","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}