European heart journal. Imaging methods and practice最新文献

{"title":"Changes in afterload and contractility in patients with severe aortic stenosis after transcatheter aortic valve replacement.","authors":"Kristian B Laursen, Rasmus Carter-Storch, Patricia A Pellikka, Mulham Ali, Nils S B Mogensen, Kristian A Øvrehus, Marie-Annick Clavel, Jordi S Dahl","doi":"10.1093/ehjimp/qyaf063","DOIUrl":"10.1093/ehjimp/qyaf063","url":null,"abstract":"<p><strong>Aims: </strong>In aortic stenosis (AS), estimation of left ventricular (LV) contractility is difficult as most markers of systolic LV function are load-dependent. The ratio of LV ejection fraction (LVEF) to end-systolic wall stress (ESWS), has been widely accepted as a marker of contractility. However, no studies have evaluated if this ratio is affected by loading conditions. The study describes changes in ESWS and ESWS corrected LVEF after transcatheter aortic valve replacement (TAVR).</p><p><strong>Methods and results: </strong>In this prospective study, 41 patients with severe AS underwent echocardiography, LV catheterisation, and computed tomography (CT) before and immediately after TAVR. ESWS was estimated from echocardiography alone (ESWS_Echo), combining CT LV dimensions and echocardiographic gradients (ESWS_CT  ₊  _echo) and combining CT LV dimensions and invasively measured LV end-systolic pressure (ESWS_CT  ₊  _Invasive). ESWS_echo, ESWS_CT  ₊  _echo and ESWS_CT  ₊  _Invasive all decreased significantly after TAVR (89 ± 48 vs. 57 ± 37 Kdynes/cm², <i>P</i> < 0.01; 69 ± 8 vs. 51 ± 8 Kdynes/cm², <i>P</i> < 0.01, and 197 ± 69 vs. 137 ± 48 Kpa/cm², <i>P</i> < 0.01, respectively). We observed weak to moderate associations between the methods. After TAVR, LVEF corrected to ESWS_echo, ESWS_CT  ₊  _echo and ESWS_CT  ₊  _Invasive increased (0.93 ± 0.07 vs. 1.91 ± 2.1, <i>P</i> = 0.013; 0.36 ± 0.19 vs. 0.58 ± 0.33, <i>P</i> < 0.01, and 0.3 ± 0.02 vs. 2.5 ± 1.5, <i>P</i> < 0.01, respectively).</p><p><strong>Conclusion: </strong>ESWS_echo, ESWS_CT  ₊  _echo and ESWS_CT  ₊  _Invasive decreased significantly after TAVR suggesting they reflect afterload, but independent of method, ESWS corrected LVEF increased slightly post-TAVR, indicating load dependency.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf063"},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251772","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 effects of cytisinicline for smoking cessation on arterial stiffness, endothelial function, and myocardial performance: a pilot study.","authors":"Ignatios Ikonomidis, John Thymis, Gavriella Kostelli, Konstantinos Katogiannis, Dimitrios Vlastos, Eleni Gatourtzidou, Kallirhoe Kourea","doi":"10.1093/ehjimp/qyaf062","DOIUrl":"10.1093/ehjimp/qyaf062","url":null,"abstract":"","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf062"},"PeriodicalIF":0.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228219","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":"Seeing through the leak: a global perspective on aortic regurgitation assessment.","authors":"Christina Binder, Lena Marie Schmid, Johanna Schlein, Christian Hengstenberg, Thomas Binder","doi":"10.1093/ehjimp/qyaf064","DOIUrl":"10.1093/ehjimp/qyaf064","url":null,"abstract":"<p><strong>Aims: </strong>Despite established guidelines, the echocardiographic quantification of aortic regurgitation (AR) remains challenging in clinical practice. While artificial intelligence (AI) solutions are being developed to support diagnostic assessment using echocardiography, their successful implementation will depend on understanding both current diagnostic challenges and clinician attitudes towards AI adoption. This study aimed to evaluate current practices in AR assessment, identify key challenges, and assess educational needs in AR diagnostics, while also investigating how healthcare professionals perceive AI assistance compared with human expert assessment.</p><p><strong>Methods and results: </strong>We conducted a global online survey among sonographers and physicians. Participants answered questions about their current AR quantification practices, perceived limitations, and willingness to seek assistance from experienced colleagues or AI tools. Additionally, they were asked to grade AR severity in three sample echocardiographic cases. Among 1032 participants from 104 countries, 42% considered AR the most challenging valve lesion to assess. While guidelines recommend a multi-parameter approach, most practitioners relied primarily on visual colour jet assessment (51.5%) and basic measurements, with advanced quantitative parameters being notably underutilized (21.7%). Main limitations included eccentric jets (61.3%) and poor image quality (49.8%). Case-based assessments revealed significant variability in AR grading across experience levels (<i>P</i> < 0.001). Participants showed high confidence in both experienced colleagues and validated AI models (median confidence score of 7/10 for both) but less trust in newly developed AI tools (median confidence score 5/10).</p><p><strong>Conclusion: </strong>This study demonstrates a substantial gap between guideline recommendations and clinical practice in AR quantification, with significant grading variability across and within expertise levels. While practitioners remain sceptical of newly developed AI tools, their openness to validated AI models suggests a potential pathway for improving the consistency of AR assessment.</p>","PeriodicalId":94317,"journal":{"name":"European heart journal. Imaging methods and practice","volume":"3 1","pages":"qyaf064"},"PeriodicalIF":0.0,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228218","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 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":"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}