Cardiovascular Ultrasound最新文献

{"title":"Prognostic value of adenosine stress echocardiography in chronic coronary syndromes with preserved left ventricular ejection fraction.","authors":"Li Zhao, Peng-Li Xu, Qing-Yi Luo, Xuan Su, Shu-Han Ye, Zi-Long Yang, Xiao-Lei Song, Qing-Hui Wang, Yun-Chuan Ding","doi":"10.1186/s12947-025-00359-x","DOIUrl":"10.1186/s12947-025-00359-x","url":null,"abstract":"<p><strong>Background: </strong>The prognostic value of functional echocardiographic parameters for risk stratification in chronic coronary syndrome (CCS) remains incompletely understood. This study aimed to integrate resting and stress echocardiographic parameters to identify sensitive non-invasive predictors of major adverse cardiovascular events (MACEs).</p><p><strong>Methods: </strong>A total of 754 CCS patients with a resting left ventricular ejection fraction (LVEF) ≥ 50% undergoing adenosine stress echocardiography were prospectively enrolled. Parameters including myocardial perfusion, coronary flow velocity reserve (CFVR), and myocardial work were assessed. Resting and stress values were compared within groups, while dynamic changes were analyzed between CFVR-normal and impaired subgroups. Cox regression was used to identify independent predictors.</p><p><strong>Results: </strong>The incidence of MACEs was significantly higher in patients with impaired CFVR compared to those with normal CFVR (71.4% vs. 6.2%, P < 0.0001). After stress, the impaired CFVR group exhibited myocardial perfusion defects, mechanical dyssynchrony, and reduced myocardial work efficiency, in contrast to the normal CFVR group. Patients with impaired CFVR combined with regional wall motion and perfusion abnormalities had the worst prognosis. Multivariate Cox model integrating CFVR and stress-derived dynamic parameters demonstrated superior predictive performance for MACEs, significantly exceeding that of the stress-substitution and base models (C-index: 0.867 vs. 0.841 vs. 0.709).</p><p><strong>Conclusion: </strong>In CCS patients with preserved LVEF, reduced CFVR indicates early myocardial dysfunction and predicts the worst prognosis when combined with wall motion and perfusion abnormalities. An integrated functional model combining CFVR and dynamic stress parameters enhances risk stratification for MACEs and supports individualized therapy.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"23 1","pages":"21"},"PeriodicalIF":1.6,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gerbode defect resulting from ineffective treatment of infective endocarditis: a case report.","authors":"Kassandra S Carter, Philip Reed, James Gentry","doi":"10.1186/s12947-025-00358-y","DOIUrl":"10.1186/s12947-025-00358-y","url":null,"abstract":"<p><strong>Background: </strong>Infective endocarditis is a common medical complication in patients with intravenous drug use (IVDU). staphylococcal infection is the predominant pathogen in left-sided endocarditis. Cardiac abscesses are more common in prosthetic valves. Should they rupture, they often create fistulous tracts in addition to prosthetic valve dehiscence, conduction abnormalities, and acute coronary syndrome.</p><p><strong>Case presentation: </strong>A 51-year-old man with history of IV drug use, methicillin-susceptible Staphylococcus aureus (MSSA) endocarditis, and bovine aortic valve replacement was treated for MSSA bacteremia and was discharged on dalbavancin. The transesophageal echocardiogram (TEE) was negative for abscess or vegetation. Three days later, he presented with fever, worsening mental status, and neurologic deficits with infarcts in the brain, lungs, spleen on imaging. TEE was negative for vegetation or abscess. After transfer to a quaternary care center four days later, TEE showed a large aortic root abscess that eroded the membranous ventricular septum resulting in a Gerbode defect. Then, he sustained a non-shockable rhythm cardiac arrest. The patient was transferred to the cardiac ICU where emergent TEE showed complete dehiscence of the septum and a loosely attached prosthetic aortic valve. After a second cardiac arrest and resuscitative efforts, the patient expired.</p><p><strong>Conclusion: </strong>This case highlights that inadequately treated infective endocarditis can rapidly progress and cause serious complications. If patients with prosthetic valves develop bacteremia and have negative TEEs, retrospectively-gated CTs should be obtained to evaluate for perivalvular extensions. Currently, there have been no published studies demonstrating patients with infective endocarditis who were treated with Dalbavancin that progressed to fistulous tracts. Further research is required to investigate the effectiveness of long-acting lipoglycopeptides, such as Dalbavancin, in treating infective endocarditis. This case demonstrates a rare, but a serious medical emergency that can arise in patients with prosthetic heart valves and positive blood cultures when not detected early and treated promptly.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"23 1","pages":"20"},"PeriodicalIF":1.6,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current status and advances in ultrasound evaluation of neovascularization within carotid artery plaques: a systematic review.","authors":"Yang Yang, Fangqin Liu, Jiaojun Yan, Yunhao Luo, Qiuyun Huang, Lang Qiao","doi":"10.1186/s12947-025-00356-0","DOIUrl":"10.1186/s12947-025-00356-0","url":null,"abstract":"<p><p>Vulnerable plaques are significant risk factors for acute ischemic events, and intraplaque neovascularization (IPN) is an important indicator for evaluating plaque vulnerability. This review summarizes the importance of IPN in the assessment of carotid plaque vulnerability, the current status of ultrasound examination of IPN, and the technical advancements in ultrasound imaging of IPN, These techniques include: Superb micro-vascular imaging; Contrast-enhanced ultrasound; Plane wave ultra-sensitive blood flow imaging; Ultrasound-targeted microbubble destruction; Ultrasound Super-Resolution Imaging. Aiming to provide a reference for the prevention and treatment of ischemic cardiovascular and cerebrovascular events.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"23 1","pages":"19"},"PeriodicalIF":1.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodal imaging in young male with bicuspid aortic valve, right-sided aorto-atrial fistula and single coronary artery.","authors":"Marco Fabio Costantino, Gianpaolo D'Addeo, Stefano Mancino, Luisiana Stolfi, Teresa Mannarino","doi":"10.1186/s12947-025-00357-z","DOIUrl":"https://doi.org/10.1186/s12947-025-00357-z","url":null,"abstract":"<p><p>A 35-year-old male, without significant cardiovascular history, presented with recurrent palpitations. Initial echocardiographic evaluation demonstrated eccentric left ventricular hypertrophy, mild systolic dysfunction, suspicion of a ventricular septal defect, bicuspid aortic valve, and right ventricular dilation. Transesophageal echocardiography revealed an aneurysmal dilation of the right coronary sinus with an aorto-atrial/ventricular fistula, further confirmed by contrast-enhanced computed tomography angiography. Coronary angiography identified a single anomalous coronary artery with left dominance and absence of the right coronary artery. Surgical repair successfully closed the fistula, with mild post-operative aortic regurgitation. Follow-up at one year indicated normalization of cardiac dimensions and function, with stable moderate aortic valve regurgitation. Genetic sequencing found no identifiable mutations. Regular monitoring was recommended due to the potential risk of complications related to the bicuspid aortic valve and coronary anomaly.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"23 1","pages":"18"},"PeriodicalIF":1.6,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mini 3D transesophageal probe: technical advances and clinical applications.","authors":"Monica Barki, Rebecca T Hahn","doi":"10.1186/s12947-025-00354-2","DOIUrl":"10.1186/s12947-025-00354-2","url":null,"abstract":"<p><p>With the growing complexity of structural heart disease procedures, the need for advanced intraprocedural imaging has become increasingly critical. Transesophageal echocardiography remains the gold standard for procedural guidance but is associated with risks such as upper gastrointestinal tract injury and the need for general anesthesia for patient comfort and safety. Miniaturized three-dimensional transesophageal echocardiography (miniTEE) probes offer a promising solution by providing high-resolution imaging which could be performed under conscious sedation. Studies evaluating the miniTEE probe for safety, image quality, and ability to guide specific structural and non-structural heart disease procedures will be reviewed. The limitations and future developments will be discussed.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"23 1","pages":"17"},"PeriodicalIF":1.6,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left atrium phasic function decreases in adult patients with repaired tetralogy of fallot: a case-control study.","authors":"Keiya Sato, Ken Takahashi, Yusuke Akatsuka, Hiroyuki Sato, Hirohisa Kago, Azusa Akiya, Satoshi Akimoto, Mayumi Ifuku, Yu Hosono, Sachie Shigemitsu, Kotoko Matsui, Keisuke Nakanishi, Shiori Kawasaki, Toshiaki Shimizu","doi":"10.1186/s12947-025-00355-1","DOIUrl":"10.1186/s12947-025-00355-1","url":null,"abstract":"<p><strong>Background: </strong>Although the left atrium (LA) plays a key role in diastolic function, LA dysfunction in patients with repaired tetralogy of Fallot (rTOF) remains unclear. Recently, LA strains assessed using a speckle tracking system have been used as novel sensitive indicators of LA function. Therefore, we aimed to evaluate LA function and investigate changes with age in patients with rTOF using speckle-tracking echocardiography.</p><p><strong>Methods: </strong>We analyzed three age-based subgroups of patients with rTOF (T1, T2, T3) and their corresponding healthy control groups (C1, C2, C3) to assess phasic left atrial function: T1 and C1 (3-9 years [children]), T2 and C2 (10-19 years [adolescents and young adults]), and T3 and C3 (20-44 years [adults]). LA strain was assessed by two-dimensional speckle-tracking echocardiography and defined according to its three distinct phases, with the LA serving as a reservoir during systole, a conduit during early diastole, and a booster pump at the end of diastole. Furthermore, we examined the correlations between LA strains and left ventricular longitudinal strain (LVLS) as well as conventional echocardiographic parameters.</p><p><strong>Results: </strong>LA reservoir and pump strains were lower in the T3 group than in the C3 group (35.5 (30.1/41.3) vs. 42.9 (41.1/48.1), P = 0.010; 8.3 (7.4/10.6) vs. 11.4 (10.7/13.5), P = 0.025, respectively). In the T1 and T2 groups, no significant differences in LA strains were reported. LA functions based on LA volume did not show any difference between rTOF and controls among all age groups. All LA strains only moderately or weakly correlated with LVLS and mitral E/A, but not with left ventricular (LV) lateral e' nor E/e'. Reservoir strain-LVLS (ρ = 0.476, P < 0.001), conduit strain-LVLS (r = 0.382, P < 0.001), pump strain-LVLS (ρ = 0.337, P < 0.001), reservoir strain-E/A (ρ = 0.200, P = 0.026), conduit strain-E/A (ρ = 0.282, P = 0.002), and pump strain-E/A (ρ = -0.209, P = 0.02).</p><p><strong>Conclusions: </strong>LA phasic function decreases in adult patients with rTOF. LA reservoir and pump strains may serve as sensitive indicators of diastolic dysfunction in these patients.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"23 1","pages":"16"},"PeriodicalIF":1.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12291484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of noninvasive indices of right ventricular diastolic function. Simultaneous echocardiography and pressure-volume catheterization studies.","authors":"Candelas Pérez Del Villar, Raquel Prieto-Arévalo, Jorge García-Carreño, Pablo Martínez-Legazpi, Daniel Rodríguez-Pérez, Yolanda Benito, Antonia Delgado-Montero, J Carlos Antoranz, M Mar Desco, Cristian Herrera Flores, Rafael Corisco Beltrán, Francisco Fernández-Avilés, Javier Bermejo","doi":"10.1186/s12947-025-00351-5","DOIUrl":"10.1186/s12947-025-00351-5","url":null,"abstract":"<p><strong>Background: </strong>The reliability of the recommended echocardiographic methods for assessing RV diastolic function has been questioned. We aimed to validate noninvasive indices of RV diastolic function, derived from tricuspid Doppler and myocardial deformation metrics, against intrinsic diastolic chamber properties and filling pressures.</p><p><strong>Methods: </strong>We obtained simultaneous high-fidelity pressure-volume loops and echocardiographic data in separate animal and clinical settings: (1) a porcine model of acute hemodynamic interventions (n = 13), and (2) patients with Fallot tetralogy and pulmonary hypertension (n = 9). These designs allow for within- and between-subject validation. From the PV loops data, we obtained the reference values of RV stiffness (S₊), elastic recoil (S_-) and relaxation (τ) constants, as well as the contribution of passive properties to instantaneous diastolic pressures.</p><p><strong>Results: </strong>In the animal setting, only the tricuspid E/A ratio and e' velocity weakly correlated with S₊ (R_rm:0.36 and 0.28 respectively, p < 0.01 for both). In the clinical group, no correlation was found between the echocardiographic indices and the intrinsic diastolic properties. Isovolumic relaxation time and early diastolic global strain-rate (GSR) correlated with mean right atrial pressure (RAP) (Spearman r: -0.73 and 0.85, respectively, p < 0.05 for both). E/e' and E/GSR ratio were not associated with RAP. Tricuspid e' and GSR negatively correlated with passive pressure component (only due to) at valve opening (R_rm -0.27 and - 0.33, respectively, p < 0.01 for both).</p><p><strong>Conclusions: </strong>Recommended echocardiographic indices of RV diastolic function do not reflect intrinsic RV diastolic properties. Therefore, the application of these indices for inferring RV diastolic function and filling pressures is limited.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"23 1","pages":"15"},"PeriodicalIF":1.9,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left ventricular flow dynamics by cardiac imaging techniques in heart failure patients: state of the art.","authors":"Donato Mele, Lorenzo Serio, Riccardo Beccari, Antonella Cecchetto, Stefano Nistri, Gianni Pedrizzetti","doi":"10.1186/s12947-025-00347-1","DOIUrl":"10.1186/s12947-025-00347-1","url":null,"abstract":"<p><strong>Background: </strong>The evaluation of left ventricular (LV) flow dynamics is a novel approach to assessing LV function that goes beyond traditional metrics. This approach has been applied to patients with heart failure (HF), providing valuable insights that are discussed in this review, with the aim of enhancing our understanding of LV function in the context of the HF syndrome.</p><p><strong>Methods: </strong>The analysis of LV flow dynamics is typically conducted using ultrasound and magnetic resonance imaging (MRI) techniques, primarily including particle image velocimetry echocardiography, Vector Flow Imaging, HyperDoppler, and four-dimensional flow MRI. A variety of parameters can be obtained that describe the geometry of the LV vortex, vorticity, kinetic energy, energy dispersion, as well as the amplitude and direction of the hemodynamic forces within the LV cavity.</p><p><strong>Results: </strong>In normal subjects, vortex formation plays a crucial role in optimizing LV filling, diastolic-systolic coupling, and energy transfer during systolic ejection. In patients with HF, alterations in vortex structure and dynamics have been associated with both systolic and diastolic LV dysfunction, demonstrating the potential to diagnose early LV dysfunction. Furthermore, these alterations have been linked to LV remodeling and thrombus formation. Several studies have also explored intracardiac flow metrics as biomarkers for guiding HF treatments, including pharmacological interventions, cardiac resynchronization therapy, and LV assist devices.</p><p><strong>Conclusions: </strong>Currently available data suggest that the evaluation of LV flow dynamics can have diagnostic and prognostic utility in HF. However, large-scale, multicenter, and prospective studies are needed, particularly to validate therapeutic implications.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"23 1","pages":"13"},"PeriodicalIF":1.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Echocardiographic imaging in patients with conduction system pacing.","authors":"Alexander Suchodolski, Ewa Jędrzejczyk-Patej, Wiktoria Kowalska, Michał Mazurek, Radosław Lenarczyk, Oskar Kowalski, Zbigniew Kalarus, Mariola Szulik","doi":"10.1186/s12947-025-00349-z","DOIUrl":"10.1186/s12947-025-00349-z","url":null,"abstract":"<p><p>Conduction system pacing (CSP), encompassing His-bundle pacing (HBP) and left bundle branch area pacing (LBBAP), revolutionizes cardiac pacing, allowing a more physiological left ventricular activation than conventional right ventricular (RV) pacing through electrode placed in RV apex, interventricular septum or right ventricular outflow tract. Echocardiography plays a pivotal role in patient assessment, primarily by measuring left ventricular ejection fraction (LVEF) to determine the pacing strategy in alignment with current guidelines. Clinical data, simulations and ongoing trials on CSP explore CSP viability across various LVEF conditions. CSP is supposed to defer pacing-induced cardiomyopathy (PiCM) associated with conventional right ventricular pacing (RVP). This paper aims to review the current literature regarding the use of echocardiography in CSP. Images from our experience in the echocardiographic lab were used throughout this document to show our proposals of imaging in CSP. Echocardiography may help to determine lead localization within the interventricular septum (IVS), customizing pacing to individual anatomy and electromechanical indices (like atro-ventricular delay) and evaluates often-overlooked valvular function, a potential PiCM contributor. Three-dimensional (3-D) echocardiography widens the knowledge of lead localization and valvular dysfunction, as well as dyssynchrony assessment. Dyssynchrony, crucial both to resynchronization per se and physiological stimulation is quantified via echocardiography, especially using speckle-tracking imaging. Baseline LVEF and follow-up observation of CSP effects: early in Global Longitudinal Strain (GLS), afterwards in LV volumes and LVEF may improve the future proper qualification of patients. Limited left atrial (LA) and right atrial (RA) strain assessments hold potential in the CSP qualification and response assessment context. Echocardiography complements other imaging modalities for comprehensive patient evaluation. Echocardiography is integral in the CSP clinical use, from patient selection (by showing subtle changes in myocardial function) to post-procedure follow-up (tricuspid regurgitation, LV and RV function, leads and synchrony assessment). GLS, assessed by speckle tracking imaging and profound 2D and 3D (lead placement, septum morphology and global heart function under CSP) analyses show promise in CSP outcome assessment, though standardization is needed.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"23 1","pages":"14"},"PeriodicalIF":1.9,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between electrocardiographic characteristics and subclinical left ventricular systolic dysfunction in isolated left bundle branch block patients.","authors":"Guangyuan Li, Yonghuai Wang, Bo Pang, Jun Yang, Chunyan Ma","doi":"10.1186/s12947-025-00342-6","DOIUrl":"https://doi.org/10.1186/s12947-025-00342-6","url":null,"abstract":"<p><strong>Background: </strong>Early identification of subclinical left ventricular (LV) systolic dysfunction (LVSD) in patients with isolated left bundle branch block (LBBB) and preserved LV ejection fraction (LVEF), termed LBBB_pEF, is clinically important. Electrocardiography (ECG) has been proposed as a potential screening tool for detecting subclinical LVSD in LBBB_pEF patients, but its effectiveness has not been fully validated. This study investigated the relationships between specific ECG characteristics and subclinical LVSD in LBBB_pEF patients.</p><p><strong>Methods: </strong>The study included 111 patients with LBBB_pEF. Two-dimensional speckle-tracking echocardiography was used to derive the LV global longitudinal strain (LV GLS), with LV GLS>-20% indicating subclinical LVSD. The recorded ECG characteristics included heart rate, QRS duration, P-R duration, QRS morphology, T-wave morphology, the presence of QS patterns, and discordant LBBB, among others. The presence of QS patterns was defined as the absence of R-waves in lead V1 (or R-waves < 1 mm with a scale of 10 mm/mV). Discordant LBBB was defined as an inconsistency between the T wave and QRS complex in leads I, V5, and V6.</p><p><strong>Results: </strong>Among the patients, 52 exhibited subclinical LVSD. Compared with those with normal LV systolic function, patients with subclinical LVSD had longer QRS durations, a higher frequency of QS patterns, and more instances of discordant LBBB. A QRS duration of 153 ms was identified as the optimal cut-off for detecting subclinical LVSD, with a sensitivity of 75.00% and specificity of 72.88%. The combination of QRS duration, the presence of QS patterns, and discordant LBBB produced the highest area under the curve of 0.82. Incorporating the presence of QS patterns and discordant LBBB into the QRS duration model increased the integrated discriminant index from 0.07 to 0.15.</p><p><strong>Conclusions: </strong>QRS duration, the presence of QS patterns, and discordant LBBB are independent predictors of subclinical LVSD in patients with LBBB_pEF. An integrated ECG assessment may offer a straightforward screening method for identifying subclinical LVSD in this population.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"23 1","pages":"7"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}