Cardiovascular Ultrasound最新文献

{"title":"Prenatal diagnosis of pulmonary atresia with intact ventricular septum: a single-center study in China.","authors":"Qiong Huang, Tingting Dang, Zhenzhen Zhan, Zongjie Weng, Wen Ling, Huagu Tian, Qiumei Wu","doi":"10.1186/s12947-025-00348-0","DOIUrl":"10.1186/s12947-025-00348-0","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the efficacy of prenatal ultrasound in diagnosing pulmonary atresia with intact ventricular septum (PA/IVS).</p><p><strong>Methods: </strong>This retrospective study analyzed 48 cases of PA/IVS at the Fujian Maternity and Child Health Hospital between January 2013 and December 2023. Prenatal ultrasound was used to characterize and classify the features of PA/IVS. Pregnancy outcomes were followed up, and the results were compared with post-termination pathological anatomical findings or postnatal imaging. This study aims to enhance the understanding of PA/IVS and improve the accuracy of its prenatal diagnosis.</p><p><strong>Results: </strong>Among the 48 PA/IVS cases, four were diagnosed during early pregnancy and 44 during mid-to-late pregnancy. In the mid-to-late pregnancy group, there were 29 cases of type I (TV-Z scores ranging from - 1.77 to 5.22), 10 cases of type II (TV-Z scores ranging from - 3.50 to -2.06), and five cases of type III (TV-Z scores ranging from - 4.29 to -7.41). The cohort included 41 singleton pregnancies and seven twin pregnancies. Ventriculo-coronary artery communication (VCAC) was observed in 19 cases. Additional abnormalities included Ebstein's anomaly (EA) in three cases, restricted opening of the foramen ovale in one case, increased inner diameter of the foramen ovale in one case, reversal or deepening of the a-wave of the ductus venosus in six cases, and umbilical vein pulsation in one case. Genetic testing (amniocentesis, NIPT, or SNP-array) was performed in 19 cases, with one case revealing a genomic copy number deletion in the q22.3 region of chromosome 21. Pregnancy outcomes included 41 terminations (five with pathologic dissection or vascular casting), five live births, one selective reduction, and one intrauterine death.</p><p><strong>Conclusion: </strong>Fetal echocardiography is an effective tool for diagnosing PA/IVS. While PA/IVS can be diagnosed in early gestation, it remains diagnostical challenging. Given the progressive nature of PA/IVS in utero, sequential ultrasound examinations during the second and third trimesters are essential for monitoring disease progression and hemodynamic changes. Additionally, a comprehensive evaluation for associated intracardiac and extracardiac anomalies should be systematically conducted throughout the pregnancy.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"23 1","pages":"12"},"PeriodicalIF":1.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968290","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":"Diagnostic value of lung ultrasound B-lines for evaluating left ventricular filling pressure.","authors":"Takahiro Sakamoto, Toshihiko Asanuma, Hiroyuki Sasaki, Hiroshi Kawahara, Kazuhiko Uchida, Akihiro Endo, Hiroyuki Yoshitomi, Kazuaki Tanabe","doi":"10.1186/s12947-025-00341-7","DOIUrl":"https://doi.org/10.1186/s12947-025-00341-7","url":null,"abstract":"<p><strong>Background: </strong>The assessment of left ventricular (LV) diastolic function based on the American Society of Echocardiography and the European Association of Cardiovascular Imaging (ASE/EACVI) guidelines requires measurement of several echocardiographic indices. However, these assessments often yield inconclusive results owing to the absence of measurable parameters. Multiple B-lines on lung ultrasound have been proposed as a method for evaluating pulmonary congestion. We aimed to evaluate the association between B-lines and LV diastolic function and to examine whether B-lines show potential as an alternative to conventional indices for assessing LV diastolic function.</p><p><strong>Methods: </strong>This prospective study included 172 patients with pre-heart failure (HF) or HF. We investigated (i) the relationship between B-lines and LV diastolic function using echocardiography, (ii) the diagnostic accuracy of B-lines compared to echocardiography indices for estimating LV filling pressures and (iii) the relationship between B-lines and risk of hospitalisation for HF.</p><p><strong>Results: </strong>Among patients for whom the ASE/EACVI guideline algorithm for LV diastolic dysfunction was available (n = 89), the number of B-lines typically increased with the severity of diastolic dysfunction grade. In patients who underwent left heart catheterisation (n = 20), the LV filling pressure was significantly correlated with B-lines (r = 0.690, P < 0.001). The diagnostic accuracy of B-lines for detecting high LV filling pressure was comparable to that of tricuspid regurgitation peak gradient (TRPG). When TRPG was replaced with B-lines to diagnose grade II or III diastolic dysfunction using the ASE/ESCVI algorithm, sensitivity remained comparable (0.80); however, specificity improved (0.80 vs. 0.50). In patients who underwent lung ultrasound while they were hemodynamically stable and were followed up for prognosis (median, 730 days; n = 75), 14 hospitalisations for HF were observed. Kaplan-Meier analysis revealed that the high B-line group had a significantly higher incidence of hospitalisation events for HF (P = 0.036, log-rank test).</p><p><strong>Conclusion: </strong>B-lines have shown potential as an alternative to conventional indices for assessing LV diastolic dysfunction.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"23 1","pages":"6"},"PeriodicalIF":1.9,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974091","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":"Prediction of pulmonary artery sling in children using echocardiography: scoring based on pulmonary artery bifurcation and pulmonary valve ring distance.","authors":"Qiu-Chen Xu, Jian-Feng Liu, Min Xie, Zong-Jie Weng, Qiang Chen, Shan Guo","doi":"10.1186/s12947-025-00340-8","DOIUrl":"10.1186/s12947-025-00340-8","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the echocardiography characteristics of pulmonary artery sling (PAS) and explore the diagnostic value of the distance between the bifurcation of the left and right pulmonary arteries and the pulmonary artery valve annulus (DBP) in diagnosing PAS in children.</p><p><strong>Methods: </strong>This retrospective study analyzed echocardiographic data from 27 children diagnosed with PAS at our hospital from March 2014 to December 2022. The data were compared with those from 77 normal children. The study examined statistical differences between the two groups in the diameters of the left and right pulmonary arteries, the main pulmonary artery valve annulus diameter, and the DBP, both uncorrected and corrected for body surface area (BSA). The diagnostic utility of these measurements for distinguishing children with PAS from those without was assessed using receiver operating characteristic (ROC) curves.</p><p><strong>Results: </strong>The DBP and the corrected DBP values were significantly higher in the PAS group than in the normal group, with areas under the ROC curve of 0.909 for DBP and 0.951 for DBP/BSA (P < 0.05). A DBP of 1.87 cm as the diagnostic threshold yielded a sensitivity of 98.9% and specificity of 84.4%. A DBP/BSA of 7.68 cm/m² had a sensitivity of 98.3% and specificity of 92.2%. The diagnostic odds ratios (OR) were 76.38% and 79.99%, respectively.</p><p><strong>Conclusion: </strong>The pivotal element in echocardiography diagnosis of PAS is the identification of the spatial relationship between the left pulmonary artery (LPA) and the trachea. The use of quantitative indices such as DBP and DBP/BSA for adjunctive diagnosis can positively impact the early detection of PAS.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"23 1","pages":"5"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751322","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":"The role of left atrio-ventricular coupling index and left atrial ejection fraction in predicting onset of atrial fibrillation and adverse cardiac events in hypertrophic cardiomyopathy.","authors":"Parisi Francesca, La Franca Eluisa, Pistelli Lorenzo, Gentile Giovanni, Bellavia Diego, Nuzzi Vincenzo, Manca Paolo, Massimiliano Mulè, Zito Concetta, Di Bella Gianluca, Scipione Carerj, Cipriani Manlio, Francesco F Faletra","doi":"10.1186/s12947-025-00343-5","DOIUrl":"10.1186/s12947-025-00343-5","url":null,"abstract":"<p><strong>Background: </strong>Several predictors of atrial fibrillation (AF) onset in patients with hypertrophic cardiomyopathy (HCM) have been proposed, however, all of them showed limited accuracy. This study aims to assess the role of new echographic parameters in predicting AF onset and major adverse cardiovascular outcomes (cardiovascular death or heart transplantation).</p><p><strong>Methods: </strong>Clinical and imaging data from 141 patients with HCM and without a history of AF were retrospectively analyzed over a 5-year period. Patients who developed AF during the study were compared to those who did not. The analysis focused on key atrial parameters, including the Left Atrial Contraction Index (LACI) and Left Atrial Ejection Fraction (LAEF). LACI was defined as the ratio of left atrial end-diastolic volume to left ventricular end-diastolic volume. Echocardiographic measurements were standardized using cardiac magnetic resonance (CMR) as the reference. Regarding statistical analysis, each significant continuous variable was categorized by identifying a cut-off value using the Youden index. Independent associations with outcomes and cumulative survival were assessed using Cox regression analysis.</p><p><strong>Results: </strong>Thirty-five patients developed AF, at a mean time of 4 years. The HCM-AF group had significantly higher values of LACI, left atrial diameter (LAD), and left atrial minimum volume (LAVmin). A LACI > 43% on echocardiography and LACI > 44% on CMR showed the best performance in identifying patients at risk for AF. In multivariate analysis, an echocardiographic LAEF < 43% was independently associated with the occurrence of AF (HR 2.9, 95% CI: 1.2-6.9). Additionally, a LAD > 40.5 mm was independently associated with AF onset, with a hazard ratio of 2.5 (95% CI 1.1-5.5). Eleven patients experienced the composite outcome of cardiovascular death or heart transplant, and a LACI > 60% was associated with this outcome.</p><p><strong>Conclusion: </strong>In patients with HCM, both LACI and LAEF were significantly associated with the occurrence of AF over a 4-year period, demonstrating higher sensitivity and specificity compared to other parameters. A LACI > 60% was also found to be associated with cardiovascular death or heart transplant in this population.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"23 1","pages":"10"},"PeriodicalIF":1.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742552","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":"Diagnostic characteristics of multimodality imaging for left ventricular lipoma: new insights on surgical intervention.","authors":"Tianshu Liu, Lingyun Fang, Jiawei Shi, Lin He, Jing Zhang, Yuman Li, Mingxing Xie, Jing Wang","doi":"10.1186/s12947-025-00346-2","DOIUrl":"10.1186/s12947-025-00346-2","url":null,"abstract":"<p><strong>Background: </strong>The echocardiography is the first-line imaging modality in detecting the cardiac lipoma. Contrast-enhanced echocardiography improves its structural definition and characteristics of blood supply to exclude thrombus and malignant tumors.</p><p><strong>Case presentation: </strong>We introduced a case that large cardiac mass involving nearly the whole left ventricular cavity and papillary muscles without any complications. Multimodal imaging has confirmed lipoma before surgery. However, rather than recommending conservative treatment in accordance with guidelines, surgical intervention was performed to prevent future hemodynamic abnormalities.</p><p><strong>Conclusion: </strong>Combined with multimodal imaging, we showed a rare case on comprehensive evaluation of left ventricular silent lipoma and provided new clues for surgical strategy, which were different from guideline recommendations.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"23 1","pages":"11"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742550","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":"Determinants of left atrial reservoir strain and diagnostic potential for cardiac amyloidosis in pathological left ventricular hypertrophy.","authors":"Katsuji Inoue, Yasuhisa Nakao, Makoto Saito, Masaki Kinoshita, Haruhiko Higashi, Osamu Yamaguchi","doi":"10.1186/s12947-025-00339-1","DOIUrl":"10.1186/s12947-025-00339-1","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular (LV) long-axis shortening at the cardiac base is a determinant of left atrial (LA) reservoir function. Cardiac amyloidosis (CA) is characteristic of amyloid deposition predominantly in the LV basal wall. We investigated the relationship between LV basal strain and LA reservoir strain among patients with pathological LV hypertrophy and subsequently evaluated the diagnostic ability of LA reservoir strain to identify CA etiology and its predictive value for heart failure hospitalization.</p><p><strong>Methods: </strong>We retrospectively analyzed 341 patients with LV hypertrophy. Cardiac etiologies were diagnosed by tissue biopsy, cardiac magnetic resonance imaging or ^99mTc-PYP scintigraphy. LV basal strain and LA reservoir strain were analyzed.</p><p><strong>Results: </strong>Patients were diagnosed with CA (n = 75) and other etiologies (n = 266). LV basal strain was correlated with LA reservoir strain in the CA group (r = 0.58, p < 0.01) and the non-CA group (r = 0.44, p < 0.01). A binary logistic regression analysis showed that relative apical sparing of longitudinal strain, septal E/e' and LA reservoir strain had the ability to discriminate between the CA and non-CA groups (p < 0.01 for all). The area under the curve for relative apical sparing of longitudinal strain had a stronger ability than LA reservoir strain to discriminate CA from non-CA etiologies (0.90 versus 0.81, respectively; p < 0.01). During the follow-up period (median 2.7 years), the incidence of heart failure hospitalization was higher in the CA group than the non-CA group (35% versus 14%, respectively; p < 0.01). According to univariate Cox regression analysis, three LA factors (LA reservoir strain, E/e' and LA volume index) were associated with heart failure hospitalization in the non-CA group (p < 0.05 for all).</p><p><strong>Conclusions: </strong>LA reservoir strain was associated with LV basal strain among patients with pathological LV hypertrophy. Echocardiographic assessment of LA reservoir strain might add diagnostic value to identify CA etiology in these patients.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"23 1","pages":"4"},"PeriodicalIF":1.9,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647464","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":"Transthoracic echocardiographic assessment of ventricular function in functional single ventricle: a comprehensive review.","authors":"Mengqian Liao, Junxiang Pan, Tianhao Liao, Xuechen Liu, Lianyi Wang","doi":"10.1186/s12947-025-00345-3","DOIUrl":"10.1186/s12947-025-00345-3","url":null,"abstract":"<p><strong>Background: </strong>Functional single ventricle represents a complex congenital cardiac malformation where ventricular function directly impacts patients' quality of life and prognosis. Accurate assessment of ventricular function in FSV patients is crucial for treatment planning, surgical intervention, and monitoring therapeutic efficacy.</p><p><strong>Main text: </strong>Echocardiography, as a non-invasive, readily available, and real-time cardiac imaging modality, has emerged as the preferred method for evaluating functional single ventricle ventricular function. With continuous advancement and innovation in echocardiographic technology, methods for evaluating functional single ventricle ventricular function have become increasingly diverse and refined. This review synthesizes recent research developments in echocardiographic assessment of functional single ventricle ventricular function and analyzes the advantages, limitations, and future applications of various techniques.</p><p><strong>Conclusion: </strong>Strain and strain rate derived from two-dimensional speckle tracking imaging have progressively entered clinical application, demonstrating substantial potential as crucial parameters for evaluating single ventricular function. Emerging technologies, including three-dimensional speckle tracking imaging and non-invasive pressure-strain loops, show promise for contributing to multi-dimensional, integrated assessment as research continues to advance.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"23 1","pages":"9"},"PeriodicalIF":1.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633637","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":"A new noninvasive evaluation method of pulmonary thromboembolism in rabbits-pulmonary transit time.","authors":"He Zhang, Jianfeng Chen, Jiayu Wang, Song Kang, Yingying Liu, Binyang Zhu, Xue Mei, Xin Ai, Guangyin Li, Shuangquan Jiang","doi":"10.1186/s12947-025-00344-4","DOIUrl":"10.1186/s12947-025-00344-4","url":null,"abstract":"<p><strong>Background and aim: </strong>Pulmonary thromboembolism (PTE) is a common cause of cardiovascular death worldwide. Due to its nonspecific clinical symptoms, PTE is easy to be missed or misdiagnosed. Pulmonary transit time (PTT) is a noninvasive cardiopulmonary hemodynamic index, which is the time required for a blood sample to pass through pulmonary circulation. This study is aim to establish a rabbit PTE model using auto-thrombus, evaluating the dynamic changes in a rabbit's heart structure and function at multiple time points before and after modeling by echocardiography and exploring the application value of PTT obtained by contrast enhanced ultrasound (CEUS) in evaluating a PTE model.</p><p><strong>Methods: </strong>Twenty-four healthy rabbits were intubated by femoral vein puncture to establish the PTE model. Echocardiography was performed before embolization, 2 h, 24 h, 3 days, 5 days, and 7 days after embolization to obtain conventional ultrasonic parameters. Then, CEUS was performed to obtain the PTT.</p><p><strong>Results: </strong>Seventh day after modeling, nineteen rabbits were alive. Compared with pre-modeling, right heart parameters and heart rate in echocardiography were significantly impaired in the acute phase (2 and 24 h after modeling) and gradually returned to normal in the compensatory phase (3, 5, and 7 days after modeling). In contrast with conventional ultrasound parameters, PTT and nPTT revealed a gradually increasing trend at each time point. Receiver operating characteristic (ROC) curve analysis revealed with an extension of molding time, the area under the curve (AUC) of (n)PTT is larger and larger.</p><p><strong>Conclusions: </strong>Right heart parameters obtained using conventional echocardiography can accurately indicate changes in the structure and function of the right heart during the acute phase of PTE, while (n)PTT measured by CEUS continues to extend during the acute and compensatory phases of PTE. Therefore, PTT (nPTT) obtained by CEUS is a useful clinical indicator for the diagnosis of PTE and can be utilized as a supplement to conventional echocardiography parameters.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"23 1","pages":"8"},"PeriodicalIF":1.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11900611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613474","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":"Performance of a point-of-care ultrasound platform for artificial intelligence-enabled assessment of pulmonary B-lines.","authors":"Ashkan Labaf, Linda Åhman-Persson, Leo Silvén Husu, J Gustav Smith, Annika Ingvarsson, Anna Werther Evaldsson","doi":"10.1186/s12947-025-00338-2","DOIUrl":"10.1186/s12947-025-00338-2","url":null,"abstract":"<p><strong>Background: </strong>The incorporation of artificial intelligence (AI) into point-of-care ultrasound (POCUS) platforms has rapidly increased. The number of B-lines present on lung ultrasound (LUS) serve as a useful tool for the assessment of pulmonary congestion. Interpretation, however, requires experience and therefore AI automation has been pursued. This study aimed to test the agreement between the AI software embedded in a major vendor POCUS system and visual expert assessment.</p><p><strong>Methods: </strong>This single-center prospective study included 55 patients hospitalized for various respiratory symptoms, predominantly acutely decompensated heart failure. A 12-zone protocol was used. Two experts in LUS independently categorized B-lines into 0, 1-2, 3-4, and ≥ 5. The intraclass correlation coefficient (ICC) was used to determine agreement.</p><p><strong>Results: </strong>A total of 672 LUS zones were obtained, with 584 (87%) eligible for analysis. Compared with expert reviewers, the AI significantly overcounted number of B-lines per patient (23.5 vs. 2.8, p < 0.001). A greater proportion of zones with > 5 B-lines was found by the AI than by the reviewers (38% vs. 4%, p < 0.001). The ICC between the AI and reviewers was 0.28 for the total sum of B-lines and 0.37 for the zone-by-zone method. The interreviewer agreement was excellent, with ICCs of 0.92 and 0.91, respectively.</p><p><strong>Conclusion: </strong>This study demonstrated excellent interrater reliability of B-line counts from experts but poor agreement with the AI software embedded in a major vendor system, primarily due to overcounting. Our findings indicate that further development is needed to increase the accuracy of AI tools in LUS.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"23 1","pages":"3"},"PeriodicalIF":1.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536574","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":"MAD or MADness?","authors":"Francesco Fulvio Faletra, Giuseppe Sgarito, Francesca Parisi, Eluisa La Franca, Massimiliano Mulè, Alessandra Carvelli, Giovanni Di Stefano, Rita Laura Borrello, Vincenzo Nuzzi, Paolo Manca, Manlio Cipriani","doi":"10.1186/s12947-025-00337-3","DOIUrl":"10.1186/s12947-025-00337-3","url":null,"abstract":"<p><p>Mitral valve prolapse (MVP) is a common condition affecting approximately 3% of the population, typically with a benign clinical course. However, a small subset of patients (5-10%) may develop severe mitral regurgitation or arrhythmias, which can lead to sudden cardiac death (SCD). Among the morphological features of MVP, mitral annular disjunction (MAD) has emerged as a potential marker of malignant MVP, with some studies suggesting an association with ventricular arrhythmias and SCD. MAD refers to a structural abnormality where there is a separation between the posterior mitral annulus and the ventricular myocardium, particularly during systole. Initially described in the 1980s, MAD has been primarily studied through echocardiography, although its dynamic nature during the cardiac cycle has complicated its diagnosis. The clinical significance of MAD has been debated, as its presence is not exclusive to pathological MVP, being observed in structurally normal mitral valves as well. Recent research, using advanced imaging techniques such as three-dimensional echocardiography, cardiac magnetic resonance and computed tomography, has provided a more refined understanding of MAD. These studies suggest that MAD can be found in normal hearts, particularly in the posterior mitral annulus, and is often considered a benign anatomical variant. However, the occurrence of MAD in patients with MVP, especially those with leaflet redundancy, has been linked to an increased risk of arrhythmias and SCD. The exact role of MAD in arrhythmogenesis remains unclear, but it is hypothesized that MAD may contribute to electrical instability by altering the mechanical properties of the mitral valve, potentially promoting fibrosis in the surrounding myocardium. Despite these associations, the direct causal role of MAD in SCD requires further investigation, and it may ultimately prove to be an innocent bystander rather than the primary cause of fatal arrhythmias.</p>","PeriodicalId":9613,"journal":{"name":"Cardiovascular Ultrasound","volume":"23 1","pages":"2"},"PeriodicalIF":1.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432579","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}