Pub Date : 2025-12-01DOI: 10.1016/j.jcmg.2025.07.002
Thomas H. Marwick MBBS, PhD, MPH , Edgar M. Hidalgo PhD , Leah Wright PhD , Mariadas Roshan PhD , Mats Isaksson PhD
Echocardiography is the gateway to appropriate therapy for many cardiovascular diseases, but access to this test is sometimes challenging. The consequence is that patients in rural and remote areas need to travel for testing, and the resulting time and monetary costs may prove a barrier, especially for hospital inpatients. Delays in obtaining echocardiograms lead to delayed diagnosis and treatment. Technological advances in miniaturization and processing power, and reductions in cost, have enabled diagnostic images to be obtained from inexpensive echocardiography machines. However, imaging by nonexperts is difficult, even with guidance by artificial intelligence. An alternative strategy is to use high-bandwidth, low-latency communication systems to bring the expertise of an expert sonographer to a remote patient by using a robot. Previous work has shown that remote robots are able to reproduce the hand movements performed by sonographers, and multiple types of robot-guided ultrasound examinations have been performed successfully in remote areas. However, despite clear clinical need and ongoing interest, the promise of robotic tele-echocardiography awaits clinical translation. Existing research points toward longer examination times and a need for additional personnel for local supervision of remotely acquired echocardiograms. The efficiencies of longer examinations and more personnel may be worthwhile to facilitate remote access, or within a hospital to avoid sonographer injury, or to improve safety from infection or radiation exposure during structural heart disease interventions. Potentially, autonomous robot-assisted ultrasound may replace the sonographer, by interfacing with artificial intelligence–guided acquisition, although this remains futuristic and uncertain. This paper reviews recent developments in controlling the speed and force of a recently developed robotic system, means of facilitating positioning of the probe, and haptic control. It emphasizes the primary concerns to be imaging time and safety.
{"title":"Current Status and Pending Developments of Robotic Tele-Echocardiography","authors":"Thomas H. Marwick MBBS, PhD, MPH , Edgar M. Hidalgo PhD , Leah Wright PhD , Mariadas Roshan PhD , Mats Isaksson PhD","doi":"10.1016/j.jcmg.2025.07.002","DOIUrl":"10.1016/j.jcmg.2025.07.002","url":null,"abstract":"<div><div>Echocardiography is the gateway to appropriate therapy for many cardiovascular diseases, but access to this test is sometimes challenging. The consequence is that patients in rural and remote areas need to travel for testing, and the resulting time and monetary costs may prove a barrier, especially for hospital inpatients. Delays in obtaining echocardiograms lead to delayed diagnosis and treatment. Technological advances in miniaturization and processing power, and reductions in cost, have enabled diagnostic images to be obtained from inexpensive echocardiography machines. However, imaging by nonexperts is difficult, even with guidance by artificial intelligence. An alternative strategy is to use high-bandwidth, low-latency communication systems to bring the expertise of an expert sonographer to a remote patient by using a robot. Previous work has shown that remote robots are able to reproduce the hand movements performed by sonographers, and multiple types of robot-guided ultrasound examinations have been performed successfully in remote areas. However, despite clear clinical need and ongoing interest, the promise of robotic tele-echocardiography awaits clinical translation. Existing research points toward longer examination times and a need for additional personnel for local supervision of remotely acquired echocardiograms. The efficiencies of longer examinations and more personnel may be worthwhile to facilitate remote access, or within a hospital to avoid sonographer injury, or to improve safety from infection or radiation exposure during structural heart disease interventions. Potentially, autonomous robot-assisted ultrasound may replace the sonographer, by interfacing with artificial intelligence–guided acquisition, although this remains futuristic and uncertain. This paper reviews recent developments in controlling the speed and force of a recently developed robotic system, means of facilitating positioning of the probe, and haptic control. It emphasizes the primary concerns to be imaging time and safety.</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 12","pages":"Pages 1377-1388"},"PeriodicalIF":15.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.jcmg.2025.07.018
Xander Jacquemyn MD , Michel Pompeu Sá MD, MSc, MHBA, PhD , Kasper Korsholm MD, PhD , Jens Erik Nielsen-Kudsk MD , Xavier Iriart MD , Jacqueline Saw MD , Mohamad Alkhouli MD , Sandeep Jain MD , Marcio Sommer Bittencourt MD, MPH, PhD , Ibrahim Sultan MD
Background
Residual leaks are common after left atrial appendage occlusion (LAAO).
Objectives
The authors aimed to systematically evaluate the prognostic implications of residual left atrial appendage (LAA) patency and peridevice leaks (PDLs) detected by cardiac computed tomography (CT) following LAAO.
Methods
The authors used traditional meta-analytical methods and a Bayesian framework to assess the probability of increased risks associated with these residual leaks.
Results
Seventeen studies encompassing 2,036 patients met the inclusion criteria. During follow-up, the presence of any LAA patency was significantly associated with an almost 2-fold increased OR of thromboembolism (pooled OR: 1.87, 95% CI: 1.08-3.24), corresponding to 28 (95% CI: 3-68) additional events per 1,000 patients. Although PDL showed a similar trend, it was not significantly associated with increased thromboembolism risk (pooled OR: 1.50, 95% CI: 0.85-2.65). For thromboembolism with LAA patency, under a noninformative prior, the mean logOR was 0.59 (95% credible interval [Crl]: 0.06-1.15), and translated median OR of 1.87 (95% CrI: 1.06-3.14) and a mean absolute risk difference (ARD) of 2.8% (95% CrI: 0.2%-6.8%). The posterior probability of ARD >0% was 98.5%. For any PDL, the mean logOR was 0.38 (95% CrI: −0.22 to 0.95), with a median OR of 1.53 (95% CrI: 0.80-2.59) and mean ARD of 1.9% (95% CrI: −0.7% to 5.4%). The posterior probability of ARD >0% was 89.8%.
Conclusions
LAA patency and PDL identified by CT may be associated with an increased risk of thromboembolism. These findings indicate that residual leaks detected by CT may be clinically significant and should not be regarded as benign.
{"title":"Outcomes of Left Atrial Appendage Patency After Device Closure Detected by Cardiac CT","authors":"Xander Jacquemyn MD , Michel Pompeu Sá MD, MSc, MHBA, PhD , Kasper Korsholm MD, PhD , Jens Erik Nielsen-Kudsk MD , Xavier Iriart MD , Jacqueline Saw MD , Mohamad Alkhouli MD , Sandeep Jain MD , Marcio Sommer Bittencourt MD, MPH, PhD , Ibrahim Sultan MD","doi":"10.1016/j.jcmg.2025.07.018","DOIUrl":"10.1016/j.jcmg.2025.07.018","url":null,"abstract":"<div><h3>Background</h3><div>Residual leaks are common after left atrial appendage occlusion (LAAO).</div></div><div><h3>Objectives</h3><div>The authors aimed to systematically evaluate the prognostic implications of residual left atrial appendage (LAA) patency and peridevice leaks (PDLs) detected by cardiac computed tomography (CT) following LAAO.</div></div><div><h3>Methods</h3><div>The authors used traditional meta-analytical methods and a Bayesian framework to assess the probability of increased risks associated with these residual leaks.</div></div><div><h3>Results</h3><div>Seventeen studies encompassing 2,036 patients met the inclusion criteria. During follow-up, the presence of any LAA patency was significantly associated with an almost 2-fold increased OR of thromboembolism (pooled OR: 1.87, 95% CI: 1.08-3.24), corresponding to 28 (95% CI: 3-68) additional events per 1,000 patients. Although PDL showed a similar trend, it was not significantly associated with increased thromboembolism risk (pooled OR: 1.50, 95% CI: 0.85-2.65). For thromboembolism with LAA patency, under a noninformative prior, the mean logOR was 0.59 (95% credible interval [Crl]: 0.06-1.15), and translated median OR of 1.87 (95% CrI: 1.06-3.14) and a mean absolute risk difference (ARD) of 2.8% (95% CrI: 0.2%-6.8%). The posterior probability of ARD >0% was 98.5%. For any PDL, the mean logOR was 0.38 (95% CrI: −0.22 to 0.95), with a median OR of 1.53 (95% CrI: 0.80-2.59) and mean ARD of 1.9% (95% CrI: −0.7% to 5.4%). The posterior probability of ARD >0% was 89.8%.</div></div><div><h3>Conclusions</h3><div>LAA patency and PDL identified by CT may be associated with an increased risk of thromboembolism. These findings indicate that residual leaks detected by CT may be clinically significant and should not be regarded as benign.</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 12","pages":"Pages 1348-1359"},"PeriodicalIF":15.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145017869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.jcmg.2025.06.013
Tristan T. Demmert MD, Konstantin Klambauer MD, Lukas J. Moser MD, Victor Schweiger MD, Victor Mergen MD, Michael Würdinger MD, Davide Di Vece MD, Andrea Biondo MD, Alexander Gotschy MD, Barbara Stähli MD, Julia Stehli MD, Martin F. Reiner MD, PhD, Jelena-R. Ghadri MD, Robert Manka MD, Matthias Eberhard MD, Christian Templin MD, PhD, Hatem Alkadhi MD, MPH
{"title":"Coronary CT Angiography to Diagnose Healing of Spontaneous Coronary Artery Dissection","authors":"Tristan T. Demmert MD, Konstantin Klambauer MD, Lukas J. Moser MD, Victor Schweiger MD, Victor Mergen MD, Michael Würdinger MD, Davide Di Vece MD, Andrea Biondo MD, Alexander Gotschy MD, Barbara Stähli MD, Julia Stehli MD, Martin F. Reiner MD, PhD, Jelena-R. Ghadri MD, Robert Manka MD, Matthias Eberhard MD, Christian Templin MD, PhD, Hatem Alkadhi MD, MPH","doi":"10.1016/j.jcmg.2025.06.013","DOIUrl":"10.1016/j.jcmg.2025.06.013","url":null,"abstract":"","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 12","pages":"Pages 1402-1404"},"PeriodicalIF":15.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.jcmg.2025.07.016
Sebastiaan Dhont MD , Wouter L'Hoyes MD , Sara Moura Ferreira MD , Pieter Martens MD, Msc, PhD , Jan Stassen MD , Guido Claessen MD, PhD , Sarah Stroobants MD , Siddharth Jogani MD , Ruta Jasaityte MD, PhD , Lieven Herbots MD, PhD , Jan Verwerft MD , Philippe B. Bertrand MD, PhD
Background
Atrial functional mitral regurgitation (AFMR) is prevalent among patients with heart failure with preserved ejection fraction (HFpEF) and associated with adverse outcome, yet this bidirectional association remains underexplored.
Objectives
The purpose of this study was to elucidate the pathophysiological and prognostic significance of AFMR in HFpEF, both at rest and during exercise.
Methods
In this multicenter cohort study, consecutive patients with HFpEF underwent cardiopulmonary exercise testing with echocardiography, with a particular focus on mitral regurgitation (MR) severity assessment in rest and during exercise. Longitudinal follow-up included cardiovascular hospitalizations and all-cause mortality.
Results
The study involved 429 patients with HFpEF (age 74 ± 8 years, 65% female). AFMR was observed in 35% of patients at rest (24% mild, 11% ≥ moderate). Increasing AFMR severity correlated with atrial fibrillation, larger left atrium volumes, reduced left atrial function, lower peak oxygen consumption, and increased exercise-induced pulmonary hypertension. After adjusting for age, sex, ventricular and atrial volume and function, moderate or severe MR remained linked with worse outcomes (HR: 4.03; 95% CI: 2.26-7.21; P < 0.001). During exercise, MR severity increased in 12% of patients based on guideline-based thresholds. Notably, even in patients without formal reclassification, an absolute increase in effective regurgitant orifice area ≥5 mm2 during exercise was independently predictive of adverse outcomes (HR: 2.43; 95% CI 1.34-4.41; P = 0.004). This increase was not related to systemic blood pressure, chronotropic incompetence, or left ventricular dysfunction.
Conclusions
AFMR is common in HFpEF and independently associated with adverse outcomes when moderate or severe at rest. Even mild, exercise-induced increases carry additional prognostic value, underscoring the relevance of both resting and dynamic AFMR assessment.
背景：心房功能性二尖瓣反流（AFMR）在保留射血分数（HFpEF）的心力衰竭患者中普遍存在，并与不良结局相关，但这种双向关联仍未得到充分探讨。目的：本研究的目的是阐明静息和运动时AFMR在HFpEF中的病理生理和预后意义。方法：在这项多中心队列研究中，连续的HFpEF患者通过超声心动图进行心肺运动试验，特别关注休息和运动期间二尖瓣反流（MR）严重程度的评估。纵向随访包括心血管住院和全因死亡率。结果：本研究纳入429例HFpEF患者（年龄74±8岁，65%为女性）。35%的患者在休息时观察到AFMR（24%轻度，11%≥中度）。AFMR严重程度的增加与心房颤动、左心房容量增大、左心房功能降低、峰值耗氧量降低和运动性肺动脉高压升高相关。在调整了年龄、性别、心室和心房容积和功能后，中度或重度MR仍然与较差的结果相关（HR: 4.03; 95% CI: 2.26-7.21; P < 0.001）。在运动期间，基于指南的阈值，12%的患者MR严重程度增加。值得注意的是，即使在没有正式重新分类的患者中，运动期间有效反流口面积≥5 mm2的绝对增加也是不良结局的独立预测因素（HR: 2.43; 95% CI 1.34-4.41; P = 0.004）。这种增加与全身血压、变时功能不全或左心室功能不全无关。结论：AFMR在HFpEF中很常见，并且在休息时与中度或重度不良结局独立相关。即使是轻微的运动引起的增加也具有额外的预后价值，强调静息和动态AFMR评估的相关性。
{"title":"Atrial Functional Mitral Regurgitation and Exercise-Induced Changes in Heart Failure With Preserved Ejection Fraction","authors":"Sebastiaan Dhont MD , Wouter L'Hoyes MD , Sara Moura Ferreira MD , Pieter Martens MD, Msc, PhD , Jan Stassen MD , Guido Claessen MD, PhD , Sarah Stroobants MD , Siddharth Jogani MD , Ruta Jasaityte MD, PhD , Lieven Herbots MD, PhD , Jan Verwerft MD , Philippe B. Bertrand MD, PhD","doi":"10.1016/j.jcmg.2025.07.016","DOIUrl":"10.1016/j.jcmg.2025.07.016","url":null,"abstract":"<div><h3>Background</h3><div>Atrial functional mitral regurgitation (AFMR) is prevalent among patients with heart failure with preserved ejection fraction (HFpEF) and associated with adverse outcome, yet this bidirectional association remains underexplored.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to elucidate the pathophysiological and prognostic significance of AFMR in HFpEF, both at rest and during exercise.</div></div><div><h3>Methods</h3><div>In this multicenter cohort study, consecutive patients with HFpEF underwent cardiopulmonary exercise testing with echocardiography, with a particular focus on mitral regurgitation (MR) severity assessment in rest and during exercise. Longitudinal follow-up included cardiovascular hospitalizations and all-cause mortality.</div></div><div><h3>Results</h3><div>The study involved 429 patients with HFpEF (age 74 ± 8 years, 65% female). AFMR was observed in 35% of patients at rest (24% mild, 11% ≥ moderate). Increasing AFMR severity correlated with atrial fibrillation, larger left atrium volumes, reduced left atrial function, lower peak oxygen consumption, and increased exercise-induced pulmonary hypertension. After adjusting for age, sex, ventricular and atrial volume and function, moderate or severe MR remained linked with worse outcomes (HR: 4.03; 95% CI: 2.26-7.21; <em>P</em> < 0.001). During exercise, MR severity increased in 12% of patients based on guideline-based thresholds. Notably, even in patients without formal reclassification, an absolute increase in effective regurgitant orifice area ≥5 mm<sup>2</sup> during exercise was independently predictive of adverse outcomes (HR: 2.43; 95% CI 1.34-4.41; <em>P</em> = 0.004). This increase was not related to systemic blood pressure, chronotropic incompetence, or left ventricular dysfunction.</div></div><div><h3>Conclusions</h3><div>AFMR is common in HFpEF and independently associated with adverse outcomes when moderate or severe at rest. Even mild, exercise-induced increases carry additional prognostic value, underscoring the relevance of both resting and dynamic AFMR assessment.</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 12","pages":"Pages 1285-1296"},"PeriodicalIF":15.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.jcmg.2025.07.019
Milind Y. Desai MD, MBA , Yuichiro Okushi MD , Kathy Wolski MPH , Jeffrey B. Geske MD , Anjali Tiku Owens MD , Qiuqing Wang MPH , Sara Saberi MS, MD , Andrew Wang MD , Paul Cremer MS, MD , Neal K. Lakdawala MD , Mark V. Sherrid MD , Albree Tower-Rader MD , David R. Fermin MD , Mark A. Zenker MD , Srihari S. Naidu MD , Kathy Lampl MD , Steven E. Nissen MD , Zoran Popovic MD, MPH
Background
In the VALOR-HCM (A Study to Evaluate Mavacamten in Adults With Symptomatic Obstructive HCM Who Are Eligible for Septal Reduction Therapy; NCT04349072) trial, patients with severely symptomatic obstructive hypertrophic cardiomyopathy (HCM) treated with mavacamten demonstrated significant improvement in left ventricular outflow tract (LVOT) gradients and echocardiographic indices of cardiac remodeling in the short term.
Objectives
The authors sought to assess whether mavacamten results in sustained favorable long-term cardiac remodeling at 128 weeks (end of trial).
Methods
A total of 112 adult symptomatic obstructive HCM patients (mean age: 60.3 years; 50% men; and 94% NYHA functional class III/IV) who were referred for septal reduction therapy were randomized 1:1 to mavacamten or placebo for 16 weeks. Subsequently, placebo patients transitioned to and received 112 weeks of mavacamten, and the original mavacamten group received 128 weeks of mavacamten. All patients had comprehensive echocardiographic assessments (including LV and left atrial [LA] global longitudinal strain measurements using vendor neutral software [TOMTEC-ARENA TTA2, Philips Healthcare]) at baseline and 128-week follow-up.
Results
At week 128, there was a sustained improvement (mean percentage of change from baseline, all P < 0.05) in LVOT gradients (resting [–61%], post-Valsalva [–72%], and postexercise [–53%]), LV mass index (–11%), septal E/e′ (–18%), LV global longitudinal strain (4.5%), LA volume index (–6%), and LA strain (conduit strain [16%], contraction [35%], and reservoir [32%]). In 71 patients with ≥5 point improvement in the Kansas City Cardiomyopathy Questionnaire 23-item Clinical Summary Score (KCCQ-23-CSS), there was a significant and sustained improvement (all P < 0.05), whereas in 25 patients with <5 point improvement in the KCCQ-23-CSS, there was no significant improvement in various LA and LV strain values.
Conclusions
In the VALOR-HCM trial, treatment with mavacamten resulted in sustained favorable cardiac remodeling, including improvement in LVOT gradients, cardiac volumes, cardiac hypertrophy, diastolic function, and markers of LA and LV strain from baseline through week 128, suggesting disease modification. These favorable changes also occurred in association with meaningful improvement in quality of life.
{"title":"Long-Term Favorable Cardiac Remodeling in Obstructive Hypertrophic Cardiomyopathy Patients Treated With Mavacamten for Up to 128 Weeks","authors":"Milind Y. Desai MD, MBA , Yuichiro Okushi MD , Kathy Wolski MPH , Jeffrey B. Geske MD , Anjali Tiku Owens MD , Qiuqing Wang MPH , Sara Saberi MS, MD , Andrew Wang MD , Paul Cremer MS, MD , Neal K. Lakdawala MD , Mark V. Sherrid MD , Albree Tower-Rader MD , David R. Fermin MD , Mark A. Zenker MD , Srihari S. Naidu MD , Kathy Lampl MD , Steven E. Nissen MD , Zoran Popovic MD, MPH","doi":"10.1016/j.jcmg.2025.07.019","DOIUrl":"10.1016/j.jcmg.2025.07.019","url":null,"abstract":"<div><h3>Background</h3><div>In the VALOR-HCM (A Study to Evaluate Mavacamten in Adults With Symptomatic Obstructive HCM Who Are Eligible for Septal Reduction Therapy; <span><span>NCT04349072</span><svg><path></path></svg></span>) trial, patients with severely symptomatic obstructive hypertrophic cardiomyopathy (HCM) treated with mavacamten demonstrated significant improvement in left ventricular outflow tract (LVOT) gradients and echocardiographic indices of cardiac remodeling in the short term.</div></div><div><h3>Objectives</h3><div>The authors sought to assess whether mavacamten results in sustained favorable long-term cardiac remodeling at 128 weeks (end of trial).</div></div><div><h3>Methods</h3><div>A total of 112 adult symptomatic obstructive HCM patients (mean age: 60.3 years; 50% men; and 94% NYHA functional class III/IV) who were referred for septal reduction therapy were randomized 1:1 to mavacamten or placebo for 16 weeks. Subsequently, placebo patients transitioned to and received 112 weeks of mavacamten, and the original mavacamten group received 128 weeks of mavacamten. All patients had comprehensive echocardiographic assessments (including LV and left atrial [LA] global longitudinal strain measurements using vendor neutral software [TOMTEC-ARENA TTA2, Philips Healthcare]) at baseline and 128-week follow-up.</div></div><div><h3>Results</h3><div>At week 128, there was a sustained improvement (mean percentage of change from baseline, all <em>P</em> < 0.05) in LVOT gradients (resting [–61%], post-Valsalva [–72%], and postexercise [–53%]), LV mass index (–11%), septal E/e′ (–18%), LV global longitudinal strain (4.5%), LA volume index (–6%), and LA strain (conduit strain [16%], contraction [35%], and reservoir [32%]). In 71 patients with ≥5 point improvement in the Kansas City Cardiomyopathy Questionnaire 23-item Clinical Summary Score (KCCQ-23-CSS), there was a significant and sustained improvement (all <em>P</em> < 0.05), whereas in 25 patients with <5 point improvement in the KCCQ-23-CSS, there was no significant improvement in various LA and LV strain values.</div></div><div><h3>Conclusions</h3><div>In the VALOR-HCM trial, treatment with mavacamten resulted in sustained favorable cardiac remodeling, including improvement in LVOT gradients, cardiac volumes, cardiac hypertrophy, diastolic function, and markers of LA and LV strain from baseline through week 128, suggesting disease modification. These favorable changes also occurred in association with meaningful improvement in quality of life.</div></div>","PeriodicalId":14767,"journal":{"name":"JACC. Cardiovascular imaging","volume":"18 12","pages":"Pages 1300-1311"},"PeriodicalIF":15.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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