Pub Date : 2025-11-12DOI: 10.1016/j.jjcc.2025.11.002
Dan Qian, Hongting Wang, Jie Wang
{"title":"Daprodustat in heart failure and renal anemia: Still early, but promising.","authors":"Dan Qian, Hongting Wang, Jie Wang","doi":"10.1016/j.jjcc.2025.11.002","DOIUrl":"10.1016/j.jjcc.2025.11.002","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145523290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-12DOI: 10.1016/j.jjcc.2025.11.001
Andrea Freixa-Benavente, Carolina Juzga-Corrales, Ariadna Ayerza-Casas, Marc Figueras-Coll, Silvia Escribà-Bori, Beatriz Plata-Izquierdo, Rosa Collell, María Arantzazu González-Marín, José Manuel Siurana, Moisés Sorlí-García, Leticia Albert-De La Torre, Sílvia Teodoro-Marín, Mónica Rodríguez, Olga Domínguez-García, Sara Rellán, Begoña Manso, Bernardo López-Abel, Roser Álvarez-Pérez, Manuel Portillo-Márquez, Erika Rezola-Arcelus, Fernando Centeno-Malfaz, Ruth Solana-Gracia, Henar Rojo-Sombrero, María-Teresa Cantero-Tejedor, Bibiana Riaño, María Ángeles Tejero-Hernández, Marisol Jiménez-Casso, Anna Sabaté-Rotés
Background: Ascending aorta (AscAo) dilatation assessment and definition in pediatric bicuspid aortic valve (BAV) is challenging. We compared the Pediatric Heart Network (PHN) nomogram against the Halifax (HZ) one and analyzed their association with body surface area indexing (BSAI).
Methods: Echocardiographies from a national BAV registry were analyzed. AscAo and sinus of Valsalva, standardized using nomograms and BSAI, were compared by correlation and Bland-Altman tests. Nomogram +2 and + 3 z-scores thresholds contrasted against >21 mm/BSA-m2 by logistic regression and kappa agreement index. Age subgroup analysis was between adult-size (≥10 years and BSA ≥1.5 m2) and small children.
Results: A total 3858 reports were analyzed. The PHN nomogram resulted in higher AscAo z-scores (median 1.516 versus 1.413). Nomogram correlation was RhoSpearman = 0.979 and Bland-Altman agreement bias was 0.302, with higher divergence in extreme z-scores. Patients ≥10 years and BSA ≥1.5 m2 showed better concordance (bias -0.212 versus 0.440) despite similar correlation to the younger group. There was moderate but significant correlation amongst AscAo BSA-indexed diameters and PHN (RhoSpearman = 0.514, p < 0.001) and HZ nomograms (RhoSpearman = 0.366, p < 0.001), being higher in the older cohort than the younger, both by PHN (RhoSpearmam 0.961 versus 0.424) and HZ (RhoSpearman 0.952 versus 0.540). Higher area under the curve was obtained by PHN. A lower percentage was classified as dilated with PHN than by BSA-I in the adult-size cohort, but not in younger patients.
Discussion: There was good correlation and concordance between HZ and PHN nomograms, the latter resulting in higher z-scores. PHN has better agreement with BSA-I than HZ, with the PHN > +3 z-score threshold being the highest predictor for BSA-I dilatation definition, also showing higher specificity and sensitivity. BSA-I classified fewer patients as dilated than nomograms in adult-sized children but not in the younger cohort. Clinicians should be aware of this effect of BSA when normalizing diameters.
{"title":"Defining ascending aorta dilatation in pediatric bicuspid aortic valve: Comparison of known classical and new z-score nomograms, and anthropometric parameters indexing for its assessment.","authors":"Andrea Freixa-Benavente, Carolina Juzga-Corrales, Ariadna Ayerza-Casas, Marc Figueras-Coll, Silvia Escribà-Bori, Beatriz Plata-Izquierdo, Rosa Collell, María Arantzazu González-Marín, José Manuel Siurana, Moisés Sorlí-García, Leticia Albert-De La Torre, Sílvia Teodoro-Marín, Mónica Rodríguez, Olga Domínguez-García, Sara Rellán, Begoña Manso, Bernardo López-Abel, Roser Álvarez-Pérez, Manuel Portillo-Márquez, Erika Rezola-Arcelus, Fernando Centeno-Malfaz, Ruth Solana-Gracia, Henar Rojo-Sombrero, María-Teresa Cantero-Tejedor, Bibiana Riaño, María Ángeles Tejero-Hernández, Marisol Jiménez-Casso, Anna Sabaté-Rotés","doi":"10.1016/j.jjcc.2025.11.001","DOIUrl":"10.1016/j.jjcc.2025.11.001","url":null,"abstract":"<p><strong>Background: </strong>Ascending aorta (AscAo) dilatation assessment and definition in pediatric bicuspid aortic valve (BAV) is challenging. We compared the Pediatric Heart Network (PHN) nomogram against the Halifax (HZ) one and analyzed their association with body surface area indexing (BSAI).</p><p><strong>Methods: </strong>Echocardiographies from a national BAV registry were analyzed. AscAo and sinus of Valsalva, standardized using nomograms and BSAI, were compared by correlation and Bland-Altman tests. Nomogram +2 and + 3 z-scores thresholds contrasted against >21 mm/BSA-m2 by logistic regression and kappa agreement index. Age subgroup analysis was between adult-size (≥10 years and BSA ≥1.5 m<sup>2</sup>) and small children.</p><p><strong>Results: </strong>A total 3858 reports were analyzed. The PHN nomogram resulted in higher AscAo z-scores (median 1.516 versus 1.413). Nomogram correlation was Rho<sub>Spearman</sub> = 0.979 and Bland-Altman agreement bias was 0.302, with higher divergence in extreme z-scores. Patients ≥10 years and BSA ≥1.5 m<sup>2</sup> showed better concordance (bias -0.212 versus 0.440) despite similar correlation to the younger group. There was moderate but significant correlation amongst AscAo BSA-indexed diameters and PHN (Rho<sub>Spearman</sub> = 0.514, p < 0.001) and HZ nomograms (Rho<sub>Spearman</sub> = 0.366, p < 0.001), being higher in the older cohort than the younger, both by PHN (Rho<sub>Spearmam</sub> 0.961 versus 0.424) and HZ (Rho<sub>Spearman</sub> 0.952 versus 0.540). Higher area under the curve was obtained by PHN. A lower percentage was classified as dilated with PHN than by BSA-I in the adult-size cohort, but not in younger patients.</p><p><strong>Discussion: </strong>There was good correlation and concordance between HZ and PHN nomograms, the latter resulting in higher z-scores. PHN has better agreement with BSA-I than HZ, with the PHN > +3 z-score threshold being the highest predictor for BSA-I dilatation definition, also showing higher specificity and sensitivity. BSA-I classified fewer patients as dilated than nomograms in adult-sized children but not in the younger cohort. Clinicians should be aware of this effect of BSA when normalizing diameters.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145523231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-06DOI: 10.1016/j.jjcc.2025.10.011
Chunyang Lü, Li Wei
{"title":"Comment on 'Night-time penalties in OHCA outcomes' by Tateishi et al.","authors":"Chunyang Lü, Li Wei","doi":"10.1016/j.jjcc.2025.10.011","DOIUrl":"10.1016/j.jjcc.2025.10.011","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145476852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-06DOI: 10.1016/j.jjcc.2025.10.012
Fumiya Oguro, Yoshitaka Nishikawa
{"title":"An evidence-based tool for screening for heart failure with preserved ejection fraction in primary care: The BREATH<sub>2</sub> score: Discussion from a statistical perspective.","authors":"Fumiya Oguro, Yoshitaka Nishikawa","doi":"10.1016/j.jjcc.2025.10.012","DOIUrl":"10.1016/j.jjcc.2025.10.012","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145476869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-06DOI: 10.1016/j.jjcc.2025.10.010
Wenhua Zhou, Liuying Li, Xia Zhou
{"title":"Cardiothoracic ratio in HFpEF: Insights and unanswered questions.","authors":"Wenhua Zhou, Liuying Li, Xia Zhou","doi":"10.1016/j.jjcc.2025.10.010","DOIUrl":"10.1016/j.jjcc.2025.10.010","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145476796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Physical frailty is a prognostic determinant in heart failure (HF) patients, but its association with the modes of death remains unclear. We investigated the associations between walking status and modes of death in patients with HF with preserved ejection fraction (HFpEF) and those with non-HFpEF.
Methods: We analyzed 2009 patients with acute HF enrolled in two Japanese HF registries. We compared post-discharge causes of death in HFpEF and non-HFpEF patients, classified into three walking status groups: robust, impaired walking (IW), and disability groups.
Results: HF was the predominant cause of death in non-HFpEF patients across all walking categories, whereas HF deaths in HFpEF patients increased with worsening walking status, accounting for 35 % of deaths among those with disability. In robust HFpEF patients, non-cardiovascular (CV) deaths, particularly from cancer, were as frequent as HF deaths. The risk of CV death was higher in the IW group [hazard ratio (HR): 1.639; 95 % confidence interval (CI): 1.050-2.559] and the disability group (HR: 2.678; 95 % CI: 1.382-5.189) among non-HFpEF patients, while the risk of non-CV death was higher only in the disability group (HR: 2.495; 95 % CI: 1.206-5.159). HFpEF patients with IW and those with disability had higher risks of both CV death (IW group, HR: 2.369; 95 % CI: 1.486-3.776; disability group, HR: 5.768; 95 % CI: 3.051-10.900) and non-CV death (IW group, HR: 2.444; 95 % CI: 1.468-4.068; disability group, HR: 2.732; 95 % CI: 1.246-5.989).
Conclusion: Poor walking status at discharge was associated with higher risks of both CV and non-CV deaths, irrespective of HF type. HF was the predominant cause of mortality overall, whereas non-CV death, especially cancer death, was more common in robust HFpEF patients. These results highlight the clinical importance of walking status assessment in HF management.
{"title":"Associations between modes of death and physical impairment in patients with heart failure with preserved or reduced ejection fraction.","authors":"Tomoyuki Hamada, Toru Kubo, Kensuke Takabayashi, Kazuya Kawai, Yoko Nakaoka, Toshikazu Yabe, Takashi Furuno, Eisuke Yamada, Ryoko Fujita, Tetsuhisa Kitamura, Ryuji Nohara, Hiroaki Kitaoka","doi":"10.1016/j.jjcc.2025.10.013","DOIUrl":"10.1016/j.jjcc.2025.10.013","url":null,"abstract":"<p><strong>Background: </strong>Physical frailty is a prognostic determinant in heart failure (HF) patients, but its association with the modes of death remains unclear. We investigated the associations between walking status and modes of death in patients with HF with preserved ejection fraction (HFpEF) and those with non-HFpEF.</p><p><strong>Methods: </strong>We analyzed 2009 patients with acute HF enrolled in two Japanese HF registries. We compared post-discharge causes of death in HFpEF and non-HFpEF patients, classified into three walking status groups: robust, impaired walking (IW), and disability groups.</p><p><strong>Results: </strong>HF was the predominant cause of death in non-HFpEF patients across all walking categories, whereas HF deaths in HFpEF patients increased with worsening walking status, accounting for 35 % of deaths among those with disability. In robust HFpEF patients, non-cardiovascular (CV) deaths, particularly from cancer, were as frequent as HF deaths. The risk of CV death was higher in the IW group [hazard ratio (HR): 1.639; 95 % confidence interval (CI): 1.050-2.559] and the disability group (HR: 2.678; 95 % CI: 1.382-5.189) among non-HFpEF patients, while the risk of non-CV death was higher only in the disability group (HR: 2.495; 95 % CI: 1.206-5.159). HFpEF patients with IW and those with disability had higher risks of both CV death (IW group, HR: 2.369; 95 % CI: 1.486-3.776; disability group, HR: 5.768; 95 % CI: 3.051-10.900) and non-CV death (IW group, HR: 2.444; 95 % CI: 1.468-4.068; disability group, HR: 2.732; 95 % CI: 1.246-5.989).</p><p><strong>Conclusion: </strong>Poor walking status at discharge was associated with higher risks of both CV and non-CV deaths, irrespective of HF type. HF was the predominant cause of mortality overall, whereas non-CV death, especially cancer death, was more common in robust HFpEF patients. These results highlight the clinical importance of walking status assessment in HF management.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145476799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.jjcc.2025.05.004
Hoang Nhat Pham MD , Ramzi Ibrahim MD , Xuan Ci Mee MBBS , Ghee Kheng Lim MBBS , Mahmoud Abdelnabi MBBCh, MSc , Beani Forst MD , Patrick Sarkis MD , George Bcharah BS , Juan Farina MD , Chadi Ayoub MBBS, PhD , Amitoj Singh MD , Reza Arsanjani MD , Anwar Chahal MD, PhD , Kwan Lee MD
Introduction
Left ventricular assist devices (LVADs) provide critical support for patients with advanced heart failure (HF), but complications and suboptimal outcomes remain challenges. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have shown promise in HF, but their role in patients with LVADs is not well established. We aimed to evaluate the association of SGLT2 inhibitors with clinical outcomes and heart transplantation rates in patients with LVADs.
Methods
We conducted a retrospective cohort study using the TriNetX Network (2014–2022) to identify all adults (≥18 years old) with LVADs. Patients were stratified into SGLT2 inhibitor users and non-users during LVAD-supported period. Propensity score matching (1:1, PSM) was performed to balance baseline characteristics between two cohorts. Efficacy outcomes included all-cause mortality/hospitalization, HF exacerbations, acute myocardial infarction, cerebral infarction, cardiac arrest, and heart transplant. Safety outcomes included acute kidney injury (AKI), urinary tract infection (UTI), and urogenital candidiasis. Adjusted odds ratios (aORs) with 95 % confidence intervals (CIs) were calculated.
Results
Among 3736 patients with LVADs, 1106 received SGLT2 inhibitors from 2014 to 2022. After PSM, 656 patients were included in each group. SGLT2 inhibitor use was associated with lower risks of all-cause mortality [0.571 (95 % CI, 0.430–0.759)], all-cause hospitalization [aOR 0.619 (0.478–0.802)], acute HF exacerbations [aOR 0.687 (0.539–0.877)], cerebral infarction [aOR 0.676 (0.501–0.912)], and cardiac arrest [aOR 0.441 (0.269–0.725)]. No significant differences were observed for heart transplantation rates [aOR 1.084 (0.834–1.408)] or acute MI [aOR 0.881 (0.663–1.172)]. Safety outcomes favored SGLT2 inhibitor cohort with lower risks of AKI [aOR 0.767 (0.617–0.954)], with no significant difference for UTI [aOR 0.730 (0.527–1.012)] or urogenital candidiasis [aOR 1.000 (0.413–2.419)].
Conclusions
SGLT2 inhibitor use in LVAD-supported patients was associated with improved survival, reduced hospitalizations and heart failure exacerbation alongside favorable safety outcomes. These findings support further investigation into SGLT2 inhibitors as a potential adjunctive therapy in the management of patients with LVADs.
{"title":"SGLT2 inhibitors and cardiovascular outcomes in patients with left ventricular assist devices","authors":"Hoang Nhat Pham MD , Ramzi Ibrahim MD , Xuan Ci Mee MBBS , Ghee Kheng Lim MBBS , Mahmoud Abdelnabi MBBCh, MSc , Beani Forst MD , Patrick Sarkis MD , George Bcharah BS , Juan Farina MD , Chadi Ayoub MBBS, PhD , Amitoj Singh MD , Reza Arsanjani MD , Anwar Chahal MD, PhD , Kwan Lee MD","doi":"10.1016/j.jjcc.2025.05.004","DOIUrl":"10.1016/j.jjcc.2025.05.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Left ventricular assist devices<span> (LVADs) provide critical support for patients with advanced heart failure (HF), but complications and suboptimal outcomes remain challenges. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have shown promise in HF, but their role in patients with LVADs is not well established. We aimed to evaluate the association of SGLT2 inhibitors with clinical outcomes and heart transplantation rates in patients with LVADs.</span></div></div><div><h3>Methods</h3><div><span>We conducted a retrospective cohort study using the TriNetX Network (2014–2022) to identify all adults (≥18 years old) with LVADs. Patients were stratified into SGLT2 inhibitor users and non-users during LVAD-supported period. </span>Propensity score matching<span><span><span> (1:1, PSM) was performed to balance baseline characteristics between two cohorts. Efficacy outcomes included all-cause mortality/hospitalization, HF exacerbations, acute myocardial infarction, </span>cerebral infarction<span><span>, cardiac arrest, and heart transplant. Safety outcomes included </span>acute kidney injury (AKI), </span></span>urinary tract infection<span> (UTI), and urogenital candidiasis. Adjusted odds ratios (aORs) with 95 % confidence intervals (CIs) were calculated.</span></span></div></div><div><h3>Results</h3><div>Among 3736 patients with LVADs, 1106 received SGLT2 inhibitors from 2014 to 2022. After PSM, 656 patients were included in each group. SGLT2 inhibitor use was associated with lower risks of all-cause mortality [0.571 (95 % CI, 0.430–0.759)], all-cause hospitalization [aOR 0.619 (0.478–0.802)], acute HF<span> exacerbations [aOR 0.687 (0.539–0.877)], cerebral infarction [aOR 0.676 (0.501–0.912)], and cardiac arrest [aOR 0.441 (0.269–0.725)]. No significant differences were observed for heart transplantation rates [aOR 1.084 (0.834–1.408)] or acute MI [aOR 0.881 (0.663–1.172)]. Safety outcomes favored SGLT2 inhibitor cohort with lower risks of AKI [aOR 0.767 (0.617–0.954)], with no significant difference for UTI [aOR 0.730 (0.527–1.012)] or urogenital candidiasis [aOR 1.000 (0.413–2.419)].</span></div></div><div><h3>Conclusions</h3><div>SGLT2 inhibitor use in LVAD-supported patients was associated with improved survival, reduced hospitalizations and heart failure exacerbation alongside favorable safety outcomes. These findings support further investigation into SGLT2 inhibitors as a potential adjunctive therapy in the management of patients with LVADs.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"86 5","pages":"Pages 425-434"},"PeriodicalIF":2.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The trace line for left ventricular (LV) volumes and ejection fraction (EF) measurements in 2-dimensional echocardiography (2DE) are often based on the empirical judgment of the examiner. We evaluated whether trace lines along the inner side of the high-intensity echo band that characterized LV endocardial boundary is useful for accurate measurements, with cardiac magnetic resonance (CMR) imaging as reference.
Methods
We compared the accuracy of LV volumes [end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV)] and EF in 73 patients, using CMR imaging as a reference. Protocol 1: 10 patients were compared by two examiners using the biplane disk summation method with trace line based on the empirical judgment of the examiner (before-learning) and trace line along the inner side of the high-intensity echo band (after-learning), and inter- and intra-observer variabilities were calculated. Protocol 2: the accuracy of LV volumes and EF was compared in 73 patients using the after-learning method. Bland-Altman analysis were used to compare with 2DE and CMR. The coefficient of variation was used for inter- and intra-observer variabilities.
Results
Protocol 1: For examiner 1, EDV (−16 ml vs 1 ml, p = 0.001), ESV (−9 ml vs 1 ml, p = 0.004), and SV (−7 ml vs 0 ml, p = 0.037) after learning compared with before learning were significantly approximated CMR measurements. For examiner 2, no significant differences were noted between before and after learning. The variability in measurements was smaller for all items by both examiners. Inter-observer variability after learning was improved compared with before learning, and intra-observer variability was also better. Protocol 2: LV volumes and EF measurements after learning were almost as accurate as CMR.
Conclusions
LV volumes and EF using after-learning trace approximated CMR measurements. Having landmark on trace line may contribute to quality control.
背景：二维超声心动图（2DE）中左心室（LV）容量和射血分数（EF）测量的痕迹线通常基于检查者的经验判断。我们评估沿高强度回波带内侧表征左室心内膜边界的痕迹线是否有助于准确测量，并以心脏磁共振（CMR）成像为参考。方法：我们比较73例患者左室容积[舒张末期容积（EDV）、收缩末期容积（ESV）、卒中容积（SV）]和EF的准确性，并以CMR成像为参考。方案1:10例患者由两名检查人员采用基于检查人员经验判断（学习前）和沿高强度回波带内侧（学习后）的迹线双翼盘累加法进行比较，并计算观察者之间和观察者内部的变量。方案2：采用后学习法比较73例患者左室容积和EF的准确性。采用Bland-Altman分析与2DE和CMR进行比较。变异系数用于观察者之间和观察者内部的变异。结果:协议1:考官1,产品类别(-16 vs 毫升 ml, p = 0.001),ESV(9 毫升vs 1 ml, p = 0.004),和SV(7 毫升vs 0 ml, p = 0.037)学习与之前相比学习后明显近似CMR测量。对于考官2来说，学习前后没有明显的差异。在测量的变异性是较小的所有项目由两个审查员。与学习前相比，学习后观察者间的变异性有所改善，观察者内的变异性也有所改善。方案2：学习后左室容积和EF测量几乎与CMR一样准确。结论：左室体积和EF使用学习后跟踪近似CMR测量。在跟踪线上有标记有助于质量控制。
{"title":"Accuracy of left ventricular volumes and ejection fraction using high-intensity echo band as a landmark: Comparison between two-dimensional echocardiography and cardiac magnetic resonance imaging","authors":"Takaya Higuchi MT , Yasuyuki Chiba MD, PhD , Nobuaki Yoshino MT , Kenichi Matsubara RT , Mashiro Taniguchi MT , Yuki Ogino MT , Toshihiro Shimizu MD, PhD , Toshihisa Anzai MD, PhD, FJCC","doi":"10.1016/j.jjcc.2025.05.017","DOIUrl":"10.1016/j.jjcc.2025.05.017","url":null,"abstract":"<div><h3>Background</h3><div>The trace line for left ventricular (LV) volumes and ejection fraction<span> (EF) measurements in 2-dimensional echocardiography<span><span> (2DE) are often based on the empirical judgment of the examiner. We evaluated whether trace lines along the inner side of the high-intensity echo band that characterized LV </span>endocardial boundary is useful for accurate measurements, with cardiac magnetic resonance (CMR) imaging as reference.</span></span></div></div><div><h3>Methods</h3><div>We compared the accuracy of LV volumes [end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume<span> (SV)] and EF in 73 patients, using CMR imaging as a reference. Protocol 1: 10 patients were compared by two examiners using the biplane disk summation method with trace line based on the empirical judgment of the examiner (before-learning) and trace line along the inner side of the high-intensity echo band (after-learning), and inter- and intra-observer variabilities were calculated. Protocol 2: the accuracy of LV volumes and EF was compared in 73 patients using the after-learning method. Bland-Altman analysis were used to compare with 2DE and CMR. The coefficient of variation was used for inter- and intra-observer variabilities.</span></div></div><div><h3>Results</h3><div>Protocol 1: For examiner 1, EDV (−16 ml vs 1 ml, <em>p</em> = 0.001), ESV (−9 ml vs 1 ml, <em>p</em> = 0.004), and SV (−7 ml vs 0 ml, <em>p</em> = 0.037) after learning compared with before learning were significantly approximated CMR measurements. For examiner 2, no significant differences were noted between before and after learning. The variability in measurements was smaller for all items by both examiners. Inter-observer variability after learning was improved compared with before learning, and intra-observer variability was also better. Protocol 2: LV volumes and EF measurements after learning were almost as accurate as CMR.</div></div><div><h3>Conclusions</h3><div>LV volumes and EF using after-learning trace approximated CMR measurements. Having landmark on trace line may contribute to quality control.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"86 5","pages":"Pages 444-452"},"PeriodicalIF":2.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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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