Journal of the American Society of Echocardiography最新文献

{"title":"'Divide et impera' in cardiac resynchronization therapy?","authors":"Thomas Van Overmeiren, Simon Calle, Jan De Pooter, Frank Timmermans","doi":"10.1016/j.echo.2025.12.016","DOIUrl":"https://doi.org/10.1016/j.echo.2025.12.016","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Left Ventricular Diastolic Function on Right Ventricular Size and Function.","authors":"Muhammad U Almani, Ardel J Romero, Emmanuel Akuna, Audry C Suarez, Evan Isaacs, Nano Chikovani, John Malin, Lucas C Pereira, Carol Fernandez Hazim, Jafar Alzubi, Zachary Port, Gregg S Pressman","doi":"10.1016/j.echo.2025.12.015","DOIUrl":"https://doi.org/10.1016/j.echo.2025.12.015","url":null,"abstract":"<p><strong>Background: </strong>Diastolic dysfunction (DD) of the left ventricle (LV) is common. When severe it can result in heart failure with preserved ejection fraction (HFpEF). While right ventricular (RV) dilation and dysfunction are known to occur in HFpEF, effects of lesser degrees of DD on RV size and function have not been explored.</p><p><strong>Methods: </strong>A broad sample of 370 patients (age 60±15 years, 66% female) undergoing clinically indicated echocardiography had 3-dimensional imaging of the RV. A semi-automated program was used to measure RV volumes, ejection fraction, linear dimensions and longitudinal strain. LV diastolic function was graded per the 2025 ASE algorithm and RV measurements were compared across diastolic function groups.</p><p><strong>Results: </strong>RV end-diastolic volume (RVEDV) and indexed RVEDV increased moving from normal diastolic function to grade 2/3 DD (p<0.0001). Regression analysis, controlling for age, sex, race, body surface area (BSA) and systolic pulmonary artery pressure (SPAP), found DD (diastolic dysfunction) remained significantly associated with RVEDV. RV basal and mid-cavity dimensions also increased across diastolic function groups (p = 0.0001) while RV longitudinal dimension was not associated with DD. RVEF showed a significant, graded decrease across diastolic function groups, independent of age, sex, race, BSA, and SPAP. Even comparing grade 1 DD with normal, there was a significant decrease in RVEF (p < 0.0003). Indexed left and right atrial volumes were similar when comparing normal with grade 1 DD; however, reservoir strain of each atrium was decreased with grade 1 DD.</p><p><strong>Conclusions: </strong>RVEDV and RVEF were significantly associated with LV diastolic function. Even moving from normal diastolic function to grade 1 DD was associated with a statistically significant drop in RVEF. Right and left atrial strains also decreased comparing grade 1 DD with normal diastolic function while indexed atrial volumes showed no significant change.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolving Paradigms in Quantifying Functional Tricuspid Regurgitation: The Doppler Shape Dimension","authors":"Luigi P. Badano MD, PhD ,&nbsp;Denisa Muraru MD, PhD","doi":"10.1016/j.echo.2025.07.017","DOIUrl":"10.1016/j.echo.2025.07.017","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 1","pages":"Pages 55-57"},"PeriodicalIF":6.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tricuspid Regurgitation Grading: Time to Harmonization","authors":"Julien Dreyfus MD, PhD ,&nbsp;David Messika-Zeitoun MD, PhD","doi":"10.1016/j.echo.2025.10.001","DOIUrl":"10.1016/j.echo.2025.10.001","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 1","pages":"Pages 68-70"},"PeriodicalIF":6.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Echocardiographic and Pathophysiologic Insights Into Mitral Regurgitation, Mitral Annular Disjunction, and Ventricular Arrhythmias in Patients with Mitral Valve Prolapse","authors":"Jeffrey J. Silbiger MD,&nbsp;Oksana Marchenko MD, PhD,&nbsp;Lucy Safi DO,&nbsp;Priya Panday MD","doi":"10.1016/j.echo.2025.08.014","DOIUrl":"10.1016/j.echo.2025.08.014","url":null,"abstract":"<div><div>Mitral valve prolapse affects approximately 2.5% of the population and represents the most common cause of primary mitral regurgitation. Mitral regurgitation is related to increased leaflet size, prolapse asymmetry, long clefts, calcification, and restricted leaflet motion. Chordal abnormalities, including increased length and rupture, also play a role. Mitral valve prolapse is also recognized as an important cause of ventricular arrhythmias and sudden arrhythmic death. Patients with arrhythmic mitral valve prolapse commonly exhibit an echocardiographic phenotype characterized by thick, long mitral leaflets with multisegment bileaflet prolapse and mitral annular disjunction, with or without significant mitral regurgitation. This review discusses the pathophysiology and echocardiographic features of these abnormalities.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 1","pages":"Pages 107-119"},"PeriodicalIF":6.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Flow Status on Effective Orifice Area in Transcatheter Heart Valves: A COMPARE-TAVI 1 Substudy","authors":"Lytfi Krasniqi MD ,&nbsp;Christian Juhl Terkelsen MD, DMSc, PhD ,&nbsp;Henrik Nissen MD, PhD ,&nbsp;Philip Freeman MD, PhD ,&nbsp;Christian Alcaraz Frederiksen MD, PhD ,&nbsp;Henrik Vase MD, PhD ,&nbsp;Kristian Hejlesen RN ,&nbsp;Christian Byskov Fur MD ,&nbsp;Troels Thim MD, PhD ,&nbsp;Ashkan Eftekhari MD, PhD ,&nbsp;Frederik Uttenthal MD ,&nbsp;Julia Ellert MD, PhD ,&nbsp;Nils Sofus Borg Mogensen MD, PhD ,&nbsp;Amal Haujir MD ,&nbsp;Evald Høj Christiansen MD, PhD ,&nbsp;Jordi Sanchez Dahl MD, DMSc, PhD","doi":"10.1016/j.echo.2025.09.017","DOIUrl":"10.1016/j.echo.2025.09.017","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study was to study the impact of flow status on effective orifice area (EOA) in patients treated with the balloon-expandable Myval and Sapien transcatheter heart valves (THVs).</div></div><div><h3>Methods</h3><div>We collected the core laboratory-measured EOA, mean and peak gradients, Doppler velocity index (DVI), and stroke volume index (SVi) from the 30-day echocardiograms in patients treated with the balloon-expandable Myval and Sapien THVs in the COMPARE-TAVI 1 trial. Patients were stratified according to flow into low flow (SVi &lt;35 mL/m²), normal flow (SVi 35-50 mL/m²), and high flow (SVi &gt;50 mL/m²).</div></div><div><h3>Results</h3><div>A total of 1,031 patients were included in COMPARE-TAVI 1. Myval THVs (20.0-32.0 mm) exhibited overall higher mean EOA and lower mean gradients (1.99 ± 0.55 cm², 9.46 ± 3.84 mm Hg) compared to Sapien THVs (20-29 mm; 1.81 ± 0.56 cm², 11.47 ± 4.47 mm Hg). Compared to normal-flow patients, low-flow patients exhibited smaller EOA (<em>P</em> &lt; .001) and lower DVI (<em>P</em> &lt; .001) in all valve sizes irrespective of THV platform, while high-flow patients had larger EOA (<em>P</em> &lt; .001) and higher DVI (<em>P</em> &lt; .001). Female sex was associated with lower stroke volume, resulting in lower mean and peak gradients independent of valve size and platform (<em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>The study indicates that EOA may be underestimated after TAVI in patients with low-flow status, which can impact the assessment of prosthesis-patient mismatch.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 1","pages":"Pages 80-88"},"PeriodicalIF":6.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guide for Authors","authors":"","doi":"10.1016/S0894-7317(25)00705-9","DOIUrl":"10.1016/S0894-7317(25)00705-9","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 1","pages":"Pages A9-A18"},"PeriodicalIF":6.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145852431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Clinical Significance of Non-Ebsteinoid Fetal Tricuspid Valve Regurgitation","authors":"Daniel O'Meara MD ,&nbsp;Erik C. Michelfelder MD ,&nbsp;Andrew Jergel MPH ,&nbsp;Sanghee S. Ro MD","doi":"10.1016/j.echo.2025.08.019","DOIUrl":"10.1016/j.echo.2025.08.019","url":null,"abstract":"<div><h3>Background</h3><div>Tricuspid regurgitation (TR) is commonly identified via fetal echocardiography (FE). The association of TR in the fetal heart with neonatal outcomes remains poorly understood. We aimed to assess the spectrum and evolution of non-Ebsteinoid TR in fetuses and to understand the associated clinical outcomes in the current era.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of all fetuses diagnosed with non-Ebsteinoid TR at a single center from January 1, 2012, to October 1, 2023. Eligible fetuses were divided into 3 groups based on the severity of TR on initial FE: mild, moderate, and severe. Initial and serial FE were reviewed along with postnatal echocardiographic findings. Prenatal variables and neonatal outcomes were also collected.</div></div><div><h3>Results</h3><div>A total of 67 fetuses met the inclusion criteria. Based on initial FE, 49 (73.1%) fetuses had mild TR, 15 (22.4%) had moderate TR, and 3 (4.5%) had severe TR, diagnosed at a median gestational age of 26.3 weeks [23.4, 32.3]. Of fetuses with mild TR that had worsening TR in utero (17.9%) or postnatally (17.6%), all had tricuspid valve (TV) dysplasia or right ventricle (RV) dysfunction noted prenatally. Compared to fetuses with mild TR and normal TV anatomy, fetuses with mild TR and TV dysplasia had larger TV annuli (1.12 cm vs 0.96 cm; <em>P</em> = .035) and RV internal diameter in diastole (1.59 cm vs 1.26 cm; <em>P</em> = .01). Newborns with prenatally diagnosed severe TR were more likely to require cardiac intensive care after birth (3/3 = 100%; <em>P</em> &lt; .001) than those with mild (1/49 = 2%) or moderate TR (1/15 = 6.7%).</div></div><div><h3>Conclusions</h3><div>In the absence of TV dysplasia or RV dysfunction, mild, non-Ebsteinoid fetal TR can be considered a benign finding in the current era. However, when these findings are present, or in the patient with limited imaging windows, postnatal evaluation should be performed to rule out other primary cardiac disease.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 1","pages":"Pages 89-98"},"PeriodicalIF":6.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Preoperative Cardiac Magnetic Resonance and Echocardiography with Postoperative Left Ventricular Dysfunction in Primary Mitral Regurgitation","authors":"Alexandre Altes MD ,&nbsp;Valentine Pécriaux MSc ,&nbsp;Paulin Hanvi MSc ,&nbsp;Vincent Hanet MD ,&nbsp;Inès Belhakia MD ,&nbsp;Noémie Selin MD ,&nbsp;David Vancraeynest MD, PhD ,&nbsp;Agnès Pasquet MD, PhD ,&nbsp;François Delelis MD ,&nbsp;Manuel Toledano MD ,&nbsp;Valentina Silvestri MD ,&nbsp;Bernhard L. Gerber MD, PhD ,&nbsp;Sylvestre Maréchaux MD, PhD","doi":"10.1016/j.echo.2025.09.015","DOIUrl":"10.1016/j.echo.2025.09.015","url":null,"abstract":"<div><h3>Background</h3><div>We evaluated the relationship between preoperative left ventricular (LV) structural and functional characteristics assessed by echocardiography (Echo) and cardiac magnetic resonance (CMR) and the risk of postoperative LV dysfunction in patients with primary mitral regurgitation (MR) undergoing mitral valve (MV) repair surgery.</div></div><div><h3>Methods</h3><div>We retrospectively studied 223 patients (median age, 60 years; 21% women) with chronic primary MR who underwent preoperative Echo and CMR before MV repair surgery. The primary end point was postoperative LV dysfunction, defined as LV ejection fraction (LVEF) &lt;50% on follow-up Echo.</div></div><div><h3>Results</h3><div>Postoperative LV dysfunction occurred in 41 patients (18%) after a median follow-up of 8.7 (interquartile range, 6.7-12.5) months. These patients had higher absolute and indexed (ind-) LV end-systolic diameters (LVESDs) and volumes (LVESVs; all <em>P</em> ≤ .009), lower CMR LV ejection fraction (LVEF; <em>P</em> = .003), and a trend toward lower Echo LVEF (<em>P</em> = .072). Individually, Echo and CMR parameters showed modest discriminative ability (areas under the curve from 0.59 [0.49-0.68] for Echo LVEF to 0.70 [0.61-0.78] for Echo-indLVESD). Strain imaging, whether assessed by Echo or CMR, did not improve risk stratification. Echo indLVESD and CMR LVEF were the most contributive LV characteristics. A 2-step approach based on Echo indLVESD &lt; or ≥18 mm/m², followed by CMR LVEF &gt; or ≤56% in patients with Echo indLVESD ≥18 mm/m², identified 3 subgroups with distinct rates of postoperative LV dysfunction (9%, 20%, and 41%, respectively).</div></div><div><h3>Conclusion</h3><div>In patients with primary MR undergoing MV surgery, preoperative LV characteristics assessed by Echo and CMR showed only moderate ability to identify those at higher risk of postoperative LV dysfunction. A stepwise approach using Echo indLVESD followed by CMR LVEF may help identify subgroups at differing risk levels. These exploratory findings require confirmation in larger prospective studies.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 1","pages":"Pages 28-40"},"PeriodicalIF":6.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative Doppler Shape Analysis in Functional Tricuspid Regurgitation","authors":"Arthur Iturriagagoitia MD ,&nbsp;Simon Calle MD, PhD ,&nbsp;Thomas Van Overmeiren MD ,&nbsp;Marc De Buyzere MSc ,&nbsp;Erwan Donal MD, PhD ,&nbsp;Frank Timmermans MD, PhD","doi":"10.1016/j.echo.2025.08.018","DOIUrl":"10.1016/j.echo.2025.08.018","url":null,"abstract":"<div><h3>Background</h3><div>The shape of the continuous-wave Doppler (CWD) envelope in functional tricuspid valve regurgitation (fTR) results from the dynamic interplay between flow, pressure gradient, and impedance. Although the v-wave cutoff shape in fTR is a well-recognized feature of severe tricuspid regurgitation (TR), the complete spectrum of TR CWD shapes across the different fTR severity ranges has not been thoroughly explored, which is the scope of the present study.</div></div><div><h3>Methods</h3><div>In 245 patients with fTR, TR was graded with transthoracic echocardiography using the corrected proximal isovelocity surface area method, and CWD shapes were scored, both qualitatively (using visual scoring into parabolic, triangular, or v-wave cutoff categories) and quantitatively (using a novel Vmax/Vmean parameter and time-to-peak velocity corrected for TR duration [TTP/TRD]). Linear regression analysis was performed to identify associations of Vmax/Vmean and TTP/TRD. Vmax/Vmean was categorized into tertiles to assess its association with the composite end point of death and heart failure hospitalization. Survival analysis consisted of Kaplan-Meier curves with log-rank tests and a multivariate Cox regression model.</div></div><div><h3>Results</h3><div>The Vmax/Vmean ratio as a surrogate value for fTR CWD shapes increases from a parabolic shape (1.26 ± 0.07) toward a more triangular shape without v-wave (1.32 ± 0.10) and eventually the v-wave cutoff sign (1.42 ± 0.14, <em>P</em> &lt; .001) in most severe fTR. The Vmax, effective regurgitant orifice area, and right ventricular function parameters are significantly associated with Vmax/Vmean and TTP/TRD. Vmax/Vmean is independently associated with the occurrence of the composite end point (adjusted hazard ratio = 1.32; 95% CI, 1.09-1.60 [<em>P</em> = .004], log rank <em>P</em> = .004 between the second [1.27-1.33] and third tertile [&gt;1.33]). Hierarchical Cox models show no incremental value on top of effective regurgitant orifice area (<em>P</em> = .2), whereas TTP/TRD was not associated with outcome.</div></div><div><h3>Conclusion</h3><div>Vmax/Vmean reflects the hydraulic severity of fTR and is independently associated with adverse clinical outcomes, providing a simple tool for improved risk stratification in patients with fTR.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 1","pages":"Pages 43-54"},"PeriodicalIF":6.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}