Pub Date : 2026-01-01Epub Date: 2025-12-31DOI: 10.1016/S0894-7317(25)00679-0
{"title":"Information for Readers","authors":"","doi":"10.1016/S0894-7317(25)00679-0","DOIUrl":"10.1016/S0894-7317(25)00679-0","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 1","pages":"Pages A7-A8"},"PeriodicalIF":6.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145852430","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}
Pub Date : 2026-01-01Epub Date: 2025-09-24DOI: 10.1016/j.echo.2025.09.012
Nathanael Tran MD, Shani Dahan MD, Jagdip Kang MD, Michael H. Picard MD, Jacob P. Dal-Bianco MD, Judy Hung MD
<div><h3>Background</h3><div>The clinical management and optimal timing of intervention in paradoxical low-flow, low-gradient severe aortic stenosis (PLFLG AS) is unclear. Left ventricular (LV) global longitudinal strain (GLS) has been shown to predict outcomes in high-flow severe AS, but there is a lack of data in patients with PLFLG AS. Given the exaggerated LV hypertrophy and remodeling pattern in PLFLG AS, LV GLS may be a mechanistic imaging parameter for outcomes by being a surrogate marker for subclinical myocardial fibrosis. We aimed to examine whether LV GLS in patients with PLFLG AS is associated with adverse outcomes.</div></div><div><h3>Methods</h3><div>We examined patients with PLFLG AS defined as aortic valve area <1.0 cm<sup>2</sup>, mean gradient <40 mm Hg, and preserved left ventricular ejection fraction ≥50%, with low-flow state defined as transvalvular flow rate (<em>Q</em>) ≤210 mL/sec. Exclusion criteria included moderate or greater mitral or aortic regurgitation and presence of atrial fibrillation at the time of echocardiogram. Left ventricular strain analysis was performed using two-dimensional strain imaging software. The primary outcomes were all-cause mortality censored for aortic valve replacement (AVR) and AVR via either surgical or transcatheter approach. The composite outcome was all-cause mortality and AVR. Patients were stratified by LV GLS above and below the optimal cutoff value based on spline curve analysis.</div></div><div><h3>Results</h3><div>A total of 209 patients were included in the analysis, with an optimal cutoff LV GLS of –14.6%. Over a median follow-up time of 1.2 years (interquartile range, 3.1 years), 110 deaths (52.6%) were identified. Patients with less negative LV GLS had a higher incidence of all-cause mortality than those with more negative LV GLS (82 vs 28, <em>P</em> = .014). There was no significant difference in the incidence of AVR between both groups (17 vs 27, <em>P</em> = .526). Kaplan-Meier analysis showed that patients with less negative LV GLS had a worse 5-year survival rate than those with more negative LV GLS (22% vs 48%, <em>P</em> = .003). There was no significant difference in the 5-year rate of freedom from AVR between both groups (64% vs 65%, <em>P</em> = .73). After multivariable adjustment for potential confounders (stroke volume index, aortic valve mean gradient, relative wall thickness, age, male gender, heart failure, hypertension, coronary artery disease, and diabetes), less negative LV GLS was independently associated with all-cause mortality (hazard ratio [HR] = 1.93; 95% CI [1.24-3.01]; <em>P</em> = .004), whereas hypertension was associated with improved survival (HR = 0.60; 95% CI [0.36-0.99]; <em>P</em> = .04). Continuous variable analysis demonstrated an 8% increase in the risk of all-cause mortality for every 1% less negative change in LV GLS (HR = 1.08; <em>P</em> = .005).</div></div><div><h3>Conclusions</h3><div>In patients with PLFLG AS defined by a flow
背景：矛盾型低流量、低梯度重度主动脉瓣狭窄（PLFLG AS）的临床处理和最佳干预时机尚不清楚。左心室（LV）整体纵向应变（GLS）已被证明可以预测高流量严重AS的预后，但缺乏PLFLG AS患者的数据。考虑到PLFLG AS的左室肥大和重构模式，左室GLS作为亚临床心肌纤维化的替代指标，可能是预后的一个机制成像参数。我们的目的是研究PLFLG AS患者的左室GLS是否与不良结局相关。方法：我们对主动脉瓣面积为2的PLFLG AS患者进行检查，平均梯度结果：共有209例患者纳入分析，最佳LV GLS截止值为-14.6%。中位随访时间为1.2年（四分位数间距为3.1年），共发现110例死亡（52.6%）。左室GLS阴性较少的患者的全因死亡率高于左室GLS阴性较多的患者（82 vs 28, P = 0.014）。两组AVR发生率无显著差异（17 vs 27, P = .526）。Kaplan-Meier分析显示，LV GLS阴性较少的患者的5年生存率低于LV GLS阴性较多的患者（22% vs 48%, P = 0.003）。两组患者的5年AVR自由率无显著差异（64% vs 65%, P = 0.73）。在对潜在混杂因素（脑卒中容积指数、主动脉瓣平均梯度、相对壁厚、年龄、男性、心力衰竭、高血压、冠状动脉疾病和糖尿病）进行多变量校正后，低负左室GLS与全因死亡率独立相关（风险比[HR] = 1.93; 95% CI [1.24-3.01]; P = 0.004），而高血压与生存率改善相关（风险比[HR] = 0.60; 95% CI [0.36-0.99]; P = 0.04）。连续变量分析显示，LV GLS每减少1%的负变化，全因死亡风险增加8% （HR = 1.08; P = 0.005）。结论：在流速(Q)≤210 mL/sec的PLFLG AS患者中，左室GLS降低与全因死亡率增加相关。左心室GLS可作为最佳治疗时机的影像学标记。
{"title":"Left Ventricular Global Longitudinal Strain: An Imaging Marker Associated with Outcomes in Paradoxical Low-Flow, Low-Gradient Severe Aortic Stenosis","authors":"Nathanael Tran MD, Shani Dahan MD, Jagdip Kang MD, Michael H. Picard MD, Jacob P. Dal-Bianco MD, Judy Hung MD","doi":"10.1016/j.echo.2025.09.012","DOIUrl":"10.1016/j.echo.2025.09.012","url":null,"abstract":"<div><h3>Background</h3><div>The clinical management and optimal timing of intervention in paradoxical low-flow, low-gradient severe aortic stenosis (PLFLG AS) is unclear. Left ventricular (LV) global longitudinal strain (GLS) has been shown to predict outcomes in high-flow severe AS, but there is a lack of data in patients with PLFLG AS. Given the exaggerated LV hypertrophy and remodeling pattern in PLFLG AS, LV GLS may be a mechanistic imaging parameter for outcomes by being a surrogate marker for subclinical myocardial fibrosis. We aimed to examine whether LV GLS in patients with PLFLG AS is associated with adverse outcomes.</div></div><div><h3>Methods</h3><div>We examined patients with PLFLG AS defined as aortic valve area <1.0 cm<sup>2</sup>, mean gradient <40 mm Hg, and preserved left ventricular ejection fraction ≥50%, with low-flow state defined as transvalvular flow rate (<em>Q</em>) ≤210 mL/sec. Exclusion criteria included moderate or greater mitral or aortic regurgitation and presence of atrial fibrillation at the time of echocardiogram. Left ventricular strain analysis was performed using two-dimensional strain imaging software. The primary outcomes were all-cause mortality censored for aortic valve replacement (AVR) and AVR via either surgical or transcatheter approach. The composite outcome was all-cause mortality and AVR. Patients were stratified by LV GLS above and below the optimal cutoff value based on spline curve analysis.</div></div><div><h3>Results</h3><div>A total of 209 patients were included in the analysis, with an optimal cutoff LV GLS of –14.6%. Over a median follow-up time of 1.2 years (interquartile range, 3.1 years), 110 deaths (52.6%) were identified. Patients with less negative LV GLS had a higher incidence of all-cause mortality than those with more negative LV GLS (82 vs 28, <em>P</em> = .014). There was no significant difference in the incidence of AVR between both groups (17 vs 27, <em>P</em> = .526). Kaplan-Meier analysis showed that patients with less negative LV GLS had a worse 5-year survival rate than those with more negative LV GLS (22% vs 48%, <em>P</em> = .003). There was no significant difference in the 5-year rate of freedom from AVR between both groups (64% vs 65%, <em>P</em> = .73). After multivariable adjustment for potential confounders (stroke volume index, aortic valve mean gradient, relative wall thickness, age, male gender, heart failure, hypertension, coronary artery disease, and diabetes), less negative LV GLS was independently associated with all-cause mortality (hazard ratio [HR] = 1.93; 95% CI [1.24-3.01]; <em>P</em> = .004), whereas hypertension was associated with improved survival (HR = 0.60; 95% CI [0.36-0.99]; <em>P</em> = .04). Continuous variable analysis demonstrated an 8% increase in the risk of all-cause mortality for every 1% less negative change in LV GLS (HR = 1.08; <em>P</em> = .005).</div></div><div><h3>Conclusions</h3><div>In patients with PLFLG AS defined by a flow","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 1","pages":"Pages 71-79"},"PeriodicalIF":6.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180350","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}
Severe fetal aortic stenosis (AS) has been studied extensively; however, outcomes of fetuses with mild AS are unknown. With improvements in fetal imaging, more of these patients will be identified. This is the first retrospective cohort study evaluating outcomes in mild AS on initial fetal echocardiogram.
Methods
Patients with an initial fetal echocardiogram at 4 centers between January 2009 and January 2019 with mild AS (peak aortic valve velocity > 1 m/sec, antegrade aortic arch flow, and mild or no left ventricular [LV] systolic dysfunction) were included. Fetuses with worse than mild LV hypoplasia or other heart defects were excluded. Data were collected from the initial and final fetal echocardiogram, initial postnatal echocardiogram, and echocardiogram prior to either the first aortic valve intervention or at 1 year of life. The primary outcome was aortic valve intervention at 1 year. Investigators compared echocardiographic measures for those who did and did not undergo intervention using the Wilcoxon rank-sum test.
Results
At the 4 participating centers over 10 years, there were 22 patients, with a median gestational age of 24.7 weeks (22.9, 27.3). Eight patients (36.4%) underwent a postnatal aortic valve intervention within the first year of life. Among these, 4 (50%) were considered to have critical (ductal-dependent) AS. There was a significant difference in aortic valve peak gradient between those who did and did not require an intervention on the initial fetal echocardiogram (P = .0017) and the final fetal echocardiogram (P = .0016). All patients with an aortic valve peak gradient >12.5 mm Hg on the initial fetal echocardiogram underwent intervention during the first year of life. Patients who underwent intervention also had a lower sphericity index on the initial fetal echocardiogram than those who did not (P = .045).
Conclusion
Mild fetal AS is uncommon and has variable outcomes. Approximately one-third of our cohort underwent aortic valve intervention by 1 year of life. Aortic valve peak gradient and LV sphericity index, a relatively novel marker, appear useful in identifying fetal patients that may require intervention during infancy.
{"title":"Outcomes of Fetuses with Mild Aortic Stenosis: A Multicenter Study","authors":"Koyelle Papneja MD , Wayne Tworetzky MD , Jack Rychik MD , Shobha Natarajan MD , Zhiyun Tian MD , Erin Madriago MD , Amy Zhang MPH , Meaghan Beattie MD , Doff McElhinney MD , Shiraz Arif Maskatia MD , Theresa Ann Tacy MD , Rajesh Punn MD , Michelle Kaplinski MD","doi":"10.1016/j.echo.2025.08.031","DOIUrl":"10.1016/j.echo.2025.08.031","url":null,"abstract":"<div><h3>Background</h3><div>Severe fetal aortic stenosis (AS) has been studied extensively; however, outcomes of fetuses with mild AS are unknown. With improvements in fetal imaging, more of these patients will be identified. This is the first retrospective cohort study evaluating outcomes in mild AS on initial fetal echocardiogram.</div></div><div><h3>Methods</h3><div>Patients with an initial fetal echocardiogram at 4 centers between January 2009 and January 2019 with mild AS (peak aortic valve velocity > 1 m/sec, antegrade aortic arch flow, and mild or no left ventricular [LV] systolic dysfunction) were included. Fetuses with worse than mild LV hypoplasia or other heart defects were excluded. Data were collected from the initial and final fetal echocardiogram, initial postnatal echocardiogram, and echocardiogram prior to either the first aortic valve intervention or at 1 year of life. The primary outcome was aortic valve intervention at 1 year. Investigators compared echocardiographic measures for those who did and did not undergo intervention using the Wilcoxon rank-sum test.</div></div><div><h3>Results</h3><div>At the 4 participating centers over 10 years, there were 22 patients, with a median gestational age of 24.7 weeks (22.9, 27.3). Eight patients (36.4%) underwent a postnatal aortic valve intervention within the first year of life. Among these, 4 (50%) were considered to have critical (ductal-dependent) AS. There was a significant difference in aortic valve peak gradient between those who did and did not require an intervention on the initial fetal echocardiogram (<em>P</em> = .0017) and the final fetal echocardiogram (<em>P</em> = .0016). All patients with an aortic valve peak gradient >12.5 mm Hg on the initial fetal echocardiogram underwent intervention during the first year of life. Patients who underwent intervention also had a lower sphericity index on the initial fetal echocardiogram than those who did not (<em>P</em> = .045).</div></div><div><h3>Conclusion</h3><div>Mild fetal AS is uncommon and has variable outcomes. Approximately one-third of our cohort underwent aortic valve intervention by 1 year of life. Aortic valve peak gradient and LV sphericity index, a relatively novel marker, appear useful in identifying fetal patients that may require intervention during infancy.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 1","pages":"Pages 99-106"},"PeriodicalIF":6.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208431","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}
Pub Date : 2026-01-01Epub Date: 2025-12-31DOI: 10.1016/j.echo.2025.11.004
{"title":"Continuing Education and Meeting Calendar","authors":"","doi":"10.1016/j.echo.2025.11.004","DOIUrl":"10.1016/j.echo.2025.11.004","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 1","pages":"Page A21"},"PeriodicalIF":6.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145852396","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}
Pub Date : 2026-01-01Epub Date: 2025-11-08DOI: 10.1016/j.echo.2025.11.005
Tasneem Z. Naqvi MD, MMM , Vidhu Anand MD
{"title":"Echo Combined with Cardiac Magnetic Resonance in Redefining Optimal Timing of Surgical Mitral Valve Repair: Do Conventional Criteria Endure?","authors":"Tasneem Z. Naqvi MD, MMM , Vidhu Anand MD","doi":"10.1016/j.echo.2025.11.005","DOIUrl":"10.1016/j.echo.2025.11.005","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 1","pages":"Pages 41-42"},"PeriodicalIF":6.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145490786","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}
Pub Date : 2026-01-01Epub Date: 2025-10-08DOI: 10.1016/j.echo.2025.09.018
Azin Vakilpour MD, Michael G. Levin MD, MSc, Emeka C. Anyanwu MD, MSc, Srinivas Denduluri PhD, Krishna Ravindra MD, Ellen Boakye MD, Estherland Duqueney MD, Jamey A. Cutts MD, Liam C. Giffin MD, Ian K. Weber MD, Jennifer N. Lee MD, Srinath Adusumalli MD, MSc, Juan Lopez-Mattei MD, Jesse Chittams MS, David B. Jones DNP, CRNP, BC, Kathleen Weiss BA, BS, Carlton Hartwell ACS, Michael Bolooki MD, Jamieson M. Bourque MD, MSc, Marielle Scherrer-Crosbie MD, PhD
{"title":"Surveillance Echocardiography in Severe Asymptomatic Aortic Stenosis: Guideline Adherence and Practice Patterns in a Multicenter Cohort","authors":"Azin Vakilpour MD, Michael G. Levin MD, MSc, Emeka C. Anyanwu MD, MSc, Srinivas Denduluri PhD, Krishna Ravindra MD, Ellen Boakye MD, Estherland Duqueney MD, Jamey A. Cutts MD, Liam C. Giffin MD, Ian K. Weber MD, Jennifer N. Lee MD, Srinath Adusumalli MD, MSc, Juan Lopez-Mattei MD, Jesse Chittams MS, David B. Jones DNP, CRNP, BC, Kathleen Weiss BA, BS, Carlton Hartwell ACS, Michael Bolooki MD, Jamieson M. Bourque MD, MSc, Marielle Scherrer-Crosbie MD, PhD","doi":"10.1016/j.echo.2025.09.018","DOIUrl":"10.1016/j.echo.2025.09.018","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 1","pages":"Pages 120-122"},"PeriodicalIF":6.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276373","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}
Pub Date : 2025-12-31DOI: 10.1016/j.echo.2025.12.014
Evangelos Ntalianis, Sien Keersmaekers, Everton Santana, Francois Haddad, Nicholas Cauwenberghs, Tatiana Kuznetsova
{"title":"Machine Learning-Based Clustering of Right Ventricular Free-Wall Strain Features for Cardiovascular Risk Prediction.","authors":"Evangelos Ntalianis, Sien Keersmaekers, Everton Santana, Francois Haddad, Nicholas Cauwenberghs, Tatiana Kuznetsova","doi":"10.1016/j.echo.2025.12.014","DOIUrl":"10.1016/j.echo.2025.12.014","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893392","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}
Pub Date : 2025-12-30DOI: 10.1016/j.echo.2025.12.005
Adenalva Lima de Souza Beck, Daniela do Carmo Rassi Frota, Silvio Henrique Barberato
{"title":"Practical Application of the 2025 American Society of Echocardiography Recommendations for Left Ventricular Diastolic Function Evaluation: The REAL Approach.","authors":"Adenalva Lima de Souza Beck, Daniela do Carmo Rassi Frota, Silvio Henrique Barberato","doi":"10.1016/j.echo.2025.12.005","DOIUrl":"10.1016/j.echo.2025.12.005","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890144","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}
Pub Date : 2025-12-29DOI: 10.1016/j.echo.2025.12.007
Aparna Panatpur, Donnchadh Martin O'Sullivan, Candice S Vacher, Minh B Nguyen, Tam T Doan
Left atrial strain (LAS) is a sensitive marker of early atrial dysfunction and left ventricular diastolic abnormalities in pediatric heart disease, yet clinical integration remains limited. Evidence from 57 studies (2015-2024) including >5,300 patients <21 years of age demonstrates that healthy pediatric patients have higher LAS values, particularly left atrial conduit strain, than neonates and adults. Reduced left atrial reservoir and conduit strain is consistently reported in congenital heart disease and is associated with adverse outcomes across single-ventricle palliation stages. In pediatric cardiomyopathy, LAS impairment parallels worsening diastolic function. Among heart transplant recipients, left atrial reservoir strain correlates more strongly with invasive filling pressures than conventional noninvasive metrics. LAS also predicts myocardial injury in multisystem inflammatory syndrome in children, ischemic risk in diabetes, and early left ventricular dysfunction from chemotherapy. Despite its potential for diastolic function assessment, variability in acquisition and analysis remains substantial. Standardized protocols and larger prospective studies are needed to establish normative values and define clinical thresholds.
{"title":"Left Atrial Strain in Pediatric Cardiology: Evidence to Date and Future Directions.","authors":"Aparna Panatpur, Donnchadh Martin O'Sullivan, Candice S Vacher, Minh B Nguyen, Tam T Doan","doi":"10.1016/j.echo.2025.12.007","DOIUrl":"10.1016/j.echo.2025.12.007","url":null,"abstract":"<p><p>Left atrial strain (LAS) is a sensitive marker of early atrial dysfunction and left ventricular diastolic abnormalities in pediatric heart disease, yet clinical integration remains limited. Evidence from 57 studies (2015-2024) including >5,300 patients <21 years of age demonstrates that healthy pediatric patients have higher LAS values, particularly left atrial conduit strain, than neonates and adults. Reduced left atrial reservoir and conduit strain is consistently reported in congenital heart disease and is associated with adverse outcomes across single-ventricle palliation stages. In pediatric cardiomyopathy, LAS impairment parallels worsening diastolic function. Among heart transplant recipients, left atrial reservoir strain correlates more strongly with invasive filling pressures than conventional noninvasive metrics. LAS also predicts myocardial injury in multisystem inflammatory syndrome in children, ischemic risk in diabetes, and early left ventricular dysfunction from chemotherapy. Despite its potential for diastolic function assessment, variability in acquisition and analysis remains substantial. Standardized protocols and larger prospective studies are needed to establish normative values and define clinical thresholds.</p>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879307","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}
Pub Date : 2025-12-29DOI: 10.1016/j.echo.2025.12.011
Giuseppina Novo, Cristina Madaudo, Maria Concetta Pastore, Giorgia Alberti, Giovanni Benfari, Raffaele Carluccio, Rodolfo Citro, Michele Correale, Cesare de Gregorio, Alberto Giannoni, Federico Guerra, Riccardo Maria Inciardi, Francesca Macaione, Pietro Mazzeo, Giuseppe Patti, Ciro Santoro, Paolo Sciarrone, Paolo Severino, Eugenio Stabile, Concetta Zito, Matteo Cameli
{"title":"Right Ventricular Function and Ventricular-Arterial Coupling in HFpEF and HFmrEF Treated With SGLT2 Inhibitors: A Multicenter Echocardiographic Analysis From the DISCOVER-SGLT2i Registry.","authors":"Giuseppina Novo, Cristina Madaudo, Maria Concetta Pastore, Giorgia Alberti, Giovanni Benfari, Raffaele Carluccio, Rodolfo Citro, Michele Correale, Cesare de Gregorio, Alberto Giannoni, Federico Guerra, Riccardo Maria Inciardi, Francesca Macaione, Pietro Mazzeo, Giuseppe Patti, Ciro Santoro, Paolo Sciarrone, Paolo Severino, Eugenio Stabile, Concetta Zito, Matteo Cameli","doi":"10.1016/j.echo.2025.12.011","DOIUrl":"10.1016/j.echo.2025.12.011","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879380","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}
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