Pub Date : 2026-02-01DOI: 10.1016/S0894-7317(26)00005-2
{"title":"Information for Readers","authors":"","doi":"10.1016/S0894-7317(26)00005-2","DOIUrl":"10.1016/S0894-7317(26)00005-2","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 2","pages":"Pages A10-A11"},"PeriodicalIF":6.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146098897","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 : 2026-02-01DOI: 10.1016/j.echo.2025.10.008
Derek M. Norton MD, Alejandra Iturralde Chavez MD, Ricardo H. Pignatelli MD, Lance W. Patterson BS, Christina Y. Miyake MD, MS, MPH, Tam T. Doan MD
{"title":"Diagnosing Mitral Annular Disjunction in Patients ≤21 Years in a Large Pediatric and Congenital Echocardiographic Laboratory","authors":"Derek M. Norton MD, Alejandra Iturralde Chavez MD, Ricardo H. Pignatelli MD, Lance W. Patterson BS, Christina Y. Miyake MD, MS, MPH, Tam T. Doan MD","doi":"10.1016/j.echo.2025.10.008","DOIUrl":"10.1016/j.echo.2025.10.008","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 2","pages":"Pages 225-228"},"PeriodicalIF":6.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146098842","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 : 2026-02-01DOI: 10.1016/j.echo.2025.09.004
J.Todd Belcik BS, ACS, RDCS , Aris Xie MS , Yue Qie MD , David Giraud PhD , Ruei-Jen Abraham-Fen PhD , Onur Varli MD , Jeffry Powers PhD , Jonathan R. Lindner MD
Background
Cavitation of microbubble (MB) contrast agents produces shear-mediated vasodilation and an increase in tissue perfusion. These effects are mediated through endothelial and erythrocyte shear-sensitive pathways. Our aim was to determine whether augmentation of tissue perfusion produced by cavitation is influenced by the deformability of MBs, MB charge-mediated interaction with vascular cells, or ultrasound (US) frequency, which affects MB resonance.
Methods
In mice, highly deformable lipid-stabilized decafluorobutane MBs with neutral or cationic charge, as well as less-deformable MBs (Sonazoid), were administered intravenously during proximal hind limb US (1.3 MHz, mechanical index = 1.3) for 10 minutes. In separate experiments, high-frequency US (7.0 MHz) was compared to low-frequency US. Conditional variables were compared using quantitative contrast-enhanced US perfusion imaging, and bioluminescence assays of shear-mediated adenosine triphosphate release. Beam spatial characteristics and passive cavitation detection response for each MB agent were assessed by calibrated hydrophone.
Results
Passive cavitation detection confirmed intended differences in MB deformability. Cavitation at 1.3 MHz increased perfusion in the US-exposed limb by 6- to 8-fold for highly deformable MBs. There were no differences according to MB charge despite evidence for interaction with vascular endothelial cells on intravital microscopy. Cavitation-mediated flow augmentation was lower (4-fold) for less-deformable MBs (P < .05 vs other agents). Flow augmentation was attributable to increases in microvascular flux rate (β-value). Despite producing less flow augmentation, cavitation with the less-deformable MBs produced equivalent endothelial adenosine triphosphate release. Using high-frequency US for cavitation resulted in a 60% to 70% loss of flow augmentation response.
Conclusions
Factors that affect MB resonance such as US frequency and MB deformability influence the degree of flow augmentation achieved by MB cavitation. Alteration of MB charge that enhances interaction with the endothelial cells does not influence cavitation-mediated flow augmentation.
{"title":"Influence of Microbubble Properties and Carrier Frequency on Ultrasound Cavitation-Induced Flow Augmentation","authors":"J.Todd Belcik BS, ACS, RDCS , Aris Xie MS , Yue Qie MD , David Giraud PhD , Ruei-Jen Abraham-Fen PhD , Onur Varli MD , Jeffry Powers PhD , Jonathan R. Lindner MD","doi":"10.1016/j.echo.2025.09.004","DOIUrl":"10.1016/j.echo.2025.09.004","url":null,"abstract":"<div><h3>Background</h3><div>Cavitation of microbubble (MB) contrast agents produces shear-mediated vasodilation and an increase in tissue perfusion. These effects are mediated through endothelial and erythrocyte shear-sensitive pathways. Our aim was to determine whether augmentation of tissue perfusion produced by cavitation is influenced by the deformability of MBs, MB charge-mediated interaction with vascular cells, or ultrasound (US) frequency, which affects MB resonance.</div></div><div><h3>Methods</h3><div>In mice, highly deformable lipid-stabilized decafluorobutane MBs with neutral or cationic charge, as well as less-deformable MBs (Sonazoid), were administered intravenously during proximal hind limb US (1.3 MHz, mechanical index = 1.3) for 10 minutes. In separate experiments, high-frequency US (7.0 MHz) was compared to low-frequency US. Conditional variables were compared using quantitative contrast-enhanced US perfusion imaging, and bioluminescence assays of shear-mediated adenosine triphosphate release. Beam spatial characteristics and passive cavitation detection response for each MB agent were assessed by calibrated hydrophone.</div></div><div><h3>Results</h3><div>Passive cavitation detection confirmed intended differences in MB deformability. Cavitation at 1.3 MHz increased perfusion in the US-exposed limb by 6- to 8-fold for highly deformable MBs. There were no differences according to MB charge despite evidence for interaction with vascular endothelial cells on intravital microscopy. Cavitation-mediated flow augmentation was lower (4-fold) for less-deformable MBs (<em>P</em> < .05 vs other agents). Flow augmentation was attributable to increases in microvascular flux rate (β-value). Despite producing less flow augmentation, cavitation with the less-deformable MBs produced equivalent endothelial adenosine triphosphate release. Using high-frequency US for cavitation resulted in a 60% to 70% loss of flow augmentation response.</div></div><div><h3>Conclusions</h3><div>Factors that affect MB resonance such as US frequency and MB deformability influence the degree of flow augmentation achieved by MB cavitation. Alteration of MB charge that enhances interaction with the endothelial cells does not influence cavitation-mediated flow augmentation.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 2","pages":"Pages 179-187"},"PeriodicalIF":6.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076420","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 : 2026-02-01DOI: 10.1016/j.echo.2025.08.029
Aibek E. Mirrakhimov MD
{"title":"Intraoperative Factors Should Be Considered in Assessing the Association between Three-Dimensional Right Ventricular Ejection Fraction and Early Postoperative Outcomes","authors":"Aibek E. Mirrakhimov MD","doi":"10.1016/j.echo.2025.08.029","DOIUrl":"10.1016/j.echo.2025.08.029","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 2","pages":"Page 232"},"PeriodicalIF":6.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180302","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 : 2026-02-01DOI: 10.1016/j.echo.2025.08.030
Chuanwei Zhao MS
{"title":"Optimizing Clinical Applicability of Left Atrial Strain Index in Patients with Heart Failure with Preserved Ejection Fraction","authors":"Chuanwei Zhao MS","doi":"10.1016/j.echo.2025.08.030","DOIUrl":"10.1016/j.echo.2025.08.030","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 2","pages":"Pages 230-231"},"PeriodicalIF":6.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214302","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 : 2026-02-01DOI: 10.1016/j.echo.2025.09.020
Miwa K. Geiger MD , Angela McBrien MB BCh, MD , Lisa K. Hornberger MD , Anita J. Moon-Grady MD , Nitin Madan MD , Julene S. Carvalho MD, PhD , Liat Gindes MD , Leila Rittey MBChB, MSc , Joyce T. Johnson MD, MSCI , Mary T. Donofrio MD , Sheetal Patel MD
Congenital heart defects (CHDs) are the most common lethal congenital anomalies. Fetal echocardiography is the mainstay for the diagnosis and subsequent serial assessment of fetal cardiovascular disease. Ideal timing for fetal echocardiography has traditionally been cited as between 18 and 22 weeks of gestation, although many centers now offer evaluations at 16 weeks of gestation and onward. Improved ultrasound resolution and a better understanding of early fetal cardiac development have enabled experienced specialists to diagnose major CHD as early as 11 to 15 weeks of gestation. An earlier diagnosis of CHD allows families to make time-sensitive decisions regarding the continuation of pregnancy while also providing time for additional prenatal testing and thoughtful perinatal planning. Reassuring early fetal echocardiography (eFE) can reduce anxiety in families with elevated risk for fetal CHD, such as those with a prior fetus or child with CHD. Given the benefits of early detection, the American Society of Echocardiography's 2023 Guidelines and Recommendations for Performance of the Fetal Echocardiogram included a section on eFE, which reviewed suggested elements, benefits, and limitations. However, there are challenges regarding the technical aspects of imaging a smaller heart as well as prognosticating during the late first and early second trimester. Most pediatric cardiologists have not had specific training in these skills and, therefore, often do not offer fetal echocardiography before 16 weeks of gestation. To overcome these challenges, the Program Leaders' Committee of the Fetal Heart Society developed this document, in which we review potential indications, propose an imaging protocol for early transabdominal and adjunct transvaginal (or endovaginal) fetal echocardiography, discuss unique findings in early gestation fetal heart morphology and hemodynamics, consider limitations, and discuss important aspects of patient counseling for eFE.
{"title":"Performance of Early Fetal Echocardiography: An Expert Statement from the Fetal Heart Society","authors":"Miwa K. Geiger MD , Angela McBrien MB BCh, MD , Lisa K. Hornberger MD , Anita J. Moon-Grady MD , Nitin Madan MD , Julene S. Carvalho MD, PhD , Liat Gindes MD , Leila Rittey MBChB, MSc , Joyce T. Johnson MD, MSCI , Mary T. Donofrio MD , Sheetal Patel MD","doi":"10.1016/j.echo.2025.09.020","DOIUrl":"10.1016/j.echo.2025.09.020","url":null,"abstract":"<div><div>Congenital heart defects (CHDs) are the most common lethal congenital anomalies. Fetal echocardiography is the mainstay for the diagnosis and subsequent serial assessment of fetal cardiovascular disease. Ideal timing for fetal echocardiography has traditionally been cited as between 18 and 22 weeks of gestation, although many centers now offer evaluations at 16 weeks of gestation and onward. Improved ultrasound resolution and a better understanding of early fetal cardiac development have enabled experienced specialists to diagnose major CHD as early as 11 to 15 weeks of gestation. An earlier diagnosis of CHD allows families to make time-sensitive decisions regarding the continuation of pregnancy while also providing time for additional prenatal testing and thoughtful perinatal planning. Reassuring early fetal echocardiography (eFE) can reduce anxiety in families with elevated risk for fetal CHD, such as those with a prior fetus or child with CHD. Given the benefits of early detection, the American Society of Echocardiography's 2023 <em>Guidelines and Recommendations for Performance of the Fetal Echocardiogram</em> included a section on eFE, which reviewed suggested elements, benefits, and limitations. However, there are challenges regarding the technical aspects of imaging a smaller heart as well as prognosticating during the late first and early second trimester. Most pediatric cardiologists have not had specific training in these skills and, therefore, often do not offer fetal echocardiography before 16 weeks of gestation. To overcome these challenges, the Program Leaders' Committee of the Fetal Heart Society developed this document, in which we review potential indications, propose an imaging protocol for early transabdominal and adjunct transvaginal (or endovaginal) fetal echocardiography, discuss unique findings in early gestation fetal heart morphology and hemodynamics, consider limitations, and discuss important aspects of patient counseling for eFE.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 2","pages":"Pages 188-205"},"PeriodicalIF":6.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287572","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 : 2026-02-01DOI: 10.1016/j.echo.2025.09.026
Jorge Isaac Parras PhD
{"title":"New Recommendations for the Evaluation of Diastolic Function by Echocardiography: New Questions","authors":"Jorge Isaac Parras PhD","doi":"10.1016/j.echo.2025.09.026","DOIUrl":"10.1016/j.echo.2025.09.026","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"39 2","pages":"Page 237"},"PeriodicalIF":6.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472386","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 : 2026-01-30DOI: 10.1016/j.echo.2026.01.004
Ayan R Patel, Allan L Klein, Mazen Hanna
{"title":"What's in a Name? Avoiding Misdiagnoses - The Rationale for Eliminating \"LVH\" From Echocardiography Reporting.","authors":"Ayan R Patel, Allan L Klein, Mazen Hanna","doi":"10.1016/j.echo.2026.01.004","DOIUrl":"https://doi.org/10.1016/j.echo.2026.01.004","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100757","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 : 2026-01-14DOI: 10.1016/j.echo.2025.12.016
Thomas Van Overmeiren, Simon Calle, Jan De Pooter, Frank Timmermans
{"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":"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}
Pub Date : 2026-01-02DOI: 10.1016/j.echo.2025.12.015
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
Background: Diastolic dysfunction (DD) of the left ventricle 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, the effects of lesser degrees of DD on RV size and function have not been explored.
Methods: A broad sample of 370 patients (age 60 ± 15 years, 66% female) undergoing clinically indicated echocardiography had three-dimensional imaging of the right ventricle. A semiautomated program was used to measure RV volumes, ejection fraction, linear dimensions, and longitudinal strain. Left ventricular diastolic function was graded per the 2025 American Society of Echocardiography algorithm, and RV measurements were compared across diastolic function groups.
Results: Right ventricular end-diastolic volume (RVEDV) and indexed RVEDV increased moving from normal diastolic function to grade 2/3 DD (P < .0001). Regression analysis, controlling for age, sex, race, body surface area, and systolic pulmonary artery pressure, found DD remained significantly associated with RVEDV. Right ventricular basal and midcavity dimensions also increased across diastolic function groups (P = .0001), while RV longitudinal dimension was not associated with DD. Right ventricular ejection fraction (RVEF) showed a significant, graded decrease across diastolic function groups, independent of age, sex, race, body surface area, and systolic pulmonary artery pressure. Even comparing grade 1 DD with normal, there was a significant decrease in RVEF (P < .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.
Conclusions: Right ventricular end-diastolic volume and RVEF were significantly associated with left ventricular 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 when comparing grade 1 DD with normal diastolic function, while indexed atrial volumes showed no significant change.
{"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":"10.1016/j.echo.2025.12.015","url":null,"abstract":"<p><strong>Background: </strong>Diastolic dysfunction (DD) of the left ventricle 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, the 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 three-dimensional imaging of the right ventricle. A semiautomated program was used to measure RV volumes, ejection fraction, linear dimensions, and longitudinal strain. Left ventricular diastolic function was graded per the 2025 American Society of Echocardiography algorithm, and RV measurements were compared across diastolic function groups.</p><p><strong>Results: </strong>Right ventricular end-diastolic volume (RVEDV) and indexed RVEDV increased moving from normal diastolic function to grade 2/3 DD (P < .0001). Regression analysis, controlling for age, sex, race, body surface area, and systolic pulmonary artery pressure, found DD remained significantly associated with RVEDV. Right ventricular basal and midcavity dimensions also increased across diastolic function groups (P = .0001), while RV longitudinal dimension was not associated with DD. Right ventricular ejection fraction (RVEF) showed a significant, graded decrease across diastolic function groups, independent of age, sex, race, body surface area, and systolic pulmonary artery pressure. Even comparing grade 1 DD with normal, there was a significant decrease in RVEF (P < .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>Right ventricular end-diastolic volume and RVEF were significantly associated with left ventricular 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 when 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}
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