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Dapagliflozin and Cardiac Reverse Remodeling: New Insights in the Mechanistic Puzzle of SGLT2 Inhibitors. 达格列净和心脏逆向重构:SGLT2抑制剂机制之谜的新见解。
IF 5.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-06 DOI: 10.1016/j.echo.2025.01.002
Safia Chatur, Timothy W Churchill
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引用次数: 0
Simplifying the Echocardiographic Definition of Atrial Secondary Tricuspid Regurgitation: When Less Is More.
IF 5.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-04 DOI: 10.1016/j.echo.2025.01.001
Rebecca T Hahn
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引用次数: 0
Continuing Education and Meeting Calendar
IF 5.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-01 DOI: 10.1016/j.echo.2024.11.003
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引用次数: 0
A Novel Echocardiography Feature-Tracking Algorithm for Stabilized Frame-to-Frame Extraction of Aortic Root Diameters in the Parasternal Long Axis 用于稳定提取胸骨旁长轴主动脉根直径的新型超声心动图特征追踪算法
IF 5.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-01 DOI: 10.1016/j.echo.2024.09.005
Frederick W. Damen MD, PhD, Elnaz Ghajar-Rahimi BS, Dongbing Lai PhD, Craig J. Goergen PhD, Benjamin J. Landis MD
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引用次数: 0
Mitral Leaflet Separation Revisited: A Surrogate of Mitral Valve Area in Young People With Rheumatic Mitral Regurgitation Living in Remote Areas 二尖瓣瓣叶分离再探:生活在偏远地区的风湿性二尖瓣反流年轻人二尖瓣面积的替代物。
IF 5.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-01 DOI: 10.1016/j.echo.2024.10.005
Jacqueline M. Williamson BSc, Bo Remenyi MBBS, PhD, Ari E. Horton MBBS, Peter Morris MBBS, PhD, Gillian A. Whalley PhD
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引用次数: 0
Three-Dimensional Transthoracic Echocardiography for Semiautomated Analysis of the Tricuspid Annulus: Validation and Normal Values 三维经胸超声心动图用于三尖瓣环的半自动分析:验证和正常值。
IF 5.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-01 DOI: 10.1016/j.echo.2024.09.007
Juan I. Cotella MD , Alexandra Blitz MS , Alexandra Clement MD , Michele Tomaselli MD , Denisa Muraru MD , Luigi P. Badano MD , Natascha Sauber MS , Adria Font Calvarons MS , Markus Degel MS , Agnieszka Rucki PhD , Michael Blankenhagen MS , Megan Yamat BS , Marcus Schreckenberg MS , Karima Addetia MD , Federico M. Asch MD , Victor Mor-Avi PhD , Roberto M. Lang MD

Background

The expansion of tricuspid valve (TV) interventions has underscored the need for accurate and reproducible three-dimensional (3D) transthoracic echocardiographic (TTE) tools for evaluating the tricuspid annulus and for 3D normal values of this structure. The aims of this study were to develop new semi-automated software for 3D TTE analysis of the tricuspid annulus, compare its accuracy and reproducibility against those of multiplanar reconstruction (MPR) reference, and determine normative values.

Methods

Three-dimensional TTE images of 113 patients with variable degrees of tricuspid regurgitation were analyzed using the new semiautomated software and conventional MPR methodology (as the reference standard), each by three independent readers. For each measured parameter, intertechnique agreement was assessed using linear regression and Bland-Altman analyses, and interreader variability using intraclass correlation coefficients and coefficients of variation. Additionally, 3D TTE data sets of 789 subjects from the WASE (World Alliance Societies of Echocardiography) study were analyzed using this new software to determine normal values for each tricuspid annular (TA) parameter.

Results

Semiautomated measurements showed excellent agreement with MPR reference values for all TA measurements: high correlations (all r values >0.8) and minimal biases. All measurements were more reproducible than with MPR: higher intraclass correlation coefficients (0.94-0.96 vs 0.82-0.90) and lower coefficients of variation (5%-12% vs 8%-18%). Sex- and age-related differences were identified in 3D normal values of most TA parameters. Dynamic analysis showed that TA parameters vary throughout the cardiac cycle, reaching minimal values at end-systole and maximum values in late diastole.

Conclusions

Novel software for semiautomated analysis of TA geometry and dynamics provides accurate and reproducible measurements. Normal values of TA dimensions, parsed by sex and age, are reported.
背景:随着三尖瓣(TV)介入治疗的扩大,人们更加需要准确、可重复的三维经胸超声心动图(TTE)工具来评估三尖瓣环(TA)以及该结构的三维正常值。我们的目标是:开发用于三维经胸超声心动图(TTE)分析三尖瓣环(TA)的新型半自动化软件,将其准确性和可重复性与多平面重建(MPR)参考值进行比较,并确定正常值。方法:使用新型半自动化软件和传统的 MPR 方法(作为参考标准),分别由 3 名独立读者对 113 名不同程度三尖瓣反流患者的三维经胸超声心动图图像进行分析。对于每个测量参数,采用线性回归和布兰-阿尔特曼分析评估技术间的一致性,采用类内相关(ICC)和变异系数(CoV)评估阅读器间的变异性。此外,还使用这款新软件分析了 WASE 研究中 789 名受试者的 3DTTE 数据集,以确定 TA 各参数的正常值:半自动测量结果显示,所有 TA 测量值与 MPR 参考值非常一致:相关性高(所有 r 值均大于 0.8),偏差极小。所有测量结果的可重复性均优于 MPR:ICC 值更高(0.94-0.96 vs 0.82-0.90),CoV 更低(5-12% vs 8-18%)。在大多数 TA 参数的 3D 正常值中发现了与性别和年龄相关的差异。动态分析显示,TA参数在整个心动周期中都在变化,在舒张末期达到最小值,在舒张晚期达到最大值:结论:用于对 TA 几何形状和动态进行半自动分析的新型软件可提供准确、可重复的测量结果。本文报告了按性别和年龄划分的 TA 尺寸正常值。
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引用次数: 0
Cardiac Function and Functional Capacity in Patients With Long COVID: A Comparison to Propensity-Matched Community Controls 长 COVID 患者的心功能和功能能力:与倾向匹配社区对照组的比较。
IF 5.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-01 DOI: 10.1016/j.echo.2024.09.006
Thomas H. Marwick MBBS, PhD, MPH , Noah Wexler MBBS , Joel Smith MSc , Leah Wright PhD , Felicia Ho MBBS , Marc Oreto BSc , Ashleigh-Georgia Sherriff BSc , Richard Allwood BSc , Yusuke Sata MD, PhD , Stefano Manca PhD , Erin Howden PhD , Quan Huynh PhD

Background

Cardiac impairment has been associated with acute COVID-19 since the earliest reports of the pandemic. However, its role in postacute sequelae of COVID-19 (“long COVID”) is undefined, and many existing observations about cardiovascular involvement in postacute sequelae of COVID-19 are uncontrolled.

Objective

To compare the prevalence of cardiac dysfunction in patients with long COVID and noninfected controls from the same community and explore their association with functional capacity.

Methods

Echocardiography was used to assess cardiac structure and function, including the measurement of global longitudinal strain (GLS), in 190 participants with long COVID. All underwent assessment of functional impairment by subjective (Duke Activity Status Index) and objective tests (6-minute walk test). The 190 participants from the long COVID group were matched with those from 979 patients who underwent the same tests in the pre-COVID-19 era, using a propensity score.

Results

The 190 patients with long COVID had similar age and risk factor profiles to those of their matched controls. Left ventricular dimensions and geometry, but not diastolic parameters, were significantly altered in the long COVID group. The long COVID group had subclinical systolic dysfunction (GLS 18.5% ± 2.6% vs 19.3% ± 2.7%, P = .005), and more long COVID patients had abnormal (<16%) GLS (13% vs 8%, P = .035). The association of long COVID with abnormal GLS (odds ratio, 1.49 [1.04, 2.45]) was independent of—and had a similar or greater effect size than—age and risk factors. There was no interaction of long COVID with the association of risk factors with GLS. As expected, the long COVID group had significant subjective (<85% predicted METS; 72% vs 5%, P < .001) and objective functional impairment (29% vs 24%, P = .026), but GLS was only weakly associated with both subjective (r = 0.30, P = .005) and objective (r = 0.21, P = .05) functional impairment. The presence of long COVID was independently associated with subjective (odds ratio = 159.7 [95% CI, 61.6-414.2]) and objective functional impairment (odds ratio = 2.8 [95% CI, 1.5-5.2]).

Conclusions

Impaired GLS and left ventricular dimensions are the echocardiographic features that are overrepresented in long COVID, and this association is similar to and independent of other risk factors. Impaired GLS is weakly associated with functional impairment.
背景:自最早报道 COVID-19 大流行以来,急性 COVID-19 一直与心功能损害有关。然而,它在 COVID-19 急性后遗症(PASC,或称 "长 COVID")中的作用尚未确定,而且现有的许多关于心血管受 PASC 影响的观察结果也未得到控制:比较长COVID患者和同一社区非感染对照组的心功能障碍发生率,并探讨其与功能能力的关系:方法: 采用超声心动图评估190名长COVID患者的心脏结构和功能,包括测量总体纵向应变(GLS)。所有患者都通过主观测试(杜克活动状态指数,DASI)和客观测试(6 分钟步行测试,6MWT)对功能障碍进行了评估。长COVID组的190名患者与在前COVID-19时代接受相同测试的979名患者采用倾向评分法进行了配对:结果:190 名长 COVID 患者的年龄和风险因素特征与匹配对照组相似。长COVID组患者的左心室尺寸和几何形状发生了显著变化,但舒张期参数没有变化。长COVID组存在亚临床收缩功能障碍(GLS为18.5±2.6 vs 19.3±2.7%,P=0.005),更多的长COVID患者出现异常(结论:GLS和左心室尺寸受损是导致长COVID的主要原因):GLS和左心室尺寸受损是长COVID患者高发的超声心动图特征,这种关联与其他风险因素相似,且与其他风险因素无关。GLS受损与功能障碍关系不大。
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引用次数: 0
Reduction of Coronary Flow Velocity Reserve as the Main Driver of Prognostically Beneficial Coronary Revascularization 冠状动脉血流速度储备的降低是冠状动脉血运重建预后获益的主要驱动因素。
IF 5.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-01 DOI: 10.1016/j.echo.2024.09.011
Lauro Cortigiani MD , Nicola Gaibazzi MD , Quirino Ciampi MD, PhD , Fausto Rigo MD , Domenico Tuttolomondo MD , Francesco Bovenzi MD , Dario Gregori PhD , Scipione Carerj MD , Mauro Pepi MD , Patricia A. Pellikka MD , Eugenio Picano MD, PhD , Stress Echo 2030 study group

Background

Regional wall motion abnormality (RWMA) can be absent during stress echocardiography (SE) in patients with chronic coronary syndromes (CCS) and angiographically significant coronary artery disease (CAD) despite a reduction of coronary flow velocity reserve (CFVR).

Objectives

To assess the value of a physiology-driven approach, based on CFVR, to coronary revascularization in patients with physiologically and anatomically significant disease of the left anterior descending (LAD) coronary artery.

Methods

In a 3-center, observational study with retrospective analysis of prospectively acquired data, 749 patients with CCS, CFVR of the LAD ≤2.0, and ≥50% diameter stenosis of the LAD were enrolled. All patients were evaluated with dipyridamole (0.84 mg/kg in 6’) SE. Patients were followed for 6.4 ± 4.5 years for the outcome of all-cause death.

Results

Inducible RWMA was present in 295 patients (39%). Coronary flow velocity reserve was lower in patients with inducible RWMA compared to those without (1.51 ± 0.28 vs 1.65 ± 0.25; P < .001). Coronary revascularization was performed in 514 (69%) patients (388 with percutaneous coronary intervention, 126 with coronary artery bypass surgery). Of them, 226 exhibited inducible RWMA and 288 exhibited isolated reduction of CFVR. During the follow-up, 185 (25%) deaths occurred. The 10-year survival in the entire study population was 70%. The survival at 10 years was markedly lower in conservatively treated patients compared to invasively treated patients (53 vs 76%; P < .0001), with no significant difference between those with solitary reduction of CFVR and reduction of CFVR accompanied by concurrent inducible RWMA. Propensity score–weighted all-cause mortality risk was significantly higher for conservative than for invasive strategy (propensity score adjusted hazard ratio = 2.12; 95% CI, 1.51–2.96; P < .0001).

Conclusions

In patients with CCS and physiologically and anatomically significant LAD disease, coronary revascularization driven by a reduction in CFVR is accompanied by a prognostic benefit independently of the presence of inducible RWMA.
背景:尽管冠状动脉血流速度储备(CFVR)降低,但慢性冠状动脉综合征(CCS)和血管造影显着性冠状动脉疾病(CAD)患者在负荷超声心动图(SE)检查中可能没有区域室壁运动异常(RWMA):目的:评估在左前降支(LAD)冠状动脉生理学和解剖学重大疾病患者中,基于CFVR的生理学驱动冠状动脉血运重建方法的价值:在一项由 3 个中心进行的观察性研究中,对前瞻性获得的数据进行了回顾性分析:295名患者(39%)存在诱发性RWMA。与无诱导性 RWMA 的患者相比,有诱导性 RWMA 的患者 CFVR 更低(1.51±0.28 vs 1.65±0.25;p结论:在患有慢性冠状动脉综合征并伴有生理和解剖学意义上的 LAD 病变的患者中,通过降低 CFVR 来进行冠状动脉血运重建可使预后获益,而与是否存在可诱导的 RWMA 无关。
{"title":"Reduction of Coronary Flow Velocity Reserve as the Main Driver of Prognostically Beneficial Coronary Revascularization","authors":"Lauro Cortigiani MD ,&nbsp;Nicola Gaibazzi MD ,&nbsp;Quirino Ciampi MD, PhD ,&nbsp;Fausto Rigo MD ,&nbsp;Domenico Tuttolomondo MD ,&nbsp;Francesco Bovenzi MD ,&nbsp;Dario Gregori PhD ,&nbsp;Scipione Carerj MD ,&nbsp;Mauro Pepi MD ,&nbsp;Patricia A. Pellikka MD ,&nbsp;Eugenio Picano MD, PhD ,&nbsp;Stress Echo 2030 study group","doi":"10.1016/j.echo.2024.09.011","DOIUrl":"10.1016/j.echo.2024.09.011","url":null,"abstract":"<div><h3>Background</h3><div>Regional wall motion abnormality (RWMA) can be absent during stress echocardiography (SE) in patients with chronic coronary syndromes (CCS) and angiographically significant coronary artery disease (CAD) despite a reduction of coronary flow velocity reserve (CFVR).</div></div><div><h3>Objectives</h3><div>To assess the value of a physiology-driven approach, based on CFVR, to coronary revascularization in patients with physiologically and anatomically significant disease of the left anterior descending (LAD) coronary artery.</div></div><div><h3>Methods</h3><div>In a 3-center, observational study with retrospective analysis of prospectively acquired data, 749 patients with CCS, CFVR of the LAD ≤2.0, and ≥50% diameter stenosis of the LAD were enrolled. All patients were evaluated with dipyridamole (0.84 mg/kg in 6’) SE. Patients were followed for 6.4 ± 4.5 years for the outcome of all-cause death.</div></div><div><h3>Results</h3><div>Inducible RWMA was present in 295 patients (39%). Coronary flow velocity reserve was lower in patients with inducible RWMA compared to those without (1.51 ± 0.28 vs 1.65 ± 0.25; <em>P</em> &lt; .001). Coronary revascularization was performed in 514 (69%) patients (388 with percutaneous coronary intervention, 126 with coronary artery bypass surgery). Of them, 226 exhibited inducible RWMA and 288 exhibited isolated reduction of CFVR. During the follow-up, 185 (25%) deaths occurred. The 10-year survival in the entire study population was 70%. The survival at 10 years was markedly lower in conservatively treated patients compared to invasively treated patients (53 vs 76%; <em>P</em> &lt; .0001), with no significant difference between those with solitary reduction of CFVR and reduction of CFVR accompanied by concurrent inducible RWMA. Propensity score–weighted all-cause mortality risk was significantly higher for conservative than for invasive strategy (propensity score adjusted hazard ratio = 2.12; 95% CI, 1.51–2.96; <em>P</em> &lt; .0001).</div></div><div><h3>Conclusions</h3><div>In patients with CCS and physiologically and anatomically significant LAD disease, coronary revascularization driven by a reduction in CFVR is accompanied by a prognostic benefit independently of the presence of inducible RWMA.</div></div>","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 1","pages":"Pages 24-32"},"PeriodicalIF":5.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401784","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}
引用次数: 0
The Efficacy of Goal-Directed Valsalva to Elicit Clinically Significant Gradients in Patients With Obstructive Hypertrophic Cardiomyopathy Taking Mavacamten Therapy 目标导向瓦尔萨尔瓦法在接受马伐康坦治疗的阻塞性肥厚型心肌病患者中激发临床显著梯度的效果。
IF 5.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-01 DOI: 10.1016/j.echo.2024.10.002
Cody Frye BA, ACS, RDCS, Melissa Escudero MHA, ACS, RDCS, RDMS, William Saunders PhD, MPH, Olafunke Ajijola PharmD, CPP, George Mawardi MD, Shuktika Nandkeolyar MD, Noreen Kelly MD, MBA, Dermot Phelan MD, PhD
{"title":"The Efficacy of Goal-Directed Valsalva to Elicit Clinically Significant Gradients in Patients With Obstructive Hypertrophic Cardiomyopathy Taking Mavacamten Therapy","authors":"Cody Frye BA, ACS, RDCS,&nbsp;Melissa Escudero MHA, ACS, RDCS, RDMS,&nbsp;William Saunders PhD, MPH,&nbsp;Olafunke Ajijola PharmD, CPP,&nbsp;George Mawardi MD,&nbsp;Shuktika Nandkeolyar MD,&nbsp;Noreen Kelly MD, MBA,&nbsp;Dermot Phelan MD, PhD","doi":"10.1016/j.echo.2024.10.002","DOIUrl":"10.1016/j.echo.2024.10.002","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 1","pages":"Pages 51-52"},"PeriodicalIF":5.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479305","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}
引用次数: 0
Reply to “Dobutamine in Low-Flow, Low-Gradient Severe Aortic Stenosis With Preserved Ejection Fraction: Is Exercise Testing the Key?” 多巴酚丁胺治疗射血分数保留的低流量、低梯度重度主动脉瓣狭窄:运动测试是关键吗?- 作者回复。
IF 5.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2025-01-01 DOI: 10.1016/j.echo.2024.10.013
Nils Sofus Borg Mogensen MD, Mulham Ali MD, Rasmus Carter-Storch MD, PhD, Mohamed-Salah Annabi MD, Jasmine Grenier-Delaney MD, Jacob Eifer Møller MD, PhD, DMSCi, Kristian Altern Øvrehus MD, PhD, Patricia A. Pellikka MD, Philippe Pibarot DVM, PhD, Marie-Annick Clavel DVM, PhD, Jordi Sanchez Dahl MD, PhD, DMSCi
{"title":"Reply to “Dobutamine in Low-Flow, Low-Gradient Severe Aortic Stenosis With Preserved Ejection Fraction: Is Exercise Testing the Key?”","authors":"Nils Sofus Borg Mogensen MD,&nbsp;Mulham Ali MD,&nbsp;Rasmus Carter-Storch MD, PhD,&nbsp;Mohamed-Salah Annabi MD,&nbsp;Jasmine Grenier-Delaney MD,&nbsp;Jacob Eifer Møller MD, PhD, DMSCi,&nbsp;Kristian Altern Øvrehus MD, PhD,&nbsp;Patricia A. Pellikka MD,&nbsp;Philippe Pibarot DVM, PhD,&nbsp;Marie-Annick Clavel DVM, PhD,&nbsp;Jordi Sanchez Dahl MD, PhD, DMSCi","doi":"10.1016/j.echo.2024.10.013","DOIUrl":"10.1016/j.echo.2024.10.013","url":null,"abstract":"","PeriodicalId":50011,"journal":{"name":"Journal of the American Society of Echocardiography","volume":"38 1","pages":"Pages 55-56"},"PeriodicalIF":5.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591304","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}
引用次数: 0
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Journal of the American Society of Echocardiography
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