Journal of the American Society of Echocardiography最新文献

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Machine Learning to Stratify Risk in Low-Gradient Aortic Stenosis Among Medicare Beneficiaries 通过机器学习对医疗保险受益人低梯度主动脉瓣狭窄的风险进行分层。

IF 5.4 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of the American Society of Echocardiography

Pub Date : 2025-02-01 DOI: 10.1016/j.echo.2024.10.010

Sean W. Dooley MD, Naveena V.K. Yanamala PhD, Nora Al-Roub MBBS, Nicholas Spetko MD, Madeline A. Cassidy BS, Constance Angell-James MPH, Partho P. Sengupta MD, Jordan B. Strom MD, MSc

引用次数: 0

Prognostic Value of Echocardiographic Coupling Metrics in Systemic Sclerosis–Associated Pulmonary Vascular Disease 系统性硬化症相关肺血管疾病超声心动图耦合指标的预后价值

IF 5.4 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of the American Society of Echocardiography

Pub Date : 2025-02-01 DOI: 10.1016/j.echo.2024.09.010

Abhishek Gami MD , Vivek P. Jani MS , Hoda Mombeini MD , Ryan Osgueritchian MD , Ilton M. Cubero Salazar MD , Matthew Kauffman MS , Catherine E. Simpson MD, MHS , Rachel L. Damico MD, PhD , Todd M. Kolb MD, PhD , Ami A. Shah MD, MHS , Stephen C. Mathai MD, MHS , Ryan J. Tedford MD , Steven Hsu MD , Paul M. Hassoun MD , Monica Mukherjee MD, MPH

Background

Ineffective right ventricular (RV) adaptation to increasing pulmonary arterial (PA) afterload in pulmonary vascular disease (PVD) significantly contributes to morbidity and mortality. Pulmonary vascular disease in systemic sclerosis (SSc) arises through various mechanisms, yet detecting abnormal contractile response remains challenging. Here we examine whether echocardiographic RV-PA coupling metrics correlate with invasive pressure-volume (PV) loops, enhancing the prediction of adverse clinical outcomes in SSc-PVD patients.

Methods

Prospectively enrolled patients with SSc-PVD with paired echocardiogram and PV loops were included. Linear regression and receiver-operating curve analysis were used to assess the relationship between tricuspid annular plane systolic excursion/PA systolic pressure (PASP), fractional area change/PASP, tissue Doppler velocityS’/PASP, and RV free wall strain (RVFWS)/PASP and coupling thresholds defined by end-systolic to end-arterial elastance (Ees/Ea), obtained by the multibeat method. The contribution of right atrial strain (RAS) to RV-PA coupling parameters was also investigated. Kaplan-Meier analysis was used to identify the relationship between coupling ratios and composite outcomes including clinical worsening, lung transplant, and death.

Results

Forty-two patients with SSc were studied, 91% female, with a mean age of 59 ± 12 years and varying degrees of PVD: mean pulmonary artery pressure 29.5 ± 12.8 mm Hg, PVR 4.7 ± 4.2 WU, and PCWP 10.3 ± 4.1 mm Hg. Echocardiographic coupling metrics including tricuspid annular plane systolic excursion/PASP, fractional area change/PASP, tissue Doppler velocity S’/PASP, RVFWS_global and RVFWS_basal/PASP, and RAS_reservoir/PASP were linearly associated with Ees/Ea. At cut points obtained through receiver-operating curve analysis, all ratios were predictive of RV-PA uncoupling, defined by Ees/Ea, and composite outcomes. Additionally, RAS_reservoir/RVFWS correlated with Ees/Ea even after adjustment for PASP, suggesting that diminished RAS further impacts RV performance and coupling.

Conclusion

Echocardiographic RV-PA coupling ratios strongly correlate with invasive Ees/Ea and predict adverse clinical outcomes in SSc patients across the spectrum of PVD. Further, we demonstrate how RAS impacts RV performance. These findings may refine risk stratification and prognostication in this at-risk cohort.

背景：在肺血管疾病（PVD）中，右心室（RV）对肺动脉（PA）后负荷增加的适应不良是导致发病率和死亡率的重要原因。系统性硬化症（SSc）中的肺血管病是通过各种机制引起的，但检测异常收缩反应仍具有挑战性。在此，我们研究了超声心动图 RV-PA 耦合指标是否与有创压力-容积（PV）环路相关，从而加强对 SSc-PVD 患者不良临床结局的预测：方法：纳入前瞻性入组的SSc-PVD患者，这些患者的超声心动图和PV环路成对。采用线性回归和接收者操作曲线（ROC）分析评估三尖瓣环面收缩期偏移（TAPSE）/PA 收缩压（PASP）、分数面积变化（FAC）/PASP、组织多普勒速度（TDI S'）/PASP、RV 游离壁应变（RVFWS）/PASP 与多搏法获得的收缩末至动脉末弹性（Ees/Ea）定义的耦合阈值之间的关系。此外，还研究了右心房应变（RAS）对 RV-PA 耦合参数的贡献。采用 Kaplan-Meier 分析确定耦合率与临床恶化、肺移植和死亡等综合结果之间的关系：42 名 SSc 患者接受了研究，他们的平均年龄为 59 ± 12 岁，91% 为女性，存在不同程度的 PVD：mPAP 29.5 ± 12.8 mmHg、PVR 4.7 ± 4.2 WU、PCWP 10.3 ± 4.1 mmHg。超声心动图耦合指标（包括 TAPSE/PASP、FAC/PASP、TDI S'/PASP、RVFWSglobal 和 RVFWSbasal/PASP、RASreservoir/PASP）与 Ees/Ea 呈线性相关。在通过 ROC 分析获得的切点上，所有比率都能预测由 Ees/Ea 定义的 RV-PA 解偶联和综合结果。此外，即使在调整 PASP 后，RASreservoir/RVFWS 仍与 Ees/Ea 相关，这表明 RAS 的减弱进一步影响了 RV 性能和耦合：结论：超声心动图 RV-PA 耦合比与有创 Ees/Ea 密切相关，可预测 SSc 患者各种心血管疾病的不良临床结局。此外，我们还证明了 RAS 对 RV 性能的影响。这些发现可能会完善这一高危人群的风险分层和预后。

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引用次数: 0

Hemodynamic Performance of the SAPIEN 3 Ultra Resilia Valve: Insights From a Propensity-Matched Analysis SAPIEN 3 Ultra Resilia 瓣膜的血液动力学性能：倾向匹配分析的启示。

IF 5.4 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of the American Society of Echocardiography

Pub Date : 2025-02-01 DOI: 10.1016/j.echo.2024.10.007

Marisa Avvedimento MD, Carlos Giuliani MD, Antonela Zanuttini MD, Siddhartha Mengi MD, Silvia Mas-Peiro MD, PhD, Anthony Poulin MD, Frederic Beaupré MD, Jean-Michel Paradis MD, Jean Porterie MD, Dimitri Kalavrouziotis MD, Eric Dumont MD, Siamak Mohammadi MD, Mélanie Côté MSc, Philippe Pibarot DVM, PhD, Josep Rodés-Cabau MD, PhD

引用次数: 0

Advancing Pediatric and Congenital Echocardiography: Priorities, Challenges, and Future Directions

IF 5.4 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of the American Society of Echocardiography

Pub Date : 2025-02-01 DOI: 10.1016/j.echo.2024.12.002

Craig E. Fleishman MD, FASE, Pei-Ni Jone MD, FASE

引用次数: 0

Left Atrial Volumetric/Mechanical Coupling Index: Best of Both Worlds? 左心房容积/机械耦合指数：两全其美？

IF 5.4 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of the American Society of Echocardiography

Pub Date : 2025-02-01 DOI: 10.1016/j.echo.2024.10.016

Tea Gegenava MD, PhD , Koen Nieman MD, PhD

引用次数: 0

Continuing Education and Meeting Calendar

IF 5.4 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of the American Society of Echocardiography

Pub Date : 2025-02-01 DOI: 10.1016/j.echo.2024.12.003

引用次数: 0

Clinical and Echocardiographic Features of Individuals With Cardiac Amyloidosis at Risk for Future Thrombus Formation 有未来血栓形成风险的心脏淀粉样变性患者的临床和超声心动图特征

IF 5.4 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of the American Society of Echocardiography

Pub Date : 2025-02-01 DOI: 10.1016/j.echo.2024.10.008

Cristiane C. Singulane MD, Jeremy A. Slivnick MD, Kenneth C. Bilchick MD, Maryam E. Neyestanak PhD, Jonathan R. Lindner MD, Mohammad Abuannadi MD, Steven T. Philips MD, Aditya M. Sharma MD, Karima Addetia MD, Nitasha Sarswat MD, Ryan R. Yang MD, Yu Wang PhD, Roberto M. Lang MD, Amit R. Patel MD

引用次数: 0

Information for Readers

IF 5.4 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of the American Society of Echocardiography

Pub Date : 2025-02-01 DOI: 10.1016/S0894-7317(25)00012-4

引用次数: 0

Guidelines for Performing Ultrasound-Guided Vascular Cannulation: Recommendations of the American Society of Echocardiography

IF 5.4 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of the American Society of Echocardiography

Pub Date : 2025-02-01 DOI: 10.1016/j.echo.2024.12.004

Annette Vegas MD, FRCPC, FASE, (Chair) , Bryan Wells MD, FASE, (Co-Chair) , Paul Braum BS, RDCS, RCS, FASE , Andre Denault MD, PhD, FASE , Wanda C. Miller Hance MD, FACC, FASE , Claire Kaufman MD , Mitalee Bremner Patel RDCS, FASE , Marcus Salvatori MD

Vascular access is a commonly performed procedure to facilitate patient care. This document provides expert consensus from diverse specialists on best practices and techniques for incorporating ultrasound (US) into vascular access procedures. This update replaces the 2011 American Society of Echocardiography guidelines for US-guided vascular cannulation. It includes recommendations for US-guided access to central and peripheral veins and arteries in adult and pediatric patients based on the strength of the scientific evidence present in the literature. The major roles of US during vascular access include (1) precannulation vessel assessment, (2) dynamic US guidance during cannulation, and (3) identification of local complications. This document discusses the general aspects of anatomic and US imaging of vessels, US-guided vascular cannulation techniques, and the identification of local vascular cannulation complications. Proper training should impart the cognitive knowledge and technical skills necessary to perform US-guided cannulation. There is an increasing body of literature indicating that US-guided vascular access improves success rates and reduces complications, although the quality of the evidence to date remains weak. A gap remains between the existing evidence and guidelines for the use of US in clinical practice. The availability of US equipment and clinical proficiency will more likely influence the role of US-guided vascular access as a standard of care than will future research studies.

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引用次数: 0

Left Atrial Function and Incident Heart Failure in Older Adults 左心房功能与老年人心力衰竭的发生。

IF 5.4 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of the American Society of Echocardiography

Pub Date : 2025-02-01 DOI: 10.1016/j.echo.2024.09.012

Carlo Mannina MD , Kazato Ito MD , Zhezhen Jin PhD , Yuriko Yoshida MD , Cesare Russo MD , Koki Nakanishi MS, MD , Tatjana Rundek MS, MD, PhD , Shunichi Homma MD , Mitchell S.V. Elkind MD, MS , Marco R. Di Tullio MD

Background

Heart failure (HF) prevalence is increasing, especially among older adults. Left atrial (LA) dysfunction is often associated with HF, but it is unclear whether it may contribute to its development. We investigated whether measures of LA function can predict the development of HF in older adults without a history of cardiovascular events.

Methods and Results

Seven hundred ninety-five participants from a triethnic (white, Black, Hispanic) community-based cohort of adults age ≥55 without a history of cardiovascular events underwent standard, three-dimensional, and speckle-tracking echocardiography. Left atrial volumes, LA strain, LA stiffness, and LA coupling index (LACI) were measured. Longitudinal follow-up was conducted, and new-onset HF was ascertained through standardized interviews, in-person visits, and active hospital surveillance of admission and discharge ICD-9 codes. Risk analysis with a cause-specific hazards regression model was used to assess the association of LA variables with incident HF, adjusting for other HF risk factors. The mean age was 70.9 ± 9.2 years (297 men, 498 women). During a mean follow-up of 11.4 years, new-onset HF occurred in 345 participants (43.4%). All measures of LA morphology and function were associated with incident HF (all P < .05). In multivariable analysis, LA stiffness and LACI (adjusted hazard ratio = 2.06; 95% CI, 1.08-3.94; adjusted hazard ratio = 1.25; 95% CI, 1.09-1.43, respectively) remained associated with incident HF. After further adjustment for left ventricular global longitudinal strain, only LACI remained associated with incident HF (adjusted hazard ratio = 1.22; 95% CI, 1.05-1.42).

Conclusions

Left atrial coupling index is a stronger independent predictor for incident HF in older adults than LA volumes and strain and may improve HF risk stratification.

背景：心力衰竭（HF）的发病率越来越高，尤其是在老年人中。左心房（LA）功能障碍通常与心力衰竭有关，但目前尚不清楚它是否会导致心力衰竭的发生。我们研究了测量 LA 功能是否能预测无心血管事件史的老年人是否会患高血压。方法和结果：来自三族（白人、黑人、西班牙裔）社区队列的 795 名年龄≥55 岁、无心血管事件史的成年人接受了标准、三维和斑点追踪超声心动图检查。测量了 LA 容量、LA 应变、LA 硬度和 LA 耦合指数 (LACI)。研究人员进行了纵向随访，并通过标准化访谈、亲自探访、医院对入院和出院 ICD-9 编码的主动监测来确定新发 HF。在调整其他心房颤动风险因素的基础上，采用病因特异性危险回归模型进行风险分析，以评估 LA 变量与心房颤动事件的相关性。平均年龄为 70.9±9.2（男性 297 人，女性 498 人）。在平均 11.4 年的随访期间，345 名参与者（43.4%）出现了新发高血压。LA形态和功能的所有指标均与新发心房颤动有关（所有p结论：与 LA 容积和应变相比，LACI 是老年人发生心房颤动的独立预测指标，可改善心房颤动风险分层。

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