Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques最新文献

{"title":"Functional Mitral Valve Regurgitation, Pathophysiology, Leaflet ReModeling, and the Role of Imaging","authors":"Francesco Fulvio Faletra,&nbsp;Eluisa La Franca,&nbsp;Massimiliano Mulè,&nbsp;Alessandra Carvelli,&nbsp;Francesca Parisi,&nbsp;Giovanni Di Stefano,&nbsp;Rita Laura Borrello,&nbsp;Vincenzo Nuzzi,&nbsp;Paolo Manca,&nbsp;Manlio Cipriani","doi":"10.1111/echo.70101","DOIUrl":"https://doi.org/10.1111/echo.70101","url":null,"abstract":"<p>Functional mitral regurgitation (FMR) is a complex left ventricle (LV) and left atrium (LA) disorder in which mitral valve regurgitation is just the “tip of the iceberg.” Unlike primary mitral cvalve regurgitation, in which regurgitation occurs due to anatomic abnormalities of the valve itself, the etiology of FMR is multifactorial. Regional and global LV dysfunction, extent and location of fibrotic myocardium (subendocardial/transmural scar), and annulus enlargement are the leading causes of valve regurgitation. A comprehensive understanding of the causes, mechanisms, severity, and clinical consequences of FMVR relies primarily on noninvasive imaging techniques. Echocardiography is the first-line and most commonly used imaging technique. Cardiac magnetic resonance (CMR) has gained growing consensus mainly because it can precisely identify the extent and location of fibrotic myocardium. This review aims to: (a) describe the pathophysiology of the most common phenotypes of FMR, (b) challenge the paradigm that mitral leaflets are structurally normal in FMR, and (c) illustrate the critical role of both echocardiography and CMR in the comprehensive assessment of FMR.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70101","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143489709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of Intracardiac Echocardiography-Guided Radiofrequency Catheter Ablation for Atrial Fibrillation: A Retrospective Study","authors":"Weiying Long,&nbsp;Qingsong He,&nbsp;Shi Chen,&nbsp;Xue Luo,&nbsp;Wucheng Yang,&nbsp;Jia Zheng,&nbsp;Hua Fu","doi":"10.1111/echo.70096","DOIUrl":"https://doi.org/10.1111/echo.70096","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Routine radiofrequency catheter ablation relies on x-ray imaging, which may increase the risk of radiation exposure to patients. With the rapid development of intracardiac echocardiography (ICE) technology, it provides a new guidance modality for radiofrequency catheter ablation and shows great potential for application in the treatment of atrial fibrillation (AF).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To assess the efficacy and safety of intracardiac echocardiography guided radiofrequency catheter ablation for the treatment of AF.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A retrospective cohort study was used to collect 184 patients who underwent radiofrequency catheter ablation for the treatment of AF from January 2020 to September 2021 in the cardiovascular medicine department of our hospital. According to whether they used ICE or not, they were divided into the ICE group (30 cases) and the non-ICE group (154 cases). The procedure of the intervention, complications during the intervention and follow-up periods, use of early anticoagulation and antiarrhythmic medications, and the success rate of AF ablation 1 year after the intervention were compared between the two groups.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In comparison to the non-ICE group, the septal puncture time (6.27 ± 1.91 min vs. 7.21 ± 2.08 min, &lt;i&gt;p&lt;/i&gt; = 0.022), left atrial modeling time (4.93 ± 1.84 min vs. 5.75 ± 1.96 min, &lt;i&gt;p&lt;/i&gt; = 0.035), and total ablation time (67.73 ± 2.64 min vs. 73.35 ± 1.96 min, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) in the ICE group were significantly reduced. Radiation exposure time (5.09 ± 0.23 min vs. 13.17 ± 0.28 min, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) and radiation exposure (33.13 ± 1.99 mGy/cm&lt;sup&gt;2&lt;/sup&gt; vs. 217.6 ± 15.17 mGy/cm&lt;sup&gt;2&lt;/sup&gt;, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) also were significantly less in the ICE group than in the non-ICE group. The incidence of postintervention nausea and vomiting (3.33% vs. 19.48%, &lt;i&gt;p&lt;/i&gt; = 0.032), and hypotension (3.33% vs. 18.83%, &lt;i&gt;p&lt;/i&gt; = 0.033) was significantly lower in the ICE group than in the non-ICE group. Furthermore, the proportion using amiodarone in the first 3 months during follow-up was significantly lower for the ICE group than for the non-ICE group (40.00% vs. 63.64%, &lt;i&gt;p&lt;/i&gt; = 0.024), and the rate of late recurrence remained unchanged in the ICE group, while there was a trend toward an increase in the rate of late recurrence in the non-ICE group. One year after the operation, the success rates of AF ablation in the ICE group and non-ICE group were 80.00% and 77.92%, and ","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70096","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Better Is the Enemy of Good”: The Deleterious Effects of Supra-Normal Left Ventricular Ejection Fraction","authors":"Maria Dorobanțu,&nbsp;Aura Vîjîiac","doi":"10.1111/echo.70110","DOIUrl":"https://doi.org/10.1111/echo.70110","url":null,"abstract":"&lt;p&gt;Although not recognized as a distinct clinical entity in the current guidelines [&lt;span&gt;1&lt;/span&gt;], a new phenotype of heart failure (HF), characterized by supra-normal left ventricular ejection fraction (LVEF) &gt; 65% (snLVEF), draws the attention of the scientific community in the recent years. In a large paper, Wehner et al. reported a U-shaped relationship between LVEF and all-cause mortality [&lt;span&gt;2&lt;/span&gt;], irrespective of age and other comorbidities, highlighting the fact that patients with snLVEF have an increased risk of death, which might be similar to that of patients with reduced LVEF [&lt;span&gt;2&lt;/span&gt;]. Left atrial (LA) deformation assessed by speckle-tracking echocardiography (STE) is a sensitive marker of diastolic dysfunction [&lt;span&gt;3&lt;/span&gt;] and current consensus recommendations suggest that LA reservoir strain (LARS) should be used as an additional parameter for evaluating LV filling pressures in patients with preserved LVEF [&lt;span&gt;4&lt;/span&gt;]. Moreover, LARS was recently found to be an independent predictor of mortality, stroke, and HF in patients with normal LVEF [&lt;span&gt;5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Based on this previous knowledge, in the current issue of &lt;i&gt;Echocardiography&lt;/i&gt;, Liu and colleagues [&lt;span&gt;6&lt;/span&gt;] investigated LA and LV deformation patterns in hypertensive patients with snLVEF. Their study retrospectively enrolled 101 patients with essential arterial hypertension and preserved LVEF ≥50%, who were divided into low-normal LVEF (lnLVEF; 50%–59%), mid-normal LVEF (mnLVEF; 60%–69%), and supra-normal LVEF (≥70%). Their findings showed that hypertensive patients with snLVEF had impaired LA reservoir and conduit functions with preserved pump function, while patients with lnLVEF exhibited impairment of all three LA phasic functions. The authors also found an inverted U-shaped relationship between LARS and LVEF, proving that snLVEF has a deleterious effect on LA remodeling and mechanics, potentially leading to an adverse outcome.&lt;/p&gt;&lt;p&gt;During the past years, researchers have become increasingly aware of the potential detrimental effects of snLVEF. In a population-based cohort of 486 754 individuals, a LVEF≥70% was associated with decreased survival and underdiagnosed HF [&lt;span&gt;7&lt;/span&gt;], while in women already diagnosed with HF, a snLVEF was associated with a higher risk of all-cause death, both in the acute [&lt;span&gt;8&lt;/span&gt;] and chronic setting [&lt;span&gt;9&lt;/span&gt;]. A recent study enrolling patients with transcatheter aortic valve replacement (TAVR) found that patients with LVEF&gt;65% had worse outcomes after TAVR than patients with LVEF between 50% and 65% [&lt;span&gt;10&lt;/span&gt;]. Moreover, HF with snLVEF seems to differ from HF with preserved LVEF (HFpEF) not only in terms of survival, but also of response to treatment. For example, the EMPEROR-Preserved trial proved the beneficial effects of empaglifozin in HFpEF, but these effects were not consistent in the subgroup of patients with snLVEF [&lt;span&gt;11&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;In an interesting magn","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143446689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Ventricular Outflow Indices in Chronic Systolic Heart Failure: Thresholds and Prognostic Value","authors":"Frank L. Dini,&nbsp;Valentina Barletta,&nbsp;Piercarlo Ballo,&nbsp;Giovanni Cioffi,&nbsp;Nicola Riccardo Pugliese,&nbsp;Andrea Rossi,&nbsp;Gani Bajraktari,&nbsp;Stefano Ghio,&nbsp;Michael Y. Henein","doi":"10.1111/echo.70109","DOIUrl":"https://doi.org/10.1111/echo.70109","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>The assessment of left ventricular (LV) outflow velocity time integral (LVOT-VTI) has gained favor in the stratification of patients with heart failure (HF). We evaluated the prognostic significance of LVOT-VTI compared with the commonly used indices of LV outflow: cardiac index (CI) and stroke volume index (SVI), their reproducibility and cut-off values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>A total of 424 outpatients diagnosed with HF and LV systolic dysfunction (LV ejection fraction &lt; 50%) underwent a Doppler echocardiographic examination, including the assessment of CI, SVI, and LVOT-VTI. The Bland–Altman analysis showed LVOT-VTI the most reproducible outflow index. The study follow-up duration was 3.5 years (interquartile range 1.6–6.5), at the end of which there were 94 cardiovascular deaths (29%). Cox regression univariate analysis showed that LVOT-VTI was the most predictive of the study end-point. The ratio of tricuspid annular displacement-to-pulmonary artery systolic pressure (TAPSE/PASP) (<i>p</i> &lt; 0.0001), LVOT-VTI (<i>p</i> = 0.0011), and end-systolic volume index (<i>p</i> = 0.0036) independently predicted the study end-point. At receiver-operating characteristic (ROC) analysis, LVOT-VTI &lt; 12.0 cm had the best sensitivity and specificity for predicting cardiovascular mortality. Reduced LV EF (<i>p</i> = 0.0011), raised BNP levels (<i>p</i> = 0.0053), and high LV filling pressure (<i>p</i> = 0.044) were associated with low LVOT-VTI in multivariate logistic regression analysis. Patients with low LVOT-VTI and TAPSE/PASP &lt; 0.32 mm/mmHg exhibited the worst prognosis on Kaplan–Meier survival curves (<i>p</i> &lt; 0.0001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A LVOT-VTI &lt; 12.0 cm represents the best predictor of the cardiovascular outcome and proved the most reproducible index of LV forward flow in patients with chronic HF and systolic dysfunction. The combination of impaired LVOT-VTI with TAPSE/PASP showed the worst survival.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143446688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myocardial Work and Dynamic Exercise Stress: Opening a New Window Into Diagnosis of Hypertensive Heart Disease","authors":"Elisa Gherbesi,&nbsp;Andrea Faggiano,&nbsp;Cesare Cuspidi","doi":"10.1111/echo.70112","DOIUrl":"https://doi.org/10.1111/echo.70112","url":null,"abstract":"","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143446822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CT and MR Imaging of Cardiomyopathies in Clinical Practice–An Approach After an Abnormal Echocardiogram or Electrocardiogram","authors":"Pedro Monteiro,&nbsp;Tiago Peixoto,&nbsp;Patrícia Rodrigues,&nbsp;João Gomes Carvalho","doi":"10.1111/echo.70104","DOIUrl":"https://doi.org/10.1111/echo.70104","url":null,"abstract":"<div>\u0000 \u0000 <p>Cardiomyopathies represent a diverse group of myocardial disorders characterized by structural and functional abnormalities in the absence of significant coronary artery disease or other primary causes. This review highlights the diagnostic and prognostic value of cardiac magnetic resonance and computed tomography in the assessment of cardiomyopathies. While echocardiography remains the first-line imaging modality, cardiac magnetic resonance (CMR) and cardiac computerized tomography (CCT) offer superior tissue characterization, morphological assessment, and functional evaluation, crucial for phenotyping cardiomyopathies into hypertrophic, dilated, restrictive, arrhythmogenic, and non-dilated left ventricular subtypes. For hypertrophic cardiomyopathy, CMR enables precise identification of fibrosis, hypertrophy distribution, and risk stratification for sudden cardiac death. CMR is pivotal in identifying phenocopies, like cardiac amyloidosis and Anderson–Fabry disease, and differentiating between pathological and physiological remodeling in athlete's heart. For dilated cardiomyopathy, late gadolinium enhancement, T1 mapping, and extracellular volume measurements aid in distinguishing etiologies and predicting adverse outcomes. In arrhythmogenic right ventricular cardiomyopathy, CMR demonstrates superior sensitivity for detecting structural abnormalities in the right ventricle, and the presence of fibrosis which is associated with arrhythmic risk. CCT main roles are excluding coronary artery disease and complementing CMR. This review proposes a diagnostic pathway integrating multimodality imaging for clinical management in cardiomyopathies.</p>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Value of Advanced Cardiac CTA in Clinical Assessment of Hypertrophic Cardiomyopathy: A Literature Review and Practical Implications","authors":"Rabih Touma,&nbsp;Anisha R. Pareddy,&nbsp;Aiden Abidov","doi":"10.1111/echo.70111","DOIUrl":"https://doi.org/10.1111/echo.70111","url":null,"abstract":"<div>\u0000 \u0000 <p>Hypertrophic cardiomyopathy (HCM) is a common inherited cardiac anomaly with a potentially unfavorable clinical outcome. The essential role of multimodality imaging in HCM is well recognized by major professional cardiac imaging societies and has been incorporated into the HCM clinical practice guidelines. Appropriate utilization of cardiac imaging tools is cardinal for accurate diagnosis and appropriate management for HCM patients to mitigate their lifelong risk of adverse events. Echocardiography is the imaging modality of choice for clinical diagnosis of HCM. Cardiac magnetic resonance (CMR) and coronary computed tomography angiogram (CCTA) offer complementary practical information for an inclusive evaluation in such patients. CCTA provides a thorough analysis of the cardiac anatomy and function that is paramount in HCM clinical decision-making. This review summarizes the utility of CCTA in the clinical assessment of patients with HCM. It outlines the multi-role of CCTA in HCM, including the quantification of cardiac parameters, myocardial tissue characterization, left ventricular (LV) functional analysis, the definition of cardiac and coronary arteries (CA) anatomy, and the provision of a roadmap for septal reduction therapies (SRT), mitral valve (MV) intervention, and atrial fibrillation (AF) ablation.</p>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Myocarditis and Inflammatory Cardiomyopathies: Insights From Cardiac Magnetic Resonance Findings","authors":"Francesco Lauriero,&nbsp;Camilla Vittoria Vita,&nbsp;Alessio Perazzolo,&nbsp;Giovanni Sanseverino,&nbsp;Eleonora Moliterno,&nbsp;Giuseppe Rovere,&nbsp;Riccardo Marano,&nbsp;Luigi Natale","doi":"10.1111/echo.70099","DOIUrl":"https://doi.org/10.1111/echo.70099","url":null,"abstract":"<p>Myocardial inflammation encompasses a broad spectrum of conditions, including acute myocarditis, chronic inflammatory cardiomyopathy, and several overlapping entities that differ in clinical presentation, pathophysiology, and progression. These conditions range from self-limiting acute inflammation to chronic myocardial injury and dysfunction. The etiologic classification of myocardial inflammation highlights the complexity of its pathogenesis, involving direct tissue damage, immune-mediated mechanisms, and environmental triggers. Cardiac magnetic resonance (CMR) imaging has become a central diagnostic tool in the assessment of myocardial inflammation, providing precise characterization of myocardial tissue, assessing cardiac function, and stratifying prognosis. Advanced techniques such as T1 and T2 mapping and extracellular volume quantification have further expanded its diagnostic capabilities. This review highlights the essential role of CMR in diagnosing myocardial inflammation, recognizing various imaging findings associated with different underlying causes, and informing clinical management. The standardization of CMR protocols, along with advancements in imaging techniques and strengthened interdisciplinary collaboration, represents a fundamental step toward improving diagnostic accuracy, patient outcomes, and the understanding of the broad spectrum of myocardial inflammatory diseases.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70099","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myocardial Characterization on CT: Late Iodine Enhancement and Extracellular Volume","authors":"Axel Bartoli,&nbsp;Chiara Gnasso,&nbsp;Anna Palmisano,&nbsp;Andrea Bettinelli,&nbsp;Davide Vignale,&nbsp;Antonio Esposito","doi":"10.1111/echo.70108","DOIUrl":"https://doi.org/10.1111/echo.70108","url":null,"abstract":"<div>\u0000 \u0000 <p>Myocardial tissue characterization is fundamental in diagnosing, treating, and managing various cardiac diseases. In recent years, cardiac computed tomography (CCT) emerged as a valuable alternative to cardiac magnetic resonance (CMR) for myocardial tissue characterization, with the possibility to detect myocardial scar and quantify the extracellular volume fraction in a single CT study with the advantage of combined coronary arteries evaluation, shorter scanning time, and less susceptibility to device artifacts compared to CMR. However, CCT is typically affected by a lower contrast-to-noise ratio and potentially increased radiation exposure. Therefore, a deep understanding of the available technology and the strategies for acquisition optimization is of fundamental importance to improve image quality and accuracy, while minimizing radiation exposure. This review summarizes principles of myocardial characterization on CCT, acquisition protocols according to the different technologies available including the dual-energy CT and the innovative photon-counting detector CT, and setting of clinical utility.</p>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-Operative Atrial Deformation Indices Predict Post-Operative Atrial Fibrillation in Patients Undergoing Lung Resection Surgery","authors":"Michal Schäfer,&nbsp;Nicolas Contreras,&nbsp;Satvik Ramakrishna,&nbsp;Joshua M. Zimmerman,&nbsp;Thomas K. Varghese Jr,&nbsp;Brian Mitzman","doi":"10.1111/echo.70105","DOIUrl":"https://doi.org/10.1111/echo.70105","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There are no established predictors of post-operative atrial fibrillation (POAF) in non-cardiac thoracic surgery. Pre-operative left atrial imaging has been shown to identify patients with POAF undergoing cardiac surgery. The purpose of this study was to determine whether pre-operative left atrial strain (LAS) predicts POAF in patients undergoing lung resection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>One hundred forty-nine patients who underwent cancer lung resection were retrospectively analyzed. Pre-operative imaging involved conventional transthoracic echocardiography with comprehensive speckle-tracking strain. The additional advanced LAS analysis involved three components of atrial function: reservoir, conduit, and booster.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>POAF occurred in 17 (11.4%) patients. We found no differences in demographics and peri-operative variables. Patients with POAF were more likely to have atrial fibrillation history (6.8% vs. 29.4%, <i>p</i> = 0.003). Preoperative imaging analysis revealed an increased LA volume index in patients with POAF (25.9 ± 8.8 vs. 32.3 ± 11.9 mL/m², <i>p</i> = 0.046). All three components of LAS were reduced in the POAF group. The most prominent reduction was reservoir–compliance strain (35.5% ± 4.6% vs. 24.2% ± 6.6%, <i>p</i> &lt; 0.001), then conduit strain (–18.3% ± 8.7% vs. –12.6% ± 4.7%, <i>p</i> &lt; 0.001), and booster strain (–18.3% ± 8.7% vs. –12.6% ± 4.7%, <i>p</i> &lt; 0.001). On univariable analysis, LAS reservoir strain was associated with POAF status (OR: 0.86 [95% CI: 0.78–0.92]), with a c-index of 0.81. Optimized multivariable model considering left atrial volume index, reservoir LAS, and atrial fibrillation history improved c-statistic to 0.880.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Reduced LAS metrics are more specific and sensitive than conventional demographics and standard echocardiography in predicting POAF. Preoperative LA imaging might aid with identifying patients undergoing lung resection who are high-risk and benefit from prophylactic therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143404742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}