Andrea Milzi, Antonio Landi, Rosalia Dettori, Kathrin Burgmaier, Sebastian Reith, Mathias Burgmaier
Vulnerable coronary plaques are atherosclerotic lesions which, due to their specific phenotype, are prone to plaque rupture and to cause acute coronary syndromes, with subsequent relevant morbidity and mortality. Strategies to break the chain link between plaque vulnerability and adverse clinical events include optimized pharmacologic prevention and potentially also preemptive percutaneous coronary interventions (previously defined as "plaque sealing" or "plaque passivation"). Various morphologic features of the vulnerable plaques have been described, including aspects regarding the large necrotic lipid content, the thin fibrous cap, the presence and extent of the presence of calcifications with small size and calcification angle, and as well as the large macrophage infiltration within the plaque. The detection of these features of plaque vulnerability is possible with intravascular imaging modalities such as intravascular ultrasound (IVUS), near-infrared spectroscopy (NIRS), and optical coherence tomography (OCT). This review explores the peculiarities of these three imaging modalities for the detection of vulnerable coronary plaque features.
{"title":"Multimodal Intravascular Imaging of the Vulnerable Coronary Plaque.","authors":"Andrea Milzi, Antonio Landi, Rosalia Dettori, Kathrin Burgmaier, Sebastian Reith, Mathias Burgmaier","doi":"10.1111/echo.70035","DOIUrl":"https://doi.org/10.1111/echo.70035","url":null,"abstract":"<p><p>Vulnerable coronary plaques are atherosclerotic lesions which, due to their specific phenotype, are prone to plaque rupture and to cause acute coronary syndromes, with subsequent relevant morbidity and mortality. Strategies to break the chain link between plaque vulnerability and adverse clinical events include optimized pharmacologic prevention and potentially also preemptive percutaneous coronary interventions (previously defined as \"plaque sealing\" or \"plaque passivation\"). Various morphologic features of the vulnerable plaques have been described, including aspects regarding the large necrotic lipid content, the thin fibrous cap, the presence and extent of the presence of calcifications with small size and calcification angle, and as well as the large macrophage infiltration within the plaque. The detection of these features of plaque vulnerability is possible with intravascular imaging modalities such as intravascular ultrasound (IVUS), near-infrared spectroscopy (NIRS), and optical coherence tomography (OCT). This review explores the peculiarities of these three imaging modalities for the detection of vulnerable coronary plaque features.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 12","pages":"e70035"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689502","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}
All structural and functional alterations the heart experiences due to intense sports training are collectively called the “athlete's heart” (AH). One of the main diagnostic dilemmas of today's sports cardiology is the so-called “gray zone”—the structural and functional overlap between the physiological adaptation of the AH and the pathological process of cardiomyopathy. The importance of accurate differentiation between these two entities cannot be highlighted enough—it is estimated that half of the cases of sudden cardiac death in young athletes aged 19–29 are caused by cardiomyopathies, primarily hypertrophic cardiomyopathy (HCM). In the last few years, cardiac magnetic resonance imaging (MRI) has positioned itself as the gold standard for diagnosing structural heart disease, emphasizing the role of the cardiac imaging expert. This brief literature review provides the cardiac MRI findings and techniques that aid in distinguishing the AH from the most common cardiomyopathy—HCM. We will discuss the contributions, as well as current challenges and limitations of each technique, hoping to assist imaging experts and clinicians in solving one of the biggest dilemmas of sports cardiology.
{"title":"The Role of Cardiac Magnetic Resonance Imaging in Distinguishing the Athlete's Heart From Hypertrophic Cardiomyopathy–A Brief Literature Review","authors":"Sanda Kolenda Zloić, Maja Hrabak-Paar","doi":"10.1111/echo.70021","DOIUrl":"10.1111/echo.70021","url":null,"abstract":"<div>\u0000 \u0000 <p>All structural and functional alterations the heart experiences due to intense sports training are collectively called the “athlete's heart” (AH). One of the main diagnostic dilemmas of today's sports cardiology is the so-called “gray zone”—the structural and functional overlap between the physiological adaptation of the AH and the pathological process of cardiomyopathy. The importance of accurate differentiation between these two entities cannot be highlighted enough—it is estimated that half of the cases of sudden cardiac death in young athletes aged 19–29 are caused by cardiomyopathies, primarily hypertrophic cardiomyopathy (HCM). In the last few years, cardiac magnetic resonance imaging (MRI) has positioned itself as the gold standard for diagnosing structural heart disease, emphasizing the role of the cardiac imaging expert. This brief literature review provides the cardiac MRI findings and techniques that aid in distinguishing the AH from the most common cardiomyopathy—HCM. We will discuss the contributions, as well as current challenges and limitations of each technique, hoping to assist imaging experts and clinicians in solving one of the biggest dilemmas of sports cardiology.</p>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 11","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548735","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":"The Role of Three-Dimensional Echocardiography in Defining Right Atrial Size and Function in Pediatric Populations","authors":"Ilker Ufuk Sayici","doi":"10.1111/echo.70019","DOIUrl":"10.1111/echo.70019","url":null,"abstract":"","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 11","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548736","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}
Dario Donia, Kamil Stankowski, Federica Testerini, Martina Ruffo, Lorenzo Cambini, Silvana Di Maio, Riccardo Mantovani, Carlo A. Pivato, Carlo M. Dellino, Giulio G. Stefanini, Renato Maria Bragato, Gianluigi Condorelli, Stefano Figliozzi
Purpose
Mitral valve prolapse (MVP) has been associated with left heart remodeling. This study explored cardiac remodeling in patients with MVP without significant regurgitation, focusing on the right heart.
Methods
This single-center study enrolled consecutive patients referred to trans-thoracic-echocardiography (TTE) with MVP, excluding those with significant regurgitation or known cardiovascular or pulmonary diseases. A group of healthy controls was included.
Results
Forty-nine patients with MVP and 54 controls were finally selected (mean age of 62, 52–71; 52% males), and echocardiographic parameters were compared among groups. Twenty-nine (41%) patients with MVP showed tricuspid valve prolapse (TVP). Patients with MVP, irrespective of TVP, showed greater tricuspid annulus (systolic annulus: 31±6 vs. 32±5 vs. 27±3 mm for MVP+/TVP−, MVP+/TVP+, and controls, respectively; all p < 0.01) and greater minimum right atrial volume indexed (13, 12–15 mL/m2 vs. 15, 12–20 mL/m2 vs. 11, 10–14 mL/m2; all p < 0.05). Right ventricular dimensions and systolic indexes did not differ among groups, except TAPSE, which was significantly greater in MVP+/TVP+ patients compared to controls (25±4 vs. 22±3 mm, p = 0.004). A significant correlation (ρ = 0.43; p < 0.001) and an independent association at multivariate analysis (ß = 0.28; 95% CI 0.09–0.47; p = 0.004) were observed between end-systolic tricuspid diameter and TAPSE.
Conclusion
In patients with MVP with less-than-moderate mitral or tricuspid regurgitation, dilation of the right atrium and tricuspid annulus was found. The latter finding was associated with increased values of TAPSE, which should then be used with caution, while other indexes may be preferred when assessing the systolic function of these patients.
目的：二尖瓣脱垂（MVP）与左心重塑有关。本研究探讨了无明显反流的二尖瓣脱垂患者的心脏重塑情况，重点关注右心：这项单中心研究招募了连续接受经胸超声心动图（TTE）检查的 MVP 患者，排除了有明显反流或已知心血管或肺部疾病的患者。结果：最终选出 49 名 MVP 患者和 54 名对照组患者（平均年龄 62 岁，52-71 岁；52% 为男性），并比较了各组的超声心动图参数。29 名 MVP 患者（41%）显示三尖瓣脱垂（TVP）。MVP 患者，无论 TVP 与否，三尖瓣环均较大（MVP+/TVP-、MVP+/TVP+ 和对照组的收缩期三尖瓣环分别为 31±6 vs. 32±5 vs. 27±3 mm；均 p <0.01），右心房最小容积指数较大（13、12-15 mL/m2 vs. 15、12-20 mL/m2 vs. 11、10-14 mL/m2；均 p <0.05）。除 TAPSE 外，各组间的右心室尺寸和收缩指数没有差异，MVP+/TVP+ 患者的 TAPSE 明显高于对照组（25±4 mm vs. 22±3 mm，P = 0.004）。收缩末期三尖瓣直径与 TAPSE 之间存在明显的相关性（ρ = 0.43; p < 0.001），并且在多变量分析中存在独立的关联性（ß = 0.28; 95% CI 0.09-0.47; p = 0.004）：结论：在二尖瓣或三尖瓣反流不严重的 MVP 患者中，发现右心房和三尖瓣环扩张。结论：在二尖瓣或三尖瓣反流不太严重的 MVP 患者中，发现右心房和三尖瓣环扩张，后一发现与 TAPSE 值升高有关，因此在评估这些患者的收缩功能时，应谨慎使用 TAPSE，而首选其他指标。
{"title":"Early Right Heart Remodeling in Patients With Mitral Valve Prolapse","authors":"Dario Donia, Kamil Stankowski, Federica Testerini, Martina Ruffo, Lorenzo Cambini, Silvana Di Maio, Riccardo Mantovani, Carlo A. Pivato, Carlo M. Dellino, Giulio G. Stefanini, Renato Maria Bragato, Gianluigi Condorelli, Stefano Figliozzi","doi":"10.1111/echo.70017","DOIUrl":"10.1111/echo.70017","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Mitral valve prolapse (MVP) has been associated with left heart remodeling. This study explored cardiac remodeling in patients with MVP without significant regurgitation, focusing on the right heart.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center study enrolled consecutive patients referred to trans-thoracic-echocardiography (TTE) with MVP, excluding those with significant regurgitation or known cardiovascular or pulmonary diseases. A group of healthy controls was included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-nine patients with MVP and 54 controls were finally selected (mean age of 62, 52–71; 52% males), and echocardiographic parameters were compared among groups. Twenty-nine (41%) patients with MVP showed tricuspid valve prolapse (TVP). Patients with MVP, irrespective of TVP, showed greater tricuspid annulus (systolic annulus: 31±6 vs. 32±5 vs. 27±3 mm for MVP<sup>+</sup>/TVP<sup>−</sup>, MVP<sup>+</sup>/TVP<sup>+</sup>, and controls, respectively; all <i>p</i> < 0.01) and greater minimum right atrial volume indexed (13, 12–15 mL/m<sup>2</sup> vs. 15, 12–20 mL/m<sup>2</sup> vs. 11, 10–14 mL/m<sup>2</sup>; all <i>p</i> < 0.05). Right ventricular dimensions and systolic indexes did not differ among groups, except TAPSE, which was significantly greater in MVP<sup>+</sup>/TVP<sup>+</sup> patients compared to controls (25±4 vs. 22±3 mm, <i>p</i> = 0.004). A significant correlation (<i>ρ</i> = 0.43; <i>p</i> < 0.001) and an independent association at multivariate analysis (<i>ß</i> = 0.28; 95% CI 0.09–0.47; <i>p</i> = 0.004) were observed between end-systolic tricuspid diameter and TAPSE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In patients with MVP with less-than-moderate mitral or tricuspid regurgitation, dilation of the right atrium and tricuspid annulus was found. The latter finding was associated with increased values of TAPSE, which should then be used with caution, while other indexes may be preferred when assessing the systolic function of these patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 11","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548734","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}
Atrial septal defect (ASD) is a prevalent congenital heart condition in adults, which finally leads to pulmonary hypertension and right heart failure if left untreated. Right heart catheterization (RHC), the current gold standard for determining ASD closure feasibility, is invasive. Thus, a noninvasive prescreening tool is urgently needed.
Methods and Results
In a multicenter, retrospective study, we assessed 924 ASD patients (2012–2022) to determine their suitability for ASD closure. Using LASSO regression, we identified predictors for a correctable shunt, enabling us to create the ASD model. The ASD model, comprising of estimated pulmonary artery systolic pressure (ePASP), peak velocity through the pulmonary valve (PV), peak E-wave velocity through the tricuspid valve (TVE), and right atrial longitudinal dimension (RA) by echocardiography, was constructed and exhibited favorable discriminative capability with an area under the curve (AUC) of 0.941 (95% CI: 0.920–0.961) in the derivation group. The model also demonstrated good calibration and discriminative abilities in the validation cohort. When juxtaposed with the earlier congenital heart disease (CHD) model, the newly developed ASD model demonstrated superior predictive capabilities for correctable shunt, supported by the net reclassification index (NRI) [0.063 (95% CI: 0.001–0.127, p = 0.047)] and integrated discrimination improvement (IDI) [0.023 (95% CI: 0.011–0.036, p < 0.001)].
Conclusion
In summary, our research advocates the ASD model as a superior tool for screening suitable ASD defect closure candidates.
{"title":"Echocardiographic Screening Model for Improved Assessment of Atrial Septal Defect Closure: A Multicenter Retrospective Study","authors":"Hezhi Li, Zehan Huang, Gangcheng Zhang, Qunshan Shen, Hongwen Fei, Dongling Luo, Ziyang Yang, Bin Zhang, Caojin Zhang","doi":"10.1111/echo.70023","DOIUrl":"10.1111/echo.70023","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Atrial septal defect (ASD) is a prevalent congenital heart condition in adults, which finally leads to pulmonary hypertension and right heart failure if left untreated. Right heart catheterization (RHC), the current gold standard for determining ASD closure feasibility, is invasive. Thus, a noninvasive prescreening tool is urgently needed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>In a multicenter, retrospective study, we assessed 924 ASD patients (2012–2022) to determine their suitability for ASD closure. Using LASSO regression, we identified predictors for a correctable shunt, enabling us to create the ASD model. The ASD model, comprising of estimated pulmonary artery systolic pressure (ePASP), peak velocity through the pulmonary valve (PV), peak E-wave velocity through the tricuspid valve (TVE), and right atrial longitudinal dimension (RA) by echocardiography, was constructed and exhibited favorable discriminative capability with an area under the curve (AUC) of 0.941 (95% CI: 0.920–0.961) in the derivation group. The model also demonstrated good calibration and discriminative abilities in the validation cohort. When juxtaposed with the earlier congenital heart disease (CHD) model, the newly developed ASD model demonstrated superior predictive capabilities for correctable shunt, supported by the net reclassification index (NRI) [0.063 (95% CI: 0.001–0.127, <i>p</i> = 0.047)] and integrated discrimination improvement (IDI) [0.023 (95% CI: 0.011–0.036, <i>p</i> < 0.001)].</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In summary, our research advocates the ASD model as a superior tool for screening suitable ASD defect closure candidates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 11","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523508","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}
This study aimed to assess alterations in right ventricular (RV) function following percutaneous coronary intervention (PCI) in patients with chronic coronary syndromes utilizing three-dimensional speckle tracking echocardiography (3D-STE).
Methods
A prospective study was conducted involving 136 patients diagnosed with chronic coronary syndromes undergoing PCI, constituting the study group, alongside 110 age- and gender-matched healthy volunteers serving as the control group. Echocardiographic evaluations, including both conventional and three-dimensional assessments, were performed on all study participants at 1-week, 6, and 12 months post-PCI. Parameters such as tricuspid annular plane systolic excursion (TAPSE) were derived from conventional echocardiography, while tricuspid lateral annular systolic velocity (S') was measured via tissue Doppler imaging. 3D-STE was utilized to quantify metrics including right ventricular fractional area change (RVFAC), right ventricular free wall longitudinal strain (RVFWLS), right ventricular global longitudinal strain (RVGLS), right ventricular stroke volume (RVSV), and right ventricular ejection fraction (RVEF).
Results
TAPSE, S', RVFAC, RVFWLS, RVGLS, RVSV, and RVEF exhibited significant increases from 1-week to 6 months post-PCI (p < 0.05). However, from 6 to 12 months post-PCI, RVFAC, RVGLS, RVSV, and RVEF demonstrated no notable changes (p > 0.05). Meanwhile, TAPSE, S', and RVFWLS sustained significant elevations: TAPSE (19.63 ± 3.253% to 22.603 ± 2.885%, p < 0.001); S' (10.57 ± 2.643 to 12.61 ± 2.189 cm/s, p < 0.001); RVFWLS (18.64 ± 2.745% to 19.926 ± 3.291%, p = 0.002). At 12 months post-PCI, S', RVFAC, RVGLS, RVSV, and RVEF remained lower than those of the healthy control group, but the differences were not statistically significant (p > 0.05). However, RVFWLS was significantly lower compared to the healthy control group (19.926 ± 3.291% vs. 22.10 ± 1.994%, p < 0.001).
Conclusion
Following PCI, right ventricular systolic function in patients with chronic coronary syndromes improves significantly over time. However, even at the 12-month post-PCI mark, RVFWLS remains lower than that of the control group. Notably, 3D-STE emerges as a noninvasive method for quantifying right ventricular systolic function post-PCI in chronic coronary syndrome patients.
{"title":"Three-Dimensional Speckle Tracking Echocardiography Assessment of Right Ventricular Function in Chronic Coronary Syndrome Patients After Percutaneous Coronary Intervention","authors":"WenShu Hu, Chang Zhou, Heng Sun","doi":"10.1111/echo.70020","DOIUrl":"10.1111/echo.70020","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to assess alterations in right ventricular (RV) function following percutaneous coronary intervention (PCI) in patients with chronic coronary syndromes utilizing three-dimensional speckle tracking echocardiography (3D-STE).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective study was conducted involving 136 patients diagnosed with chronic coronary syndromes undergoing PCI, constituting the study group, alongside 110 age- and gender-matched healthy volunteers serving as the control group. Echocardiographic evaluations, including both conventional and three-dimensional assessments, were performed on all study participants at 1-week, 6, and 12 months post-PCI. Parameters such as tricuspid annular plane systolic excursion (TAPSE) were derived from conventional echocardiography, while tricuspid lateral annular systolic velocity (S') was measured via tissue Doppler imaging. 3D-STE was utilized to quantify metrics including right ventricular fractional area change (RVFAC), right ventricular free wall longitudinal strain (RVFWLS), right ventricular global longitudinal strain (RVGLS), right ventricular stroke volume (RVSV), and right ventricular ejection fraction (RVEF).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>TAPSE, S', RVFAC, RVFWLS, RVGLS, RVSV, and RVEF exhibited significant increases from 1-week to 6 months post-PCI (<i>p</i> < 0.05). However, from 6 to 12 months post-PCI, RVFAC, RVGLS, RVSV, and RVEF demonstrated no notable changes (<i>p</i> > 0.05). Meanwhile, TAPSE, S', and RVFWLS sustained significant elevations: TAPSE (19.63 ± 3.253% to 22.603 ± 2.885%, <i>p</i> < 0.001); S' (10.57 ± 2.643 to 12.61 ± 2.189 cm/s, <i>p</i> < 0.001); RVFWLS (18.64 ± 2.745% to 19.926 ± 3.291%, <i>p</i> = 0.002). At 12 months post-PCI, S', RVFAC, RVGLS, RVSV, and RVEF remained lower than those of the healthy control group, but the differences were not statistically significant (<i>p</i> > 0.05). However, RVFWLS was significantly lower compared to the healthy control group (19.926 ± 3.291% vs. 22.10 ± 1.994%, <i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Following PCI, right ventricular systolic function in patients with chronic coronary syndromes improves significantly over time. However, even at the 12-month post-PCI mark, RVFWLS remains lower than that of the control group. Notably, 3D-STE emerges as a noninvasive method for quantifying right ventricular systolic function post-PCI in chronic coronary syndrome patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 11","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523510","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}
Cardiovascular magnetic resonance imaging (MRI) in patients with cardiac implants, such as pacemakers and defibrillators, has gained importance in recent years with the development of modern cardiac implantable electronic devices. The increasing clinical need to perform MRI examinations in patients with cardiac implants has driven the development of new advanced MRI sequences to mitigate image artifacts associated with cardiac implants. More specifically, advances in imaging techniques, such as wideband late gadolinium enhancement imaging, wideband T1 mapping, and wideband perfusion, have been designed to improve image quality and examinations in patients with cardiac implants, enabling a comprehensive and more reliable diagnosis, which was previously unattainable in these patients. This review article explores recent developments and applications of wideband techniques in the field of cardiovascular MRI, offering insights into their transformative potential. Clinical applications of wideband cardiovascular MRI are highlighted, particularly in assessing myocardial viability, guiding ventricular tachycardia ablation, and characterizing myocardial tissue.
{"title":"Magnetic Resonance Myocardial Imaging in Patients With Implantable Cardiac Devices: Challenges, Techniques, and Clinical Applications","authors":"Pauline Gut, Hubert Cochet, Matthias Stuber, Aurélien Bustin","doi":"10.1111/echo.70012","DOIUrl":"10.1111/echo.70012","url":null,"abstract":"<p>Cardiovascular magnetic resonance imaging (MRI) in patients with cardiac implants, such as pacemakers and defibrillators, has gained importance in recent years with the development of modern cardiac implantable electronic devices. The increasing clinical need to perform MRI examinations in patients with cardiac implants has driven the development of new advanced MRI sequences to mitigate image artifacts associated with cardiac implants. More specifically, advances in imaging techniques, such as wideband late gadolinium enhancement imaging, wideband T1 mapping, and wideband perfusion, have been designed to improve image quality and examinations in patients with cardiac implants, enabling a comprehensive and more reliable diagnosis, which was previously unattainable in these patients. This review article explores recent developments and applications of wideband techniques in the field of cardiovascular MRI, offering insights into their transformative potential. Clinical applications of wideband cardiovascular MRI are highlighted, particularly in assessing myocardial viability, guiding ventricular tachycardia ablation, and characterizing myocardial tissue.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 11","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523509","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}
Christos G. Mihos, Sarah A. Guigui, Sofia A. Horvath, Pranav Venkataraman, Rafle Fernandez, Tarec K. Elajami
Background
Left ventricular (LV) apical aneurysms (ApAn+) occur in 10%–15% of apical hypertrophic cardiomyopathy (ApHCM) patients and confer considerable morbidity. We hypothesized that ApAn+ adversely impact ventricular mechanics and mechano-energetic coupling in ApHCM.
Methods
Ninety-eight ApHCM patients were identified, of which nine (9%) had ApAn+ and were compared with 89 (91%) who did not (ApAn−). 2D speckle-tracking echocardiography assessed ventricular mechanics using LV global longitudinal strain (GLS) and torsion, and mechano-energetic coupling as myocardial work indices. Clinical events over follow-up were adjudicated.
Results
Mean age was 64 ± 15 years, 46% were female, and 3% had an HCM family history, with similar clinical risk factors between groups. Of the nine ApAn+ patients, there were six small (<2 cm) and three moderate-sized (2-4 cm) aneurysms. There was no difference in LV ejection fraction (65 ± 15 vs. 67 ± 11%, p = 0.51) or GLS (−9.6 ± 3.3 vs. −11.9 ± 3.9%, p = 0.09) between ApAn+ versus ApAn−. ApAn+ patients had greater myocardial global wasted work (347 ± 112 vs. 221 ± 165 mmHg%, p = 0.03) and lower global work efficiency (GWE, 75 ± 5 vs. 82 ± 8%, p = 0.006). LV GLS (β = −0.67, p < 0.001), ApAn+ (β = −0.15, p = 0.04), and twist rate (β = −0.14, p = 0.04) were independently associated with GWE. At 3.9-year follow-up, cardiovascular mortality (4%) and heart failure hospitalization (14%) events were similar between groups.
Conclusion
ApHCM patients with ApAn+ are characterized by more impaired LV mechano-energetic coupling when compared with ApAn−. ApAn+ is independently associated with worse GWE.
{"title":"Presence of Apical Aneurysm and Its Impact on Left Ventricular Mechanics and Mechano-Energetic Coupling in Patients With Apical Hypertrophic Cardiomyopathy","authors":"Christos G. Mihos, Sarah A. Guigui, Sofia A. Horvath, Pranav Venkataraman, Rafle Fernandez, Tarec K. Elajami","doi":"10.1111/echo.15938","DOIUrl":"10.1111/echo.15938","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Left ventricular (LV) apical aneurysms (ApAn+) occur in 10%–15% of apical hypertrophic cardiomyopathy (ApHCM) patients and confer considerable morbidity. We hypothesized that ApAn+ adversely impact ventricular mechanics and mechano-energetic coupling in ApHCM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Ninety-eight ApHCM patients were identified, of which nine (9%) had ApAn+ and were compared with 89 (91%) who did not (ApAn−). 2D speckle-tracking echocardiography assessed ventricular mechanics using LV global longitudinal strain (GLS) and torsion, and mechano-energetic coupling as myocardial work indices. Clinical events over follow-up were adjudicated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean age was 64 ± 15 years, 46% were female, and 3% had an HCM family history, with similar clinical risk factors between groups. Of the nine ApAn+ patients, there were six small (<2 cm) and three moderate-sized (2-4 cm) aneurysms. There was no difference in LV ejection fraction (65 ± 15 vs. 67 ± 11%, <i>p</i> = 0.51) or GLS (−9.6 ± 3.3 vs. −11.9 ± 3.9%, <i>p</i> = 0.09) between ApAn+ versus ApAn−. ApAn+ patients had greater myocardial global wasted work (347 ± 112 vs. 221 ± 165 mmHg%, <i>p</i> = 0.03) and lower global work efficiency (GWE, 75 ± 5 vs. 82 ± 8%, <i>p</i> = 0.006). LV GLS (<i>β</i> = −0.67, <i>p</i> < 0.001), ApAn+ (<i>β</i> = −0.15, <i>p</i> = 0.04), and twist rate (<i>β</i> = −0.14, <i>p</i> = 0.04) were independently associated with GWE. At 3.9-year follow-up, cardiovascular mortality (4%) and heart failure hospitalization (14%) events were similar between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ApHCM patients with ApAn+ are characterized by more impaired LV mechano-energetic coupling when compared with ApAn−. ApAn+ is independently associated with worse GWE.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 11","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512277","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}
Liem Audi Natalino, Real Kusumanjaya Marsam, Lucia Kris Dinarti, Hasanah Mumpuni, Dyah Wulan Anggrahini
Objectives
This study aimed to identify the utility of global longitudinal strain (GLS) as a reliable parameter that can accurately forecast left ventricle reverse remodeling (LVRR) in patients undergoing valve replacement surgery for severe chronic primary mitral regurgitation (MR), thereby aiding in assessing mortality and morbidity risk.
Methods
This retrospective observational study involved severe primary MR patients who underwent valve replacement surgery between 2018 and 2023. Pre- and postsurgery echocardiography data were collected, with GLS measurements utilized to assess left ventricular function. Various echocardiography parameters, including MR severity and LV dimensions, were analyzed. Bivariate and multivariate analyses were performed to explore relationships between GLS and LVRR.
Results
This study enrolled 103 patients (54.4% male; mean age 45.4 ± 13.6 years). Statistical analyses revealed GLS to be an independent predictor of LVRR, with a threshold of −16.25% showing 89% sensitivity and 50% specificity. Each 1% increase in GLS corresponded to a 1.14-fold (odds ratio [OR]: 1.14; 95% confidence interval [CI]: 1.01–1.31; p < 0.05) increased likelihood of LVRR.
Conclusion
These findings highlight GLS's potential as a prognostic marker for postsurgical outcomes in severe MR patients.
{"title":"The Role of Global Longitudinal Strain in Predicting Left Ventricular Reverse Remodeling After Mitral Valve Replacement Surgery in Patients With Primary Mitral Regurgitation","authors":"Liem Audi Natalino, Real Kusumanjaya Marsam, Lucia Kris Dinarti, Hasanah Mumpuni, Dyah Wulan Anggrahini","doi":"10.1111/echo.15950","DOIUrl":"10.1111/echo.15950","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to identify the utility of global longitudinal strain (GLS) as a reliable parameter that can accurately forecast left ventricle reverse remodeling (LVRR) in patients undergoing valve replacement surgery for severe chronic primary mitral regurgitation (MR), thereby aiding in assessing mortality and morbidity risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective observational study involved severe primary MR patients who underwent valve replacement surgery between 2018 and 2023. Pre- and postsurgery echocardiography data were collected, with GLS measurements utilized to assess left ventricular function. Various echocardiography parameters, including MR severity and LV dimensions, were analyzed. Bivariate and multivariate analyses were performed to explore relationships between GLS and LVRR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study enrolled 103 patients (54.4% male; mean age 45.4 ± 13.6 years). Statistical analyses revealed GLS to be an independent predictor of LVRR, with a threshold of −16.25% showing 89% sensitivity and 50% specificity. Each 1% increase in GLS corresponded to a 1.14-fold (odds ratio [OR]: 1.14; 95% confidence interval [CI]: 1.01–1.31; <i>p</i> < 0.05) increased likelihood of LVRR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These findings highlight GLS's potential as a prognostic marker for postsurgical outcomes in severe MR patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 11","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512278","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}
Ioannis Skalidis, Georgios Tzimas, Panagiotis Antiochos, Gaspard Suc, Henri Lu, Adil Salihu, Stephane Fournier, Olivier Muller, Niccolo’ Maurizi, Dimitri Arangalage
{"title":"Artificial Intelligence, Virtual Reality, and the Metaverse in Cardiovascular Imaging: Tools for Transformation or Technological Overreach?","authors":"Ioannis Skalidis, Georgios Tzimas, Panagiotis Antiochos, Gaspard Suc, Henri Lu, Adil Salihu, Stephane Fournier, Olivier Muller, Niccolo’ Maurizi, Dimitri Arangalage","doi":"10.1111/echo.70015","DOIUrl":"10.1111/echo.70015","url":null,"abstract":"","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 11","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512274","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}
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