Danilo Angotti, Gianluca Di Pietro, Sara Cimino, Sara Monosilio, Lucrezia Netti, Antonella Ciuffreda, Riccardo Improta, Marco Tocci, Paolo Severino, Emanuele Bruno, Riccardo Colantonio, Carmine Dario Vizza, Luciano Agati, Viviana Maestrini
Transcatheter aortic valve implantation (TAVI) is the main treatment option for patients with severe aortic stenosis (AS) and older age. Improved imaging techniques have enabled better patient selection, and the main role is played by echocardiography. Methods more sensitive than LVEF in assessing cardiac function, such as global longitudinal strain (GLS) and myocardial work (MW), have become widespread, and other methods, like hemodynamic forces (HDFs), might be promising.
The aim of this paper is to systematically review the parameters of GLS, MW, and HDF as predictors of reverse remodeling and their association with outcomes in patients with AS undergoing TAVI. In particular, the focus will be on the examination of the influence of TAVI on left atrial and ventricular function and right ventricular function.
{"title":"Prognostic Value of Advanced Echocardiographic Analysis for Transcatheter Aortic Valve Replacement: A Systematic Review","authors":"Danilo Angotti, Gianluca Di Pietro, Sara Cimino, Sara Monosilio, Lucrezia Netti, Antonella Ciuffreda, Riccardo Improta, Marco Tocci, Paolo Severino, Emanuele Bruno, Riccardo Colantonio, Carmine Dario Vizza, Luciano Agati, Viviana Maestrini","doi":"10.1111/echo.70063","DOIUrl":"10.1111/echo.70063","url":null,"abstract":"<div>\u0000 \u0000 <p>Transcatheter aortic valve implantation (TAVI) is the main treatment option for patients with severe aortic stenosis (AS) and older age. Improved imaging techniques have enabled better patient selection, and the main role is played by echocardiography. Methods more sensitive than LVEF in assessing cardiac function, such as global longitudinal strain (GLS) and myocardial work (MW), have become widespread, and other methods, like hemodynamic forces (HDFs), might be promising.</p>\u0000 <p>The aim of this paper is to systematically review the parameters of GLS, MW, and HDF as predictors of reverse remodeling and their association with outcomes in patients with AS undergoing TAVI. In particular, the focus will be on the examination of the influence of TAVI on left atrial and ventricular function and right ventricular function.</p>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958240","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}
Left images: Top: (A) Echocardiography shows a dilated pulmonary artery, large aortopulmonary window (dotted line), and abnormally positioned aortic arch. (B) MIP image reveals superior RV, inferior LV, and elongated arch vessels (arrows). Bottom: MinIP shows a thin left main bronchus and non-aerated RML (asterisk). Right images: VRT highlights superior RV, inferior LV, elongated arch vessels (arrows), and APW.
Diastolic dysfunction (DD) is defined as impaired left ventricular (LV) relaxation, caused by structural or functional heart diseases. We sought to assess the role of cardiac CT angiography (CCTA) as a tool to evaluate LV DD in patients with normal EF using the diastolic expansion index (DEI), as compared to transthoracic echocardiography (TTE) as the gold standard.
Methods
Patients presenting with atypical chest pain with suspected coronary artery disease (CAD) and having a normal LV ejection fraction on TTE underwent CCTA using a dual source CT scanner. Assessment of diastolic function on CCTA was done using DEI, and it was compared with TTE-derived diastolic function as per standard ASE/EACVI guidelines. DEI was measured using a dedicated postprocessing software (Syngo.via VB20, Siemens Healthcare, Germany) and was calculated as a ratio of maximum LV volume (in LV end-diastole) to maximum left atrial (LA) volume (in LV end-systole), with the mean value of readings from three independent readers taken for each calculation.
Results
The study included 141 patients (60 male; mean age 50.82 ± 10.20 years; mean heart rate 84.90 ± 16.15 beats per minute). CCTA-derived mean indexed LA volumes correlated well with TTE measurements but were larger when compared to TTE (r = 0.53, p < 0.0001). A progressive increase in LA volume index was noted with worsening DD grades. Excellent inter-observer correlation was seen between the three observers for LA volume index (intra-class correlation coefficient: 0.999 [95% CI: 0.999–0.999] and for DEI 0.996 [95% CI: 0.995–0.997]). A normal LV diastolic function was predicted by a DEI > 1.57 with a specificity and sensitivity of 88.3% and 81.6%, respectively (area under curve (AUC)-0.87), whereas an abnormal LV diastolic function was predicted by DEI <1.46 with a specificity and sensitivity of 84.8% and 62.5%, respectively (AUC-0.848). There was a significant correlation between the presence of obstructive CAD and an increase in calcium score with DD grade (p = 0.006 and 0.001, respectively).
Conclusion
CCTA-derived DEI is a reliable metric for assessing LV diastolic dysfunction in patients with suspected CAD with normal ejection fraction. The presence of obstructive CAD and an increase in calcium score correlated with worsening DD grade.
{"title":"Incremental Role of Cardiac CT Angiography in the Assessment of Left Ventricular Diastolic Function in Patients With Suspected Coronary Artery Disease With Normal Ejection Fraction: A Comparison With Transthoracic Echocardiography","authors":"Amy Fiona Suresh Kumar, Vineeta Ojha, Sreelal Thazhathu Veettil, Mohsin Mantoo, Damandeep Singh, Niraj Nirmal Pandey, Priya Jagia, Satyavir Yadav, Sanjeev Kumar","doi":"10.1111/echo.70069","DOIUrl":"https://doi.org/10.1111/echo.70069","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Diastolic dysfunction (DD) is defined as impaired left ventricular (LV) relaxation, caused by structural or functional heart diseases. We sought to assess the role of cardiac CT angiography (CCTA) as a tool to evaluate LV DD in patients with normal EF using the diastolic expansion index (DEI), as compared to transthoracic echocardiography (TTE) as the gold standard.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients presenting with atypical chest pain with suspected coronary artery disease (CAD) and having a normal LV ejection fraction on TTE underwent CCTA using a dual source CT scanner. Assessment of diastolic function on CCTA was done using DEI, and it was compared with TTE-derived diastolic function as per standard ASE/EACVI guidelines. DEI was measured using a dedicated postprocessing software (Syngo.via VB20, Siemens Healthcare, Germany) and was calculated as a ratio of maximum LV volume (in LV end-diastole) to maximum left atrial (LA) volume (in LV end-systole), with the mean value of readings from three independent readers taken for each calculation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 141 patients (60 male; mean age 50.82 ± 10.20 years; mean heart rate 84.90 ± 16.15 beats per minute). CCTA-derived mean indexed LA volumes correlated well with TTE measurements but were larger when compared to TTE (<i>r</i> = 0.53, <i>p</i> < 0.0001). A progressive increase in LA volume index was noted with worsening DD grades. Excellent inter-observer correlation was seen between the three observers for LA volume index (intra-class correlation coefficient: 0.999 [95% CI: 0.999–0.999] and for DEI 0.996 [95% CI: 0.995–0.997]). A normal LV diastolic function was predicted by a DEI > 1.57 with a specificity and sensitivity of 88.3% and 81.6%, respectively (area under curve (AUC)-0.87), whereas an abnormal LV diastolic function was predicted by DEI <1.46 with a specificity and sensitivity of 84.8% and 62.5%, respectively (AUC-0.848). There was a significant correlation between the presence of obstructive CAD and an increase in calcium score with DD grade (<i>p</i> = 0.006 and 0.001, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CCTA-derived DEI is a reliable metric for assessing LV diastolic dysfunction in patients with suspected CAD with normal ejection fraction. The presence of obstructive CAD and an increase in calcium score correlated with worsening DD grade.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143112616","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}
Karina Del Valle Zamora, Jacobo Sebastián Vera-Chávez, Alberto Aranda-Fraustro, Marcos Abraham Duarte-Gutiérrez, Angélica Vargas-Guerrero, Gina Alejandra Altamirano-Solorzano, Hilda Eloisa Delgadillo-Rodríguez
A 43-year-old woman presented with dyspnea and cough, initially misdiagnosed as respiratory syncytial virus. Persistent symptoms led to pulmonary thromboembolism treatment, but worsening issues revealed recurrent pericardial effusion. Imaging and biopsy confirmed pulmonary artery intimal sarcoma, mimicking thromboembolism, and autoimmune disease, underscoring diagnostic challenges. Contrast-enhanced angiotomography showing filling defects suggestive of pulmonary thromboembolism. Echocardiogram with severe pericardial effusion. T2-weighted MRI with two heterogeneous masses on the right side and another adjacent to the left atrium. Biopsy confirming pulmonary artery intimal sarcoma.
{"title":"Recurrent Cardiac Tamponade by Pulmonary Artery Intimal Sarcoma","authors":"Karina Del Valle Zamora, Jacobo Sebastián Vera-Chávez, Alberto Aranda-Fraustro, Marcos Abraham Duarte-Gutiérrez, Angélica Vargas-Guerrero, Gina Alejandra Altamirano-Solorzano, Hilda Eloisa Delgadillo-Rodríguez","doi":"10.1111/echo.70068","DOIUrl":"10.1111/echo.70068","url":null,"abstract":"<p>A 43-year-old woman presented with dyspnea and cough, initially misdiagnosed as respiratory syncytial virus. Persistent symptoms led to pulmonary thromboembolism treatment, but worsening issues revealed recurrent pericardial effusion. Imaging and biopsy confirmed pulmonary artery intimal sarcoma, mimicking thromboembolism, and autoimmune disease, underscoring diagnostic challenges. Contrast-enhanced angiotomography showing filling defects suggestive of pulmonary thromboembolism. Echocardiogram with severe pericardial effusion. T2-weighted MRI with two heterogeneous masses on the right side and another adjacent to the left atrium. Biopsy confirming pulmonary artery intimal sarcoma.\u0000\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907888","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}
Giacomo Ingallina, Giorgio Fiore, Francesco Ancona
{"title":"Preoperative Assessment of Degenerative Mitral Regurgitation: Advancing Toward a Less Invasive Approach With Three-Dimensional Transthoracic Echocardiography?","authors":"Giacomo Ingallina, Giorgio Fiore, Francesco Ancona","doi":"10.1111/echo.70066","DOIUrl":"10.1111/echo.70066","url":null,"abstract":"","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907887","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}
Tugba Kemaloglu Oz, Vladyslav Kavalerchyk, Krasimira Hristova, Alex dos Santos Felix, Anosh Shane Sivashanmugarajah, Angus A. Baumann, Alexander Mladenow
The pulmonary valve (PV), although often less emphasized than other heart valves, is crucial for cardiac function and hemodynamics. Historically, the PV has been underrepresented in echocardiographic assessments due to its rare involvement in pathological conditions, particularly in adults. Additionally, the anatomical position of the PV makes it one of the most challenging valves to visualize using conventional echocardiography. Traditional two-dimensional (2D) techniques, while foundational, have limitations in capturing the full spectrum of valve pathology and dynamics. Recent advancements in echocardiography, especially the integration of three-dimensional (3D) imaging, have significantly enhanced the assessment of PV disorders. 3D echocardiography (3DE) offers superior accuracy in visualizing valve morphology and function, overcoming the limitations of angle dependency and suboptimal imaging planes typical of 2D assessments. This evolution in imaging techniques facilitates more precise diagnoses and improved management of conditions such as pulmonary stenosis (PS) and regurgitation (PR). This review explores the transition from conventional echocardiographic methods to advanced approaches that are reshaping our understanding of the PV, emphasizing the importance of incorporating these cutting-edge techniques into routine clinical practice to enhance patient outcomes.
{"title":"From Traditional to Cutting-Edge: Transforming Pulmonary Valve Assessment With Advanced Echocardiography Techniques","authors":"Tugba Kemaloglu Oz, Vladyslav Kavalerchyk, Krasimira Hristova, Alex dos Santos Felix, Anosh Shane Sivashanmugarajah, Angus A. Baumann, Alexander Mladenow","doi":"10.1111/echo.70058","DOIUrl":"10.1111/echo.70058","url":null,"abstract":"<p>The pulmonary valve (PV), although often less emphasized than other heart valves, is crucial for cardiac function and hemodynamics. Historically, the PV has been underrepresented in echocardiographic assessments due to its rare involvement in pathological conditions, particularly in adults. Additionally, the anatomical position of the PV makes it one of the most challenging valves to visualize using conventional echocardiography. Traditional two-dimensional (2D) techniques, while foundational, have limitations in capturing the full spectrum of valve pathology and dynamics. Recent advancements in echocardiography, especially the integration of three-dimensional (3D) imaging, have significantly enhanced the assessment of PV disorders. 3D echocardiography (3DE) offers superior accuracy in visualizing valve morphology and function, overcoming the limitations of angle dependency and suboptimal imaging planes typical of 2D assessments. This evolution in imaging techniques facilitates more precise diagnoses and improved management of conditions such as pulmonary stenosis (PS) and regurgitation (PR). This review explores the transition from conventional echocardiographic methods to advanced approaches that are reshaping our understanding of the PV, emphasizing the importance of incorporating these cutting-edge techniques into routine clinical practice to enhance patient outcomes.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907886","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}
Jorge D. Rodríguez-Esparza, José A. Sánchez-Toscano, Gabriela Meléndez-Ramírez, Juan F. Fritche-Salazar, Hugo Rodríguez-Zanella, Edith L. Posada-Martínez, José A. Arias-Godínez, Mario J. Pozas-Rivas, Xochitl A. Ortiz-Leon
We present a case of a 72-year-old female patient with dyspnea and lipothymia. Echocardiography demonstrates an intracavitary cystic mass that fills almost all left atria causing supravalvular obstruction. The magnetic resonance image revealed a 53 × 47 × 48 mm heterogeneous mass with regular edges, tissue characterization suggested myxoma. The patient underwent surgical resection, histopathologic study was compatible with sarcoma. This case underscores the importance of multimodal imaging for an accurate approach and early diagnosis of cardiac intracavitary masses.
{"title":"Cardiac Spindle Cell Sarcoma: A Challenging Presentation and Diagnosis of a Rare Malignant Primary Cardiac Tumor","authors":"Jorge D. Rodríguez-Esparza, José A. Sánchez-Toscano, Gabriela Meléndez-Ramírez, Juan F. Fritche-Salazar, Hugo Rodríguez-Zanella, Edith L. Posada-Martínez, José A. Arias-Godínez, Mario J. Pozas-Rivas, Xochitl A. Ortiz-Leon","doi":"10.1111/echo.70070","DOIUrl":"10.1111/echo.70070","url":null,"abstract":"<p>We present a case of a 72-year-old female patient with dyspnea and lipothymia. Echocardiography demonstrates an intracavitary cystic mass that fills almost all left atria causing supravalvular obstruction. The magnetic resonance image revealed a 53 × 47 × 48 mm heterogeneous mass with regular edges, tissue characterization suggested myxoma. The patient underwent surgical resection, histopathologic study was compatible with sarcoma. This case underscores the importance of multimodal imaging for an accurate approach and early diagnosis of cardiac intracavitary masses.\u0000\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907885","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}
Flemming Javier Olsen, Nino Emanuel Landler, Jacob Christensen, Klaus Fuglsang Kofoed, Bo Feldt-Rasmussen, Ditte Hansen, Christina Christoffersen, Ellen Linnea Freese Ballegaard, Ida Maria Hjelm Sørensen, Sasha Saurbrey Bjergfelt, Eline Seidelin, Susanne Bro, Tor Biering-Sørensen
Background
Myocardial work is a novel measure of potential value for diagnosing coronary artery disease (CAD). It may therefore be useful in patients with chronic kidney disease (CKD), in whom the diagnostic work-up can be challenging.
Methods
This was a cross-sectional study of patients with CKD (G1-5, nondialysis-dependent). Cardiac computed tomography was performed to quantify coronary artery calcium score (CACS). Pressure-strain loop analysis was performed to obtain global and territorial work index (GWI and TWI, respectively). Logistic regression was applied to investigate the association between work measures and high CACS (>400).
Results
We included 455 patients (age: 57 years, 60% men, 8% with previous CAD, and eGFR of 43 mL/min/1.73 m2). High CACS across all coronary arteries was observed in 77 (17%), with 53 (12%) in the left anterior descending (LAD) artery, 28 (6%) in the right coronary artery (RCA), and 17 (4%) in the circumflex (Cx) artery.
No difference in GWI was observed for overall high versus non-high CACS (1861 vs. 1937 mmHg%, p = 0.14). TWI was reduced in patients with high versus non-high CACS in the LAD (1772 vs. 1956 mmHg%, p = 0.003) and in the Cx (1556 vs. 1934 mmHg%, p = 0.001), but not in the RCA (p = 0.68). After multivariable regression, TWI remained significantly associated with high CACS in the LAD and Cx in patients with no history of CAD, but not in the RCA.
Conclusion
In patients with CKD, GWI was not associated with an overall high CACS. TWI was, however, associated with a high CACS in specific coronary arteries, although the findings were inconsistent.
背景：心肌功是一种诊断冠状动脉疾病（CAD）的新方法。因此，它可能对慢性肾脏疾病（CKD）患者有用，在这些患者中，诊断工作可能具有挑战性。方法：这是一项CKD患者（G1-5，非透析依赖）的横断面研究。进行心脏计算机断层扫描，量化冠状动脉钙评分（CACS）。通过压力-应变环分析获得全局和区域工作指数（GWI和TWI）。采用Logistic回归研究工作措施与高CACS （bbb400）之间的关系。结果：我们纳入了455例患者（年龄：57岁，60%为男性，8%既往患有CAD， eGFR为43 mL/min/1.73 m2）。77例（17%）冠状动脉均出现高CACS，其中左前降支（LAD） 53例（12%），右冠状动脉（RCA） 28例（6%），旋支（Cx） 17例（4%）。总体高与非高CACS组GWI无差异（1861 vs 1937 mmHg%, p = 0.14）。在LAD （1772 vs. 1956 mmHg%, p = 0.003）和Cx （1556 vs. 1934 mmHg%, p = 0.001）的高CACS患者中，TWI减少（p = 0.68），但在RCA中没有（p = 0.68）。多变量回归后，TWI仍与无CAD病史的LAD和Cx患者的高CACS显著相关，但与RCA无关。结论：在CKD患者中，GWI与总体高CACS无关。然而，TWI与特定冠状动脉的高CACS有关，尽管研究结果不一致。
{"title":"Association Between Myocardial Work and Coronary Artery Calcium Score in Patients With Chronic Kidney Disease","authors":"Flemming Javier Olsen, Nino Emanuel Landler, Jacob Christensen, Klaus Fuglsang Kofoed, Bo Feldt-Rasmussen, Ditte Hansen, Christina Christoffersen, Ellen Linnea Freese Ballegaard, Ida Maria Hjelm Sørensen, Sasha Saurbrey Bjergfelt, Eline Seidelin, Susanne Bro, Tor Biering-Sørensen","doi":"10.1111/echo.70064","DOIUrl":"10.1111/echo.70064","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Myocardial work is a novel measure of potential value for diagnosing coronary artery disease (CAD). It may therefore be useful in patients with chronic kidney disease (CKD), in whom the diagnostic work-up can be challenging.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a cross-sectional study of patients with CKD (G1-5, nondialysis-dependent). Cardiac computed tomography was performed to quantify coronary artery calcium score (CACS). Pressure-strain loop analysis was performed to obtain global and territorial work index (GWI and TWI, respectively). Logistic regression was applied to investigate the association between work measures and high CACS (>400).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included 455 patients (age: 57 years, 60% men, 8% with previous CAD, and eGFR of 43 mL/min/1.73 m<sup>2</sup>). High CACS across all coronary arteries was observed in 77 (17%), with 53 (12%) in the left anterior descending (LAD) artery, 28 (6%) in the right coronary artery (RCA), and 17 (4%) in the circumflex (Cx) artery.</p>\u0000 \u0000 <p>No difference in GWI was observed for overall high versus non-high CACS (1861 vs. 1937 mmHg%, <i>p</i> = 0.14). TWI was reduced in patients with high versus non-high CACS in the LAD (1772 vs. 1956 mmHg%, <i>p</i> = 0.003) and in the Cx (1556 vs. 1934 mmHg%, <i>p</i> = 0.001), but not in the RCA (<i>p</i> = 0.68). After multivariable regression, TWI remained significantly associated with high CACS in the LAD and Cx in patients with no history of CAD, but not in the RCA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In patients with CKD, GWI was not associated with an overall high CACS. TWI was, however, associated with a high CACS in specific coronary arteries, although the findings were inconsistent.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911050","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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