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

{"title":"Multimodal Imaging Diagnosis of Left Atrial Intimal Sarcoma With Mitral Valve and Pulmonary Vein Involvement","authors":"Li Zhu, Zhenzhen Xiao, Ping Hu, Xiaojing Ma","doi":"10.1111/echo.70381","DOIUrl":"10.1111/echo.70381","url":null,"abstract":"","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 12","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145851386","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":"Handheld Focused Cardiac Ultrasound Training in Internal Medicine Curriculum","authors":"Paula Cristina Morariu,&nbsp;Alexandru Florinel Oancea,&nbsp;Maria Mihaela Godun,&nbsp;Branco Adrian Morariu,&nbsp;Oana Sirbu,&nbsp;Daniela Maria Tanase,&nbsp;Anca Ouatu,&nbsp;Anton Knieling,&nbsp;Lacramioara Ionela Serban,&nbsp;Viorel Scripcariu,&nbsp;Mariana Floria","doi":"10.1111/echo.70379","DOIUrl":"10.1111/echo.70379","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To explore medical students’ perceptions of integrating handheld focused cardiac ultrasound (FoCUS) into the internal medicine curriculum and identify factors influencing learning outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional pilot survey was conducted among 145 fourth-year medical students at “Grigore T. Popa” University of Medicine and Pharmacy, Iași, Romania, during the 2024–2025 academic year. During their internal medicine rotation, students performed FoCUS echocardiography at the bedside, using a handheld ultrasound device. A structured online questionnaire assessed perceptions of training quality, usefulness in curriculum, impact on understanding cardiac anatomy and physiology, improvement in echocardiographic skills, and interest in integrating ultrasound more broadly into the curriculum.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 145 participants (mean age 23.4 ± 2.1 years, 67.6% female), 130 (89.6%) reported using the handheld devices, with a mean frequency of 1.66 ± 0.73 times per semester. Students rated FoCUS as highly useful for bedside learning (3.92 ± 1.25/4), for understanding cardiac anatomy and physiology (4.02 ± 1.29/5), and for enhancing echocardiographic skills (3.75 ± 1.35/5). Higher usage frequency corresponded with increased perceived learning efficacy. Training quality (<i>β</i> = 0.461, 95% CI: 0.216–0.706) and practical demonstrations (<i>β</i> = 0.607, 95% CI: 0.040–1.175) were significant predictors of educational outcomes. Strong support was expressed for formal ultrasound curriculum inclusion (97.6%) and interdisciplinary expansion (99.2%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Integrating handheld FoCUS into the internal medicine curriculum is associated with substantial perceived educational benefits. Training quality and hands-on demonstrations are key determinants of successful learning outcomes, supporting the systematic inclusion of FoCUS as a core component of medical education.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 12","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145851357","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":"Incremental Value of Workload-Indexed Blood Pressure Response Over Exaggerated Blood Pressure Response to Exercise in Detecting Adverse Left Ventricular Remodeling and Function","authors":"In-Jeong Cho,&nbsp;Sang-Eun Lee,&nbsp;Wook Bum Pyun","doi":"10.1111/echo.70380","DOIUrl":"10.1111/echo.70380","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Exaggerated blood pressure response (ExBPR) to exercise, often defined as peak systolic blood pressure (SBP) ≥ 210 mm Hg in men and ≥190 mm Hg in women, has limited clinical utility due to inconsistent prognostic data. Workload-indexed SBP, expressed as SBP/metabolic equivalent of task (MET) slope, has emerged as a potentially superior marker of cardiovascular risk. This study aims to evaluate the association of exercise SBP parameters with left ventricular (LV) remodeling and function, and to unveil which exercise SBP marker more accurately reflects adverse cardiac remodeling and function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively studied 455 individuals who underwent echocardiography and treadmill testing within 1 day at a single center in Korea. Echocardiographic parameters included left ventricular (LV) end-diastolic dimension (EDD), relative wall thickness (RWT) and e′ velocity. SBP/MET slope was calculated as (peak—resting SBP)/(maximal METs−1).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants with SBP/Met slope &gt;6.2 mm Hg/MET were older, had higher body mass index, and exhibited smaller LV EDD index, higher RWT, and lower e′ velocity (all <i>p</i> &lt; 0.05). They also showed higher resting and peak SBP and lower exercise capacity. ExBPR was associated with similar structural and functional abnormalities but not with exercise capacity. In individuals without ExBPR, higher SBP/MET slope identified smaller LV EDD index, higher RWT, and lower e′ velocity (all <i>p</i> &lt; 0.05). Multivariable analyses confirmed independent associations of SBP/MET slope with concentric LV structure represented by high RWT and lower e′ velocity, beyond resting SBP. Adding SBP/MET slope to ExBPR improved prediction of reduced e′ velocity (<i>p</i> = 0.021).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>SBP/MET slope was independently associated with concentric LV structure and diastolic dysfunction, providing incremental clinical value over ExBPR in detecting subclinical cardiac abnormalities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 12","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145851379","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":"Beyond Ejection Fraction: RV Function and Diastolic Markers as Predictors of Kidney Disease","authors":"Elettra Pomiato,&nbsp;Biagio Castaldi,&nbsp;Giovanni Di Salvo","doi":"10.1111/echo.70378","DOIUrl":"10.1111/echo.70378","url":null,"abstract":"&lt;p&gt;Heart failure (HF) is one of the leading health-care problems, and despite progress in medical management, devices, and advanced therapies, the prognosis of affected patients remains poor. Among patients with HFrEF, chronic kidney disease (CKD) represents one of the most common comorbidities and, when present, confers the highest population-attributable risk for all-cause mortality and heart failure hospitalization among all comorbid conditions.&lt;/p&gt;&lt;p&gt;The recent article by Al-Rubai et al. elegantly discusses echocardiographic predictors of kidney disease in a cohort of adult patients with HFrEF. Although retrospective, this study involved a large cohort of patients (&gt;1100) with roughly 10 years of follow-up. Unsurprisingly, the cumulative prevalence of CKD in this study was as high as 25%, along with a high frequency of diabetes mellitus (DM) and hypertension [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;HF, DM, and CKD are common and interlinked conditions, yet the cross-talk between CKD and HF remains one of the most clinically challenging intersections in modern medicine. The term cardiorenal syndrome and its classification describe this bidirectional interplay, in which dysfunction of one organ adversely affects the other through hemodynamic, neurohormonal, and metabolic mechanisms. Importantly, cardiac and renal diseases have many pathophysiological pathways in common, including inflammatory and direct cellular immune-mediated mechanisms, neurohormonal responses, metabolic and nutritional deviations, altered hemodynamic and acid–base or fluid status, and impaired erythropoiesis [&lt;span&gt;2&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;According to the authors’ evaluation, left ventricular ejection fraction (LVEF), tricuspid annular plane systolic excursion (TAPSE), and E/e′ ratio were independent predictors of incident CKD in multivariate regression analysis. LVEF, as a prognostic marker in HF, has been extensively evaluated over the past decades, and its role as a risk factor is well established, although this becomes less obvious in patients with more severe ventricular dysfunction, and its correlation with functional capacity or quality of life is debated [&lt;span&gt;3&lt;/span&gt;]. Preoperative LVEF is also an independent risk factor for acute kidney injury (AKI) after noncardiac surgery [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;From a pathophysiological perspective, LVEF has traditionally been identified as the initial driver of renal dysfunction, with low cardiac output being the major determinant of renal hypoperfusion, namely pre-renal CKD, while the right ventricle was considered related only to the lungs. In contrast, emerging evidence increasingly indicates that right ventricular (RV) dysfunction and congestion may play a far more important role in the development of CKD in patients with HFrEF. RV failure results in elevated right atrial pressure and a subsequent increase in renal venous pressure. Elevated venous pressure reduces the renal perfusion gradient, impairs renal microcirculation, and increases in","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 12","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12745181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145851327","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":"Integrated Cardio-Cerebral Assessment Predicts Adverse Outcomes in Aortic Stenosis: A Preliminary Study","authors":"Tongtong Huang,&nbsp;Bingling Wu,&nbsp;Decai Zeng,&nbsp;Qiong Fang,&nbsp;Yongzhi Cai,&nbsp;Shuai Chang,&nbsp;Yue Li,&nbsp;Huiqiong Luo,&nbsp;Liuliu Huang,&nbsp;Mai Chen,&nbsp;Ji Wu","doi":"10.1111/echo.70373","DOIUrl":"10.1111/echo.70373","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Patients with aortic stenosis(AS)exhibit elevated covert brain injury. The association of AS-related cerebral impairment with cardiac remodeling and its prognostic impact remains unclear, prompting exploration of integrated cardio-cerebral assessment preliminarily.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with moderate-to-severe aortic stenosis (AS) undergoing surgery at The First Affiliated Hospital of Guangxi Medical University (June 2021–December 2024) were enrolled (<i>n</i> = 384). Patients were stratified into a cerebral hypoperfusion/embolism group (<i>n</i> = 146) and an event-free group (<i>n</i> = 238) based on the presence or absence of preoperative cerebral impairment due to severe AS-related hemodynamic compromise or embolic events. Preoperative clinical/echocardiographic and surgical data were collected. The composite primary endpoint was major adverse cardiac events (MACE) (malignant arrhythmia, heart failure rehospitalization, or all-cause death). Multivariate regression identified predictors of AS-related cerebral impairment and MACE risk factors. The C-index assessed the cardio-cerebral integrated model's prognostic value.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cerebral hypoperfusion/embolism group showed more pronounced left atrial (LA) and left ventricular (LV) remodeling. Multivariate logistic regression linked enlarged ascending aorta, left heart remodeling (increased LA size, elevated E/e' ratio, decreased LV global longitudinal strain and LA reservoir strain), reduced cardiac output (CO), and pulmonary artery systolic pressure to AS-related cerebral impairment (all <i>p &lt; </i>0.05). Over an 18-month median follow-up, 79 MACE occurred. Adjusted multivariate Cox analysis confirmed AS-related cerebral impairment as an independent MACE predictor (hazard ratio, 2.24 [95% CI: 2.13, 3.44]; <i>p</i> &lt; 0.001). The cardio-cerebral integrated model (clinical + echo + ischemia) demonstrated superior MACE prediction (C-index, 0.862; likelihood ratio, 62.12) vs. clinical-only (C-index, 0.631; likelihood ratio, 19.32; both <i>p</i> &lt; 0.001) or clinical + echo models (C-index, 0.757; likelihood ratio, 46.34; both <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>AS-related cerebral impairment independently correlates with cardiac remodeling and adverse outcomes. Integrated cardio-cerebral assessment enhances risk stratification.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 12","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145812099","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":"Hypoplastic Left Heart Syndrome: Three-Dimensional Virtual Navigation of Fetal Heart Chambers and Great Vessels","authors":"Maria de Fátima Pereira Leite,&nbsp;Nathalie Jeanne Bravo-Valenzuela,&nbsp;Edward Araujo Júnior,&nbsp;Gerson Ribeiro,&nbsp;Gustavo Yano Callado,&nbsp;Carla Verona Barreto Farias,&nbsp;Heron Werner","doi":"10.1111/echo.70374","DOIUrl":"10.1111/echo.70374","url":null,"abstract":"<p>This virtual navigation of a fetal heart with hypoplastic left heart syndrome demonstrated the potential of this technology to provide realistic views of cardiac anatomy and to enable exploration of the ventricles, valves, and outflow tracts.\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 12","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806163","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":"Critical Appraisal of Echocardiographic Predictors for Reintervention in TAPVC Surgery","authors":"Daniel Palanca Arias","doi":"10.1111/echo.70214","DOIUrl":"10.1111/echo.70214","url":null,"abstract":"&lt;p&gt;The manuscript by Stanley et al. [&lt;span&gt;1&lt;/span&gt;] presents a valuable and methodologically sound contribution to pediatric cardiology by investigating the prognostic utility of a novel echocardiographic index—the Pulmonary Venous Variability Index (PVVI)—for predicting postoperative reintervention in children undergoing surgical repair for total anomalous pulmonary venous connection (TAPVC). This commentary critically examines the methodological robustness, clinical implications, and potential future directions of this study, emphasizing its relevance to both clinical practice and ongoing academic inquiry.&lt;/p&gt;&lt;p&gt;This rigorously designed retrospective study represents a significant advancement in the non-invasive preoperative assessment of patients with TAPVC. Identifying predictors for postoperative reintervention is crucial to optimizing outcomes in this complex congenital condition.&lt;/p&gt;&lt;p&gt;The current work builds upon previous findings by the same group, which demonstrated that the PVVI (defined as Vmax − Vmin / Vmean) may serve as a surrogate marker for preoperative obstruction. The index correlated with elevated catheterization-derived gradients and clinical evidence of obstruction [&lt;span&gt;2&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;TAPVC is a rare but life-threatening congenital heart anomaly, with significant morbidity and mortality primarily attributable to postoperative pulmonary venous obstruction (PVO). Despite surgical correction, reintervention is required in 10%–20% of cases. The challenge of identifying high-risk patients preoperatively remains a pressing concern in pediatric cardiac care [&lt;span&gt;3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;The authors explore whether conventional echocardiographic parameters (e.g., Vmax, Vmean) or the PVVI can effectively predict the likelihood of reintervention. This is of high clinical relevance, as enhanced risk stratification could inform perioperative planning, improve prognostic accuracy, and potentially refine surgical strategies based on preoperative imaging.&lt;/p&gt;&lt;p&gt;Additionally, the study emphasizes the influence of TAPVC subtype and univentricular physiology on postoperative outcomes, questioning the predictive reliability of traditional Doppler metrics (e.g., Vmax, Vmean, and qualitative assessments of obstruction).&lt;/p&gt;&lt;p&gt;Given the critical importance of early identification and timely intervention in TAPVC, this study provides a valuable perspective on the limitations and potential of echocardiographic evaluation, underscoring the need to further explore novel predictive tools.&lt;/p&gt;&lt;p&gt;Despite its retrospective nature, the study is methodologically robust. The authors utilize a comprehensive statistical approach, including univariate and multivariate Cox regression, competing risk models, and Kaplan–Meier survival analysis. Notably, the use of competing risk analysis—accounting for death as a competing event—is particularly appropriate given the cohort's 17% mortality rate.&lt;/p&gt;&lt;p&gt;Sensitivity analyses were conducted to empirically establish opt","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 12","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12716103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145795682","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":"Multimodality Imaging Assessment of a Giant Middle Mediastinal Schwannoma","authors":"Qing Yan,&nbsp;Leizhi Ku,&nbsp;Yuhang Wang,&nbsp;Xiaojing Ma","doi":"10.1111/echo.70361","DOIUrl":"10.1111/echo.70361","url":null,"abstract":"<div>\u0000 \u0000 <p>Mediastinal schwannomas primarily originate from the intercostal and sympathetic nerves located in the posterior mediastinum. Tumors originating from the vagus nerve in the middle mediastinum are extremely rare, accounting for 2% of all intrathoracic schwannomas. Although schwannomas are typically asymptomatic and discovered by accident, they can produce symptoms when they compress adjacent structures, which may lead to severe complications and are hard to manage. These cardiovascular risk factors include superior vena cava syndrome, cardiac tamponade, heart failure, and pulmonary hypertension. Due to their widespread cystic degeneration, they are often misinterpreted as bronchogenic or pericardial cysts. Multimodality imaging can help differentiate diagnoses, determine the location and extent of the mass, and assess the involvement of other structures, which is essential for guiding surgical procedures and improving patient outcomes. The management approach is based on tumor size, location, concern for underlying malignant pathology, and potential complications related to tumor infiltration into surrounding structures. We report a case of a giant mediastinal tumor with a successful surgical resection under cardiopulmonary bypass. It was diagnosed as a schwannoma by pathological examination, more than 1 year postoperatively, with neither symptoms of postoperative neurological disorders nor signs of recurrence.</p>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 12","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776018","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":"Aortic Regurgitation Grading: Reproducibility, Relevance, and the Case for Individualized Imaging","authors":"Giovanni J. Nanna,&nbsp;Laura Marcela Romero-Acero,&nbsp;Michele Nanna","doi":"10.1111/echo.70376","DOIUrl":"10.1111/echo.70376","url":null,"abstract":"","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 12","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145775535","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":"Left Ventricular Multi-Directional Deformation and Coronary Microvascular Dysfunction in Patients With Angina With No Obstructive Coronary Artery Disease: A Comprehensive Analysis From the Two-Dimensional Speckle-Tracking Echocardiography","authors":"Yuhui Yang,&nbsp;Ying Li,&nbsp;Zaihan Zhu,&nbsp;Xingyu Fang,&nbsp;Anxiang Sha,&nbsp;Yupeng Wu,&nbsp;Dandan Sun","doi":"10.1111/echo.70375","DOIUrl":"10.1111/echo.70375","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The aim of this study was to investigate the relationship between coronary microvascular dysfunction (CMD) and left ventricular multi-directional deformation in patients with angina with no obstructive coronary artery disease (ANOCA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study retrospectively analyzed patients who were clinically diagnosed with ANOCA in our hospital from September 2018 to September 2024. Coronary flow velocity reserve (CFVR) was measured using adenosine stress echocardiography to evaluate CMD. Patients were divided into two groups: the CMD group (CFVR <b>≤</b> 2.0) and the control group (CFVR &gt; 2.0). The global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) of the left ventricle were analyzed by two-dimensional speckle tracking imaging (2D-STI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study included 69 patients in the CMD group and 75 individuals in the control group. Compared to the control group, the CMD group showed a lower absolute value of GLS and a higher absolute value of GCS. After adjusting for confounding factors, multivariate logistic regression analysis revealed that GLS (β: −1.119, OR: 0.327, 95% CI: 0.223–0.478, <i>p</i> &lt; 0.001), GCS (β: 0.464, OR: 1.591, 95% CI: 1.239–2.042, <i>p</i> &lt; 0.001) were independent predictors of CMD in ANOCA patients. The areas under the ROC curve of GLS, GCS, GRS, and the combination of GLS and GCS were 0.858, 0.687, 0.519, and 0.901, respectively. The results of Pearson correlation analysis showed that CFVR was negatively correlated with GCS, with <i>r</i> values of −0.264 (<i>p </i>&lt; 0.001). The correlation coefficient between CFVR and GLS was positive, with <i>r</i> values of 0.562 (<i>p </i>&lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings showed that when ANOCA patients developed CMD, the absolute value of GLS decreased, and the absolute value of GCS increased. The combination of GLS and GCS demonstrated strong predictive value and diagnostic efficiency for CMD in ANOCA patients. Our study is beneficial for the early detection of CMD in ANOCA patients and the development of intervention strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 12","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758168","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}