Peter L. M. Kerkhof, Rienzi A. Diaz-Navarro, Neal Handly
Ejection fraction (EF) is an incomplete metric and requires consideration of an associated companion (EFC) metric. This figure is based on 96 cardiac patients, including those with acute myocardial infarction (MI). For mid-range EF (with values ranging from 40% to 50%) the brown-colored area indicates the distribution of the EFC for these patients. Only the combination of EF and EFC can define the unique location of each patient. Likewise, data points are spread for any other EF range, for example, those with 55<EF<60% (see yellow area). Volume data obtained by cardiac magnetic resonance imaging (courtesy of Prof. R. A. Diaz-Navarro).
射血分数（EF）是一个不完整的指标，需要考虑相关的辅助指标（EFC）。本图基于 96 名心脏病患者，包括急性心肌梗死（MI）患者。对于中等范围的 EF 值（从 40% 到 50% 不等），棕色区域表示这些患者的 EFC 分布情况。只有 EF 和 EFC 的组合才能确定每位患者的独特位置。同样，任何其他 EF 范围的数据点也会分布，例如，EF 为 55<EF<60% 的患者（见黄色区域）。心脏磁共振成像获得的体积数据（由 R. A. Diaz-Navarro 教授提供）。
{"title":"How the Crystal Ball Helps to Beat Ejection Fraction as Predictor of Mortality After Myocardial Infarction","authors":"Peter L. M. Kerkhof, Rienzi A. Diaz-Navarro, Neal Handly","doi":"10.1111/echo.15936","DOIUrl":"https://doi.org/10.1111/echo.15936","url":null,"abstract":"<p>Ejection fraction (EF) is an incomplete metric and requires consideration of an associated companion (EFC) metric. This figure is based on 96 cardiac patients, including those with acute myocardial infarction (MI). For mid-range EF (with values ranging from 40% to 50%) the brown-colored area indicates the distribution of the EFC for these patients. Only the combination of EF and EFC can define the unique location of each patient. Likewise, data points are spread for any other EF range, for example, those with 55<EF<60% (see yellow area). Volume data obtained by cardiac magnetic resonance imaging (courtesy of Prof. R. A. Diaz-Navarro).\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":"41 10","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142443400","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}
To predict recurring atrial fibrillation (AF) following radiofrequency catheter ablation by assessing the attributes of the left atrium and the left atrial (LA) appendage (LAA) using transesophageal echocardiography (TEE) and speckle tracking imaging.
Methods
The structural and functional indices of the LA and LAA of 80 patients with AF who underwent preoperative transthoracic echocardiography and TEE were measured. Recurrence was recorded postoperatively at 3, 6, and 12 months. The independent determinants of recurring AF were identified by logistic regression, and their optimum cutoff values, sensitivity, and specificity were estimated from the receiver operating characteristic (ROC) curves.
Results
The recurrent and nonrecurrent groups comprised 17 and 63 patients, respectively. The LA internal diameter, LA end-diastolic and end-systolic volumes, LAA length, diameter and area of the opening of the LAA, and LAA end-diastolic volume were higher in the recurrent group. The LA strain in the reservoir phase, the ejection fraction and filling velocity of the LAA, the LAA emptying velocity (LAAeV), and the LAA strain (LAAS) reduced considerably. Multifactorial regression analyses demonstrated that the LAAeV and LAAS were independent determinants of recurring AF. ROC curve analysis revealed that the LAAeV and LAAS predicted postoperative recurrence at 34.5 cm/s (area under the curve [AUC]: 0.954, sensitivity: 94.1%, and specificity: 92.1%) and 11.61% (AUC: 0.925, sensitivity: 82.4%, and specificity: 95.2%), respectively, while the AUC, sensitivity, and specificity of the combined predictors (LAAeV + LAAS) were 0.978, 94.1%, and 93.7%, respectively.
Conclusion
The LAAeV and LAAS independently influenced the postoperative recurrence of AF.
{"title":"Assessing Left Atrial Appendage Functions by Transesophageal Echocardiography and Speckle Tracking Imaging to Predict Recurring Atrial Fibrillation Post-Radiofrequency Catheter Ablation","authors":"Xinyu Hao, Wei Li, Qunying Zhang, Le Cao, Jinshu Wang, Ling Guo, Qiang Zhang","doi":"10.1111/echo.15958","DOIUrl":"https://doi.org/10.1111/echo.15958","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To predict recurring atrial fibrillation (AF) following radiofrequency catheter ablation by assessing the attributes of the left atrium and the left atrial (LA) appendage (LAA) using transesophageal echocardiography (TEE) and speckle tracking imaging.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The structural and functional indices of the LA and LAA of 80 patients with AF who underwent preoperative transthoracic echocardiography and TEE were measured. Recurrence was recorded postoperatively at 3, 6, and 12 months. The independent determinants of recurring AF were identified by logistic regression, and their optimum cutoff values, sensitivity, and specificity were estimated from the receiver operating characteristic (ROC) curves.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The recurrent and nonrecurrent groups comprised 17 and 63 patients, respectively. The LA internal diameter, LA end-diastolic and end-systolic volumes, LAA length, diameter and area of the opening of the LAA, and LAA end-diastolic volume were higher in the recurrent group. The LA strain in the reservoir phase, the ejection fraction and filling velocity of the LAA, the LAA emptying velocity (LAAeV), and the LAA strain (LAAS) reduced considerably. Multifactorial regression analyses demonstrated that the LAAeV and LAAS were independent determinants of recurring AF. ROC curve analysis revealed that the LAAeV and LAAS predicted postoperative recurrence at 34.5 cm/s (area under the curve [AUC]: 0.954, sensitivity: 94.1%, and specificity: 92.1%) and 11.61% (AUC: 0.925, sensitivity: 82.4%, and specificity: 95.2%), respectively, while the AUC, sensitivity, and specificity of the combined predictors (LAAeV + LAAS) were 0.978, 94.1%, and 93.7%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The LAAeV and LAAS independently influenced the postoperative recurrence of AF.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 10","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142435340","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}
Jesús Peteiro, Marina Combarro, Alberto Bouzas-Mosquera
Case 1 (top) has an AS pattern at rest and peak exercise with values of 2.4 and 2.6, respectively. See “cherry on top” patterns at rest and at exercise (arrows). Corresponding values for global 3D longitudinal strain were -9.9 and -7.8.
The Case 2 (bottom) has absence of AS at rest (AS = 0.78), but presence of AS at peak exercise (AS = 1.53; “cherry on top” pattern only at exercise). Corresponding global 3D strain values were -8.3 and -4.3.
{"title":"Is There Apical Sparing Pattern During Stress in Cardiac Amyloidosis?","authors":"Jesús Peteiro, Marina Combarro, Alberto Bouzas-Mosquera","doi":"10.1111/echo.15946","DOIUrl":"https://doi.org/10.1111/echo.15946","url":null,"abstract":"<p>Case 1 (top) has an AS pattern at rest and peak exercise with values of 2.4 and 2.6, respectively. See “cherry on top” patterns at rest and at exercise (arrows). Corresponding values for global 3D longitudinal strain were -9.9 and -7.8.</p><p>The Case 2 (bottom) has absence of AS at rest (AS = 0.78), but presence of AS at peak exercise (AS = 1.53; “cherry on top” pattern only at exercise). Corresponding global 3D strain values were -8.3 and -4.3. \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":"41 10","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142435395","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}
Echocardiographic right ventricular (RV) dysfunction is a strong risk determinant for prognosis in patients with heart failure (HF). Although parameters of RV systolic function are widely used to define RV dysfunction, there is scarce data to suggest these parameters are best suited to predict HF-related outcomes.
Aims
We aimed to understand which morphologic or functional parameters are most closely associated with short-term mortality and HF-related hospitalization in patients with HF.
Methods
A total of 191 patients from eight study centers were included to this study. A detailed echocardiographic examination was done at enrollment, and patients were followed up for 6 months via direct interviews or phone calls.
Results
All right-sided echocardiographic parameters other than tricuspid annular plane systolic excursion were associated with outcomes. In a proportional hazards model that included right-heart parameters, RV longitudinal diameter (HR: 1.07, 95%CI: 1.04–1.10, p < 0.001), wall thickness (HR: 1.3, 95%CI: 1.13–1.50, p < 0.001), and tricuspid annular systolic velocity (HR: 0.90, 95%CI: 0.82–0.96, p = 0.02) were found as the independent predictors. However, only RV longitudinal dimension (HR: 1.04, 95%CI: 1.01–1.08, p = 0.01) and RV wall thickness (HR: 1.32, 95%CI: 1.10–1.60, p = 0.004) were associated with short-term outcomes after adjusting for other clinical and left-sided echocardiographic variables. On a Bayesian logistic regression model that included right-sided echocardiography variables, there was strong evidence for including either RV longitudinal diameter (BF10: 190.4) or wall thickness (BF10: 30.7) to the final model.
Conclusion
Parameters of RV morphology were better predictors of short-term outcomes in HF patients.
{"title":"Associations Between Echocardiographic Right Heart Measurements With Short-Term Prognosis in Heart Failure: A Prospective Study","authors":"Lale Dinç Asarcıklı, Duygu İnan, Selda Murat, İnci Tuğçe Çöllüoğlu, Nijat Bakhshaliyev, Zeynep Ulutaş, Gizem Çabuk, Senem Hasırcı, Abdulrahman Naser, Şennur Ünal Dayı, Ahmet Çelik, Tolga Sinan Güvenç","doi":"10.1111/echo.15959","DOIUrl":"https://doi.org/10.1111/echo.15959","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Echocardiographic right ventricular (RV) dysfunction is a strong risk determinant for prognosis in patients with heart failure (HF). Although parameters of RV systolic function are widely used to define RV dysfunction, there is scarce data to suggest these parameters are best suited to predict HF-related outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>We aimed to understand which morphologic or functional parameters are most closely associated with short-term mortality and HF-related hospitalization in patients with HF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 191 patients from eight study centers were included to this study. A detailed echocardiographic examination was done at enrollment, and patients were followed up for 6 months via direct interviews or phone calls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All right-sided echocardiographic parameters other than tricuspid annular plane systolic excursion were associated with outcomes. In a proportional hazards model that included right-heart parameters, RV longitudinal diameter (HR: 1.07, 95%CI: 1.04–1.10, <i>p </i>< 0.001), wall thickness (HR: 1.3, 95%CI: 1.13–1.50, <i>p</i> < 0.001), and tricuspid annular systolic velocity (HR: 0.90, 95%CI: 0.82–0.96, <i>p</i> = 0.02) were found as the independent predictors. However, only RV longitudinal dimension (HR: 1.04, 95%CI: 1.01–1.08, <i>p</i> = 0.01) and RV wall thickness (HR: 1.32, 95%CI: 1.10–1.60, <i>p</i> = 0.004) were associated with short-term outcomes after adjusting for other clinical and left-sided echocardiographic variables. On a Bayesian logistic regression model that included right-sided echocardiography variables, there was strong evidence for including either RV longitudinal diameter (BF<sub>10</sub>: 190.4) or wall thickness (BF<sub>10</sub>: 30.7) to the final model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Parameters of RV morphology were better predictors of short-term outcomes in HF patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 10","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142435341","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}
Kaitlyn Foreman, Elizabeth Lyman, Sara Conroy, Arash Salavitabar, Clifford L. Cua
Introduction
Transthoracic (TTE) follow up guidelines after PFO device closure are vague. The primary goal of this study was to perform a literature search to characterize the timing of complications that occur after PFO device placement to determine the utility of long-term routine TTE.
Methods
A search was performed in Medline (PubMed) with English language and publication date (2000–2023) filters were applied. Studies were included if they reported on patients who underwent a PFO device closure. Studies were excluded if they only reported on ASD device closure patients, were meta-analysis or review papers, or did not report any outcomes for the PFO device procedure.
Results
A total of 305 articles met the criteria (observational cohort study, n = 196; case study, n = 99; and randomized control study, n = 10). Age at the time of PFO device closure was 47.5 ± 9.3 years. The incidence of complications was 6.9% (3358/48 348). Maximum range of follow-up was 0–17 years. The plurality of complications was due to arrhythmias (46.3%, 1554/3358), followed by residual shunts (29.7%, 999/3358). The majority of complications occurred ≤6 months post-device placement (57.8%, 1941/3358). Only 0.8% (27/3358) of complications took place >5 years. All patients with complications >5 years of device placement were presented with clinical symptoms related to their complications.
Conclusion
The incidence of patients presenting with PFO-reported complications beyond 5 years post-procedure diminished. The utility of routine TTE beyond 5 years post-PFO after device placement should be further assessed.
{"title":"PFO Device Complications: Literature Review and Possible Implications for Echocardiographic Follow-Up","authors":"Kaitlyn Foreman, Elizabeth Lyman, Sara Conroy, Arash Salavitabar, Clifford L. Cua","doi":"10.1111/echo.15951","DOIUrl":"https://doi.org/10.1111/echo.15951","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Transthoracic (TTE) follow up guidelines after PFO device closure are vague. The primary goal of this study was to perform a literature search to characterize the timing of complications that occur after PFO device placement to determine the utility of long-term routine TTE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A search was performed in Medline (PubMed) with English language and publication date (2000–2023) filters were applied. Studies were included if they reported on patients who underwent a PFO device closure. Studies were excluded if they only reported on ASD device closure patients, were meta-analysis or review papers, or did not report any outcomes for the PFO device procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 305 articles met the criteria (observational cohort study, <i>n</i> = 196; case study, <i>n</i> = 99; and randomized control study, <i>n</i> = 10). Age at the time of PFO device closure was 47.5 ± 9.3 years. The incidence of complications was 6.9% (3358/48 348). Maximum range of follow-up was 0–17 years. The plurality of complications was due to arrhythmias (46.3%, 1554/3358), followed by residual shunts (29.7%, 999/3358). The majority of complications occurred ≤6 months post-device placement (57.8%, 1941/3358). Only 0.8% (27/3358) of complications took place >5 years. All patients with complications >5 years of device placement were presented with clinical symptoms related to their complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The incidence of patients presenting with PFO-reported complications beyond 5 years post-procedure diminished. The utility of routine TTE beyond 5 years post-PFO after device placement should be further assessed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 10","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142435338","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}
Taylor Ferris, Ethan Yohannan, Kurt Daniel, Karl M. Richardson
Purpose
Diagnosing cardiac amyloidosis (CA) is difficult due to nonspecific clinical symptoms and echocardiographic findings. Prior studies have suggested that apical sparing strain patterns may be diagnostically useful. With increasing strain usage, it remains unclear how specific this pattern is to diagnose CA. We analyzed strain patterns between CA and end-stage renal disease (ESRD) patient populations.
Methods
Patients with ESRD proven negative for CA (n = 19) were compared to CA patients with CKD stage 3 or less (n = 25). The ESRD cohort was stratified based on time on dialysis. Echocardiographic longitudinal strain (LS) parameters were collected, including regional and global LS, echocardiographic, and demographic parameters. Relative apical LS was calculated using the following equation: average apical LS/(average mid LS + average basal LS).
Results
No significant differences were found regarding regional strain or relative apical strain. Our study showed a sensitivity of 80% and specificity of 42% when using a relative apical strain ratio of >1. All groups demonstrated an apical sparing strain pattern visually on the bulls-eye plot.
Conclusion
ESRD demonstrates significant overlapping findings across various imaging modalities compared to CA. We demonstrated that relative apical sparing strain is nonspecific for CA among patients with ESRD. Our study calls into question the clinical value of relative apical-sparing stain patterns in identifying CA in an ESRD population and suggests that diagnostic evaluation should be driven by strong clinical suspicion and other imaging and demographic variables.
目的 由于非特异性临床症状和超声心动图检查结果，诊断心脏淀粉样变性（CA）非常困难。先前的研究表明，心尖疏松应变模式可能对诊断有用。随着应变使用的增加，目前仍不清楚这种模式对诊断 CA 的特异性有多大。我们分析了 CA 和终末期肾病（ESRD）患者之间的应变模式。 方法 将经证实为 CA 阴性的 ESRD 患者（n = 19）与 CKD 3 期或以下的 CA 患者（n = 25）进行比较。根据透析时间对 ESRD 患者进行分层。收集超声心动图纵向应变（LS）参数，包括区域和整体 LS、超声心动图和人口统计学参数。相对心尖应变的计算公式如下：平均心尖应变/（平均中间应变+平均基底应变）。 结果 在区域应变和相对心尖应变方面没有发现明显差异。我们的研究显示，当使用相对心尖应变比率为 1 时，敏感性为 80%，特异性为 42%。 结论 与 CA 相比，ESRD 在各种成像模式下都有明显的重叠发现。我们的研究表明，ESRD 患者的相对心尖疏松应变对 CA 没有特异性。我们的研究对相对心尖疏松染色模式在 ESRD 患者中识别 CA 的临床价值提出了质疑，并建议诊断评估应基于强烈的临床怀疑以及其他影像学和人口统计学变量。
{"title":"Comparing Echocardiographic Strain Imaging in Cardiac Amyloid and End-Stage Renal Disease Patients","authors":"Taylor Ferris, Ethan Yohannan, Kurt Daniel, Karl M. Richardson","doi":"10.1111/echo.15962","DOIUrl":"https://doi.org/10.1111/echo.15962","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Diagnosing cardiac amyloidosis (CA) is difficult due to nonspecific clinical symptoms and echocardiographic findings. Prior studies have suggested that apical sparing strain patterns may be diagnostically useful. With increasing strain usage, it remains unclear how specific this pattern is to diagnose CA. We analyzed strain patterns between CA and end-stage renal disease (ESRD) patient populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with ESRD proven negative for CA (<i>n</i> = 19) were compared to CA patients with CKD stage 3 or less (<i>n</i> = 25). The ESRD cohort was stratified based on time on dialysis. Echocardiographic longitudinal strain (LS) parameters were collected, including regional and global LS, echocardiographic, and demographic parameters. Relative apical LS was calculated using the following equation: average apical LS/(average mid LS + average basal LS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No significant differences were found regarding regional strain or relative apical strain. Our study showed a sensitivity of 80% and specificity of 42% when using a relative apical strain ratio of >1. All groups demonstrated an apical sparing strain pattern visually on the bulls-eye plot.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ESRD demonstrates significant overlapping findings across various imaging modalities compared to CA. We demonstrated that relative apical sparing strain is nonspecific for CA among patients with ESRD. Our study calls into question the clinical value of relative apical-sparing stain patterns in identifying CA in an ESRD population and suggests that diagnostic evaluation should be driven by strong clinical suspicion and other imaging and demographic variables.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 10","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142435342","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}
Coronary artery anomalies are rare and may involve the coronary origin, course, or termination. Most are benign; however, some can lead to myocardial damage, sudden death, or potential hazards during interventional or surgical procedures. The advancement of imaging studies has led to an increase in their diagnosis. Coronary computed tomography angiography (CCTA) especially has characterized new anomalies that were previously anecdotal. This is the case of the intra-atrial course of the right coronary artery. The present is a brief review about this rare congenital anomaly.
{"title":"Intra-Atrial Right Coronary Artery: A Condition Revealed by Coronary CT Scan","authors":"Chiara Rovera, Francesca Bisanti, Claudio Moretti","doi":"10.1111/echo.15956","DOIUrl":"https://doi.org/10.1111/echo.15956","url":null,"abstract":"<div>\u0000 \u0000 <p>Coronary artery anomalies are rare and may involve the coronary origin, course, or termination. Most are benign; however, some can lead to myocardial damage, sudden death, or potential hazards during interventional or surgical procedures. The advancement of imaging studies has led to an increase in their diagnosis. Coronary computed tomography angiography (CCTA) especially has characterized new anomalies that were previously anecdotal. This is the case of the intra-atrial course of the right coronary artery. The present is a brief review about this rare congenital anomaly.</p>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 10","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142435339","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}
Sara Amicone, Andrea Impellizzeri, Francesco Pio Tattilo, Khrystyna Ryabenko, Claudio Asta, Rebecca Belà, Nicole Suma, Lisa Canton, Damiano Fedele, Davide Bertolini, Francesca Bodega, Daniele Cavallo, Virginia Marinelli, Mariachiara Ciarlantini, Giuseppe Pastore, Ornella Di Iuorio, Marcello Casuso Alvarez, Leonardo Luca Bavuso, Jessica Salerno, Nicolò Vasumini, Angelo Maida, Matteo Armillotta, Francesco Angeli, Angelo Sansonetti, Luca Bergamaschi, Alberto Foà, Angelo Squeri, Gianni Dall'Ara, Carmine Pizzi
Takotsubo syndrome (TTS) is a clinical syndrome characterized by a transient left ventricular dysfunction whose diagnosis can be challenging due to its resemblance to acute myocardial infarction (AMI). Despite the growing recognition of TTS, acute complications and long-term mortality rates are comparable to those observed in AMI patients. In this context, a systematic diagnostic approach is imperative for an accurate patient assessment, with due consideration of the distinctive characteristics and optimal timing of each imaging modality. Coronary angiography with ventriculography may be reserved for cases presenting with ST-segment elevation, whereas in all other cases, the use of multimodality noninvasive imaging allows for a comprehensive evaluation of typical diagnostic features and detection of acute complications while also providing prognostic insights. The aim of this review is to evaluate the current research on non-invasive modalities and to propose a diagnostic algorithm that will facilitate the identification and management of TTS.
高猝死综合征（TTS）是一种以一过性左心室功能障碍为特征的临床综合征，由于与急性心肌梗死（AMI）相似，其诊断具有挑战性。尽管人们对 TTS 的认识不断提高，但其急性并发症和长期死亡率与急性心肌梗死患者不相上下。在这种情况下，必须采用系统的诊断方法对患者进行准确评估，并充分考虑到每种成像模式的独特性和最佳时机。冠状动脉造影和心室造影可用于 ST 段抬高的病例，而对于所有其他病例，使用多模态无创成像可对典型诊断特征进行全面评估，发现急性并发症，同时提供预后见解。本综述旨在评估目前对无创模式的研究，并提出一种有助于识别和管理 TTS 的诊断算法。
{"title":"Noninvasive Assessment in Takotsubo Syndrome: A Diagnostic Challenge","authors":"Sara Amicone, Andrea Impellizzeri, Francesco Pio Tattilo, Khrystyna Ryabenko, Claudio Asta, Rebecca Belà, Nicole Suma, Lisa Canton, Damiano Fedele, Davide Bertolini, Francesca Bodega, Daniele Cavallo, Virginia Marinelli, Mariachiara Ciarlantini, Giuseppe Pastore, Ornella Di Iuorio, Marcello Casuso Alvarez, Leonardo Luca Bavuso, Jessica Salerno, Nicolò Vasumini, Angelo Maida, Matteo Armillotta, Francesco Angeli, Angelo Sansonetti, Luca Bergamaschi, Alberto Foà, Angelo Squeri, Gianni Dall'Ara, Carmine Pizzi","doi":"10.1111/echo.15953","DOIUrl":"10.1111/echo.15953","url":null,"abstract":"<div>\u0000 \u0000 <p>Takotsubo syndrome (TTS) is a clinical syndrome characterized by a transient left ventricular dysfunction whose diagnosis can be challenging due to its resemblance to acute myocardial infarction (AMI). Despite the growing recognition of TTS, acute complications and long-term mortality rates are comparable to those observed in AMI patients. In this context, a systematic diagnostic approach is imperative for an accurate patient assessment, with due consideration of the distinctive characteristics and optimal timing of each imaging modality. Coronary angiography with ventriculography may be reserved for cases presenting with ST-segment elevation, whereas in all other cases, the use of multimodality noninvasive imaging allows for a comprehensive evaluation of typical diagnostic features and detection of acute complications while also providing prognostic insights. The aim of this review is to evaluate the current research on non-invasive modalities and to propose a diagnostic algorithm that will facilitate the identification and management of TTS.</p>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 10","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394934","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}
Jiaqi Zhang, Caihong Chang, Changxiu Yu, Yao Peng, Wei Feng, Juan Song, Ji Wu
Background
Gestational diabetes mellitus (GDM) poses a risk for cardiovascular damage during pregnancy. This study focused on evaluating changes in left ventricular myocardial performance in GDM patients using the left ventricular pressure-strain loop (LV-PSL) method and examining risk factors associated with reduced myocardial function.
Methods
A prospective, randomized study involving 112 pregnant women diagnosed with GDM was conducted from June 2021 to June 2024. Additionally, 84 healthy pregnant women from the same period served as the control group. Utilizing both conventional echocardiography and two-dimensional speckle tracking echocardiography, left ventricular myocardial work metrics were assessed using LV-PSL technology.
Results
GDM patients demonstrated significantly reduced values for global longitudinal strain (GLS), global work index (GWI), global work efficiency (GWE), and global constructive work (GCW) (p < 0.05), while conventional ultrasound measures showed no significant difference between GDM and control groups. GWI, GWE, GCW, and GLS had high predictive value for cardiac function changes in GDM patients, with GWE showing the highest predictive value {Area under curve (AUC) = 0.866, cutoff value = 95.5%, specificity = 0.77, sensitivity = 0.87}. GWI, GWE, and GCW were negatively correlated with GLS (r = −0.532, −0.411, −0.425, all p < 0.001), whereas global wasted work (GWW) showed a positive correlation with GLS (r = 0.325 and p < 0.001). These parameters were also correlated with HbA1c levels (r = −0.316, −0.256, −0.260, all p < 0.001 for negative correlations, and r = 0.172, p < 0.05 for positive correlations). Multivariate logistic regression indicated that 1-h OGTT (mmol/L), 2-h OGTT (mmol/L), and HbA1c (%) were significant predictors of left ventricular systolic function (GWE) in GDM patients.
Conclusions
LV-PSL is an effective tool for early detection of left ventricular systolic function impairment in GDM patients.
{"title":"Quantitative Analysis of Myocardial Work in Gestational Diabetes Mellitus Using Noninvasive Left Ventricular Pressure-Strain Loop Measurement","authors":"Jiaqi Zhang, Caihong Chang, Changxiu Yu, Yao Peng, Wei Feng, Juan Song, Ji Wu","doi":"10.1111/echo.15944","DOIUrl":"10.1111/echo.15944","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Gestational diabetes mellitus (GDM) poses a risk for cardiovascular damage during pregnancy. This study focused on evaluating changes in left ventricular myocardial performance in GDM patients using the left ventricular pressure-strain loop (LV-PSL) method and examining risk factors associated with reduced myocardial function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective, randomized study involving 112 pregnant women diagnosed with GDM was conducted from June 2021 to June 2024. Additionally, 84 healthy pregnant women from the same period served as the control group. Utilizing both conventional echocardiography and two-dimensional speckle tracking echocardiography, left ventricular myocardial work metrics were assessed using LV-PSL technology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>GDM patients demonstrated significantly reduced values for global longitudinal strain (GLS), global work index (GWI), global work efficiency (GWE), and global constructive work (GCW) (<i>p</i> < 0.05), while conventional ultrasound measures showed no significant difference between GDM and control groups. GWI, GWE, GCW, and GLS had high predictive value for cardiac function changes in GDM patients, with GWE showing the highest predictive value {Area under curve (AUC) = 0.866, cutoff value = 95.5%, specificity = 0.77, sensitivity = 0.87}. GWI, GWE, and GCW were negatively correlated with GLS (<i>r</i> = −0.532, −0.411, −0.425, all <i>p</i> < 0.001), whereas global wasted work (GWW) showed a positive correlation with GLS (<i>r</i> = 0.325 and <i>p</i> < 0.001). These parameters were also correlated with HbA1c levels (<i>r</i> = −0.316, −0.256, −0.260, all <i>p</i> < 0.001 for negative correlations, and <i>r</i> = 0.172, <i>p</i> < 0.05 for positive correlations). Multivariate logistic regression indicated that 1-h OGTT (mmol/L), 2-h OGTT (mmol/L), and HbA1c (%) were significant predictors of left ventricular systolic function (GWE) in GDM patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>LV-PSL is an effective tool for early detection of left ventricular systolic function impairment in GDM patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"41 10","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394935","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}
Toshimitsu Tsugu, Kaoru Tanaka, Yuji Nagatomo, Mayuko Tsugu, Johan De Mey
{"title":"Unexpected Computed Tomography Derived Fractional Flow Reserve Decline Due to a Short Left Main Coronary Artery and a Wide Bifurcation Angle","authors":"Toshimitsu Tsugu, Kaoru Tanaka, Yuji Nagatomo, Mayuko Tsugu, Johan De Mey","doi":"10.1111/echo.15948","DOIUrl":"10.1111/echo.15948","url":null,"abstract":"<p>\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":"41 10","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394936","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号