Oleksandr Danylenko, Myo Thidar Lwin, Ioannis Kasouridis, Abigail Masding, Katherine Von Klemperer, Rebecca Macrae, Ricardo Prista Monteiro, Roxy Senior, Wei Li
Aims
The objective of our study was to establish the prevalence of ischemia during exercise stress echocardiography (ESE) in patients with anomalous aortic origin of coronary arteries (AAOCA).
Methods and results
A cohort of 46 patients with AAOCA was retrospectively included in this study. Treadmill/bike exercise stress echo tests for ischemia assessment were performed and analyzed according to ESC guidelines. Computed tomography coronary angiography (CTCA), cardiac magnetic resonance, myocardial perfusion scintigraphy and invasive angiography with intravascular ultrasound if needed were used for coronary artery (CA) morphology and myocardial perfusion assessment. Most patients (70%) were overall symptomatic at rest, 57% reported chest pain and 2% had cardiac arrest before the ESE. By contrast, only 2% of patients reported chest pain during ESE. CTCA revealed that 70% of patients had an inter-arterial course, 17% were found to have an intramural course and 24% had a slit-like ostium of their anomalous CA. Other high-risk features were less frequent findings. All myocardial perfusion studies were negative and only one patient with AAOCA developed ischemia during ESE. Following investigations, four patients were eligible for surgical interventions and were operated on while the remaining patients were followed up for a median of 3 years with no adverse cardiovascular events.
Conclusions
Incidence of ischemia on exercise stress echo is extremely low among middle-aged patients with AAOCA despite symptoms at rest and malignant anatomical features. A good short-term outcome in unoperated AAOCA patients following negative exercise stress echocardiography has been shown.
{"title":"The Role of Stress Echocardiography in Patients With Anomalous Aortic Origin of Coronary Arteries: Two Tertiary Cardiac Centers’ Experience","authors":"Oleksandr Danylenko, Myo Thidar Lwin, Ioannis Kasouridis, Abigail Masding, Katherine Von Klemperer, Rebecca Macrae, Ricardo Prista Monteiro, Roxy Senior, Wei Li","doi":"10.1111/echo.70371","DOIUrl":"10.1111/echo.70371","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The objective of our study was to establish the prevalence of ischemia during exercise stress echocardiography (ESE) in patients with anomalous aortic origin of coronary arteries (AAOCA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and results</h3>\u0000 \u0000 <p>A cohort of 46 patients with AAOCA was retrospectively included in this study. Treadmill/bike exercise stress echo tests for ischemia assessment were performed and analyzed according to ESC guidelines. Computed tomography coronary angiography (CTCA), cardiac magnetic resonance, myocardial perfusion scintigraphy and invasive angiography with intravascular ultrasound if needed were used for coronary artery (CA) morphology and myocardial perfusion assessment. Most patients (70%) were overall symptomatic at rest, 57% reported chest pain and 2% had cardiac arrest before the ESE. By contrast, only 2% of patients reported chest pain during ESE. CTCA revealed that 70% of patients had an inter-arterial course, 17% were found to have an intramural course and 24% had a slit-like ostium of their anomalous CA. Other high-risk features were less frequent findings. All myocardial perfusion studies were negative and only one patient with AAOCA developed ischemia during ESE. Following investigations, four patients were eligible for surgical interventions and were operated on while the remaining patients were followed up for a median of 3 years with no adverse cardiovascular events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Incidence of ischemia on exercise stress echo is extremely low among middle-aged patients with AAOCA despite symptoms at rest and malignant anatomical features. A good short-term outcome in unoperated AAOCA patients following negative exercise stress echocardiography has been shown.</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":"145758236","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}
Jelle P. Man, Berto J. Bouma, M. A. Molenaar, Steven A. J. Chamuleau, Mark J. Schuuring
Aims
To understand prognostic differences between sexes in (subtypes of) secondary mitral valve regurgitation (SMR) and to identify avenues for improvement.
Method and results
In this retrospective study, all consecutive patients diagnosed with moderate or severe SMR by echocardiographic assessment between January 1, 2014, and June 1, 2021 were included. Sex-specific analyses were performed using Cox proportional hazards analysis, adjusted for significant covariates. A total of 1245 patients with SMR (43% female) were included. Females more often had atrial SMR (233 (29%) females vs. 200 (21%) males, p < 0.01), males more often ischemic SMR (100 females (12%) vs. 245 males (25%), p < 0.01), and there were no significant differences between sexes in the proportion of non-ischemic SMR (199 (25%) females vs. 268 (28%) males, p = 0.99). The estimated 5-year survival was 70% (CI = 68%, 73%). Median follow-up was 4.3 years [2.7–6.2], 236 males and 128 females died during follow-up. Females had a better survival than males in a multivariable Cox model (HR = 0.67, p < 0.01).
Conclusion
Overall survival in patients with SMR was low with an estimated 5-year survival of 70%. Females had a better survival in patients with SMR than males. The lower survival in males with SMR might be due to a larger proportion of atrial SMR in females, fewer patients with ischemic SMR, and lower ejection fractions in males with non-ischemic SMR. The current focus on rapid heart failure medication optimization may improve the prognosis of the most vulnerable group; future studies can be directed to see whether this will be the case.
{"title":"The Prognosis of Males and Females With Moderate or Severe Secondary Mitral Valve Regurgitation and Avenues for Improvement","authors":"Jelle P. Man, Berto J. Bouma, M. A. Molenaar, Steven A. J. Chamuleau, Mark J. Schuuring","doi":"10.1111/echo.70370","DOIUrl":"10.1111/echo.70370","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To understand prognostic differences between sexes in (subtypes of) secondary mitral valve regurgitation (SMR) and to identify avenues for improvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method and results</h3>\u0000 \u0000 <p>In this retrospective study, all consecutive patients diagnosed with moderate or severe SMR by echocardiographic assessment between January 1, 2014, and June 1, 2021 were included. Sex-specific analyses were performed using Cox proportional hazards analysis, adjusted for significant covariates. A total of 1245 patients with SMR (43% female) were included. Females more often had atrial SMR (233 (29%) females vs. 200 (21%) males, <i>p</i> < 0.01), males more often ischemic SMR (100 females (12%) vs. 245 males (25%), <i>p</i> < 0.01), and there were no significant differences between sexes in the proportion of non-ischemic SMR (199 (25%) females vs. 268 (28%) males, <i>p</i> = 0.99). The estimated 5-year survival was 70% (CI = 68%, 73%). Median follow-up was 4.3 years [2.7–6.2], 236 males and 128 females died during follow-up. Females had a better survival than males in a multivariable Cox model (HR = 0.67, <i>p</i> < 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Overall survival in patients with SMR was low with an estimated 5-year survival of 70%. Females had a better survival in patients with SMR than males. The lower survival in males with SMR might be due to a larger proportion of atrial SMR in females, fewer patients with ischemic SMR, and lower ejection fractions in males with non-ischemic SMR. The current focus on rapid heart failure medication optimization may improve the prognosis of the most vulnerable group; future studies can be directed to see whether this will be the case.</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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12704036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758084","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}
Alex D'Amico, Paul Nona, Loren Wagner, Miguel R. Sotelo, Chris Rogers, Navin Nanda, Julian Booker, Efstathia Andrikopoulou
Background
Despite increased awareness of its clinical consequences, personalized risk stratification in patients with moderate aortic stenosis (AS) remains ambiguous. We studied predictors of progression and clinical outcomes in moderate AS to improve risk stratification and add to the existing literature.
Methods
Data collected through the Tempus Next care pathway intelligence platform at our tertiary referral center were retrospectively analyzed. The reports of echocardiograms performed from October 2017 to January 2020 were screened for descriptive or quantitative evidence of moderate AS. Follow-up extended until January 2022. Clinical data were extracted following manual chart review. Socioeconomic variables were collected based on zip-code–aggregated United States census data. The endpoints were progression from moderate to severe valvular AS, all-cause mortality, all-cause hospitalization, and heart failure (HF) hospitalization. The final multivariable model was selected using a variable selection algorithm inspired by greedy causal discovery algorithms.
Results
A total of 34 450 echocardiograms (N = 25 204 patients) were screened during the inclusion period; 367 patients met inclusion criteria and were included in the final analysis. Progression to severe AS was noted in 172 patients (median time to progression 16 months). The final predictive models after variable selection exhibited modest predictive power: progression to severe AS, AUC = 0.68; all-cause mortality, 0.797; all-cause hospitalization, 0.629; heart failure hospitalization, 0.744. Variables predictive for the endpoints included comorbidities, echocardiographic variables, and demographics.
Conclusion
Our findings support further work and exploration of a paradigm shift in the assessment and management of AS, moving beyond traditional measures to a multiparametric model incorporating a broader spectrum of clinical, echocardiographic, and socioeconomic variables.
{"title":"Clinical, Echocardiographic, and Socioeconomic Predictors of Progression and Outcomes in Patients With Moderate Aortic Stenosis","authors":"Alex D'Amico, Paul Nona, Loren Wagner, Miguel R. Sotelo, Chris Rogers, Navin Nanda, Julian Booker, Efstathia Andrikopoulou","doi":"10.1111/echo.70288","DOIUrl":"10.1111/echo.70288","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite increased awareness of its clinical consequences, personalized risk stratification in patients with moderate aortic stenosis (AS) remains ambiguous. We studied predictors of progression and clinical outcomes in moderate AS to improve risk stratification and add to the existing literature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data collected through the Tempus Next care pathway intelligence platform at our tertiary referral center were retrospectively analyzed. The reports of echocardiograms performed from October 2017 to January 2020 were screened for descriptive or quantitative evidence of moderate AS. Follow-up extended until January 2022. Clinical data were extracted following manual chart review. Socioeconomic variables were collected based on zip-code–aggregated United States census data. The endpoints were progression from moderate to severe valvular AS, all-cause mortality, all-cause hospitalization, and heart failure (HF) hospitalization. The final multivariable model was selected using a variable selection algorithm inspired by greedy causal discovery algorithms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 34 450 echocardiograms (<i>N</i> = 25 204 patients) were screened during the inclusion period; 367 patients met inclusion criteria and were included in the final analysis. Progression to severe AS was noted in 172 patients (median time to progression 16 months). The final predictive models after variable selection exhibited modest predictive power: progression to severe AS, AUC = 0.68; all-cause mortality, 0.797; all-cause hospitalization, 0.629; heart failure hospitalization, 0.744. Variables predictive for the endpoints included comorbidities, echocardiographic variables, and demographics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings support further work and exploration of a paradigm shift in the assessment and management of AS, moving beyond traditional measures to a multiparametric model incorporating a broader spectrum of clinical, echocardiographic, and socioeconomic variables.</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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12704040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758140","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}
Shivani Patel, Nazia Husain, Jennifer Acevedo, Stefani Samples, Amanda Hauck
Background
Echocardiographic quantification of myocardial deformation is a valuable tool to assess left ventricular systolic function in children at risk for systolic dysfunction. Since clinical utility is dependent on accurate and reproducible data, pediatric echo labs should establish a process to ensure high quality strain performance and interpretation. We describe our institutional experience of a successful strain implementation pathway.
Methods
Starting in 2016, various plan-do-study-act cycles were implemented, including a comprehensive echocardiography function protocol, knowledge and skill-based education, updated equipment and software to optimize acquisition, reporting, and billing for global longitudinal strain (GLS). We reviewed a sample of echocardiograms annually from 2019 to 2023 on children at risk for chemotherapy related cardiotoxicity (CTRCD). We calculated the percentage of echocardiograms that performed and reported GLS, reviewing for accuracy.
Results
From 2019 to 2023, 685 echocardiograms were reviewed. GLS reporting increased from 39% in 2019 to 76% in 2023 and accuracy improved from 57% to 72% (p < 0.001). Reasons for inaccurate GLS included poor 2D image quality (24%), endocardial border tracing errors despite good image quality (45%) or both (21%). In almost half the studies where GLS was measurable but not reported [99/214; 46%], GLS had not been performed on the echo cart. Reporting of GLS improved from 27% in 2019 to 66% in 2023 with on-cart automation and easier post-processing; and other interventions, including iterative education.
Conclusions
Implementation of administrative, technological, and educational interventions helps to establish a pathway of consistent, high-quality performance and accurate reporting of GLS in pediatric echocardiography labs.
{"title":"A Pathway for Improving Performance and Interpretation of Strain in a Pediatric Echocardiography Laboratory","authors":"Shivani Patel, Nazia Husain, Jennifer Acevedo, Stefani Samples, Amanda Hauck","doi":"10.1111/echo.70369","DOIUrl":"https://doi.org/10.1111/echo.70369","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Echocardiographic quantification of myocardial deformation is a valuable tool to assess left ventricular systolic function in children at risk for systolic dysfunction. Since clinical utility is dependent on accurate and reproducible data, pediatric echo labs should establish a process to ensure high quality strain performance and interpretation. We describe our institutional experience of a successful strain implementation pathway.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Starting in 2016, various plan-do-study-act cycles were implemented, including a comprehensive echocardiography function protocol, knowledge and skill-based education, updated equipment and software to optimize acquisition, reporting, and billing for global longitudinal strain (GLS). We reviewed a sample of echocardiograms annually from 2019 to 2023 on children at risk for chemotherapy related cardiotoxicity (CTRCD). We calculated the percentage of echocardiograms that performed and reported GLS, reviewing for accuracy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 2019 to 2023, 685 echocardiograms were reviewed. GLS reporting increased from 39% in 2019 to 76% in 2023 and accuracy improved from 57% to 72% (<i>p</i> < 0.001). Reasons for inaccurate GLS included poor 2D image quality (24%), endocardial border tracing errors despite good image quality (45%) or both (21%). In almost half the studies where GLS was measurable but not reported [99/214; 46%], GLS had not been performed on the echo cart. Reporting of GLS improved from 27% in 2019 to 66% in 2023 with on-cart automation and easier post-processing; and other interventions, including iterative education.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Implementation of administrative, technological, and educational interventions helps to establish a pathway of consistent, high-quality performance and accurate reporting of GLS in pediatric echocardiography labs.</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":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70369","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739478","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}
Takotsubo syndrome (TS) is an acute and reversible form of myocardial dysfunction characterized by distinctive left ventricular (LV) wall motion abnormalities that typically extend beyond the distribution of a single epicardial coronary artery. Cardiovascular magnetic resonance (CMR) has emerged as a key non-invasive imaging modality for the evaluation of TS, offering a comprehensive assessment of myocardial function and tissue characterization. Among CMR techniques, late gadolinium enhancement (LGE) is a cornerstone for the diagnosis and risk stratification of various cardiopathies, primarily identifying areas of myocardial fibrosis or expansion of the interstitial space. In TS, the typical CMR profile includes myocardial edema in the absence of corresponding LGE, a finding often used to support the diagnosis. However, emerging evidence has reported the presence of LGE in a subset of TS patients, raising questions about its prevalence, underlying mechanisms, and clinical significance. This narrative review aims to explore current evidence on LGE in TS, examining its pathophysiological basis, diagnostic value, and potential prognostic implications.
{"title":"Late Gadolinium Enhancement in Takotsubo Syndrome: Mechanism and Its Clinical Significance","authors":"Riccardo Cau, Jasjit S. Suri, Luca Saba","doi":"10.1111/echo.70321","DOIUrl":"https://doi.org/10.1111/echo.70321","url":null,"abstract":"<div>\u0000 \u0000 <p>Takotsubo syndrome (TS) is an acute and reversible form of myocardial dysfunction characterized by distinctive left ventricular (LV) wall motion abnormalities that typically extend beyond the distribution of a single epicardial coronary artery. Cardiovascular magnetic resonance (CMR) has emerged as a key non-invasive imaging modality for the evaluation of TS, offering a comprehensive assessment of myocardial function and tissue characterization. Among CMR techniques, late gadolinium enhancement (LGE) is a cornerstone for the diagnosis and risk stratification of various cardiopathies, primarily identifying areas of myocardial fibrosis or expansion of the interstitial space. In TS, the typical CMR profile includes myocardial edema in the absence of corresponding LGE, a finding often used to support the diagnosis. However, emerging evidence has reported the presence of LGE in a subset of TS patients, raising questions about its prevalence, underlying mechanisms, and clinical significance. This narrative review aims to explore current evidence on LGE in TS, examining its pathophysiological basis, diagnostic value, and potential prognostic implications.</p>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 12","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739476","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}
Qin Zhang, Limin Xiang, Gege Zhao, Enbo Zhan, Jiali Tian
<div> <section> <h3> Background</h3> <p>Previous studies have shown that atrial high-rate episodes (AHREs) after cardiac device implantation are associated with the occurrence of stroke. This study aimed to explore the predictive value of echocardiographic indices, namely left ventricular mass index (LVMI) and relative wall thickness (RWT), for AHREs following implantation of a cardiac implantable electronic device (CIED).</p> </section> <section> <h3> Methods</h3> <p>This was a single-center retrospective study. Patients who underwent initial dual-chamber permanent pacemaker implantation at the Fifth Affiliated Hospital of Sun Yat-sen University from January 1, 2020 to March 30, 2025, were included. Routine postoperative pacemaker programming was performed, and the occurrence of AHREs was set as the study endpoint. Based on whether AHREs were recorded in pacemaker programming, patients were divided into the AHREs group and non-AHREs group. Clinical baseline data, serological indicators, and echocardiographic indices were compared between the two groups. Spearman correlation analysis was used to evaluate the correlations between echocardiographic indices and permanent pacemaker implantation parameters (pacemaker threshold, pacemaker sensing, atrial output voltage). Cox regression analysis was conducted to identify independent predictors of AHREs. Receiver operating characteristic (ROC) curve analysis was performed to assess the predictive value of these indices for AHREs. Additionally, Kaplan–Meier survival analysis was used to compare the cumulative incidence of AHREs among groups with different levels of RWT and LVMI.</p> </section> <section> <h3> Results</h3> <p>A total of 122 patients were included, and 45 patients developed AHREs during the follow-up period. Early diastolic mitral inflow E-wave velocity (<i>r</i> = 0.297, <i>p</i> < 0.001) and right atrial parameters (<i>r</i> = 0.280, <i>p</i> = 0.002) were positively correlated with pacemaker sensing parameters, with statistically significant yet weak correlations. Univariate Cox regression analysis revealed significant correlations between the occurrence of AHREs and early diastolic tricuspid inflow E-wave velocity, fractional shortening (FS), RWT, diastolic wall strain (DWS), LVMI, and type of cardiac remodeling (all <i>p</i> < 0.05). Multivariate Cox regression analysis demonstrated that lower RWT (<i>B</i> = −7.576, <i>p</i> = 0.007) and higher LVMI (<i>B</i> = 0.013, <i>p</i> = 0.003) were associated with an increased risk of AHREs. ROC curve analysis showed that the area under the curve (AUC) of LVMI and RWT for predicting AHREs were 0.722 and 0.716, respectively. Kaplan–Meier su
{"title":"Left Ventricular Mass Index and Relative Wall Thickness Predict Atrial High-Rate Episodes in Patients With Pacemaker Implantation","authors":"Qin Zhang, Limin Xiang, Gege Zhao, Enbo Zhan, Jiali Tian","doi":"10.1111/echo.70363","DOIUrl":"10.1111/echo.70363","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Previous studies have shown that atrial high-rate episodes (AHREs) after cardiac device implantation are associated with the occurrence of stroke. This study aimed to explore the predictive value of echocardiographic indices, namely left ventricular mass index (LVMI) and relative wall thickness (RWT), for AHREs following implantation of a cardiac implantable electronic device (CIED).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a single-center retrospective study. Patients who underwent initial dual-chamber permanent pacemaker implantation at the Fifth Affiliated Hospital of Sun Yat-sen University from January 1, 2020 to March 30, 2025, were included. Routine postoperative pacemaker programming was performed, and the occurrence of AHREs was set as the study endpoint. Based on whether AHREs were recorded in pacemaker programming, patients were divided into the AHREs group and non-AHREs group. Clinical baseline data, serological indicators, and echocardiographic indices were compared between the two groups. Spearman correlation analysis was used to evaluate the correlations between echocardiographic indices and permanent pacemaker implantation parameters (pacemaker threshold, pacemaker sensing, atrial output voltage). Cox regression analysis was conducted to identify independent predictors of AHREs. Receiver operating characteristic (ROC) curve analysis was performed to assess the predictive value of these indices for AHREs. Additionally, Kaplan–Meier survival analysis was used to compare the cumulative incidence of AHREs among groups with different levels of RWT and LVMI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 122 patients were included, and 45 patients developed AHREs during the follow-up period. Early diastolic mitral inflow E-wave velocity (<i>r</i> = 0.297, <i>p</i> < 0.001) and right atrial parameters (<i>r</i> = 0.280, <i>p</i> = 0.002) were positively correlated with pacemaker sensing parameters, with statistically significant yet weak correlations. Univariate Cox regression analysis revealed significant correlations between the occurrence of AHREs and early diastolic tricuspid inflow E-wave velocity, fractional shortening (FS), RWT, diastolic wall strain (DWS), LVMI, and type of cardiac remodeling (all <i>p</i> < 0.05). Multivariate Cox regression analysis demonstrated that lower RWT (<i>B</i> = −7.576, <i>p</i> = 0.007) and higher LVMI (<i>B</i> = 0.013, <i>p</i> = 0.003) were associated with an increased risk of AHREs. ROC curve analysis showed that the area under the curve (AUC) of LVMI and RWT for predicting AHREs were 0.722 and 0.716, respectively. Kaplan–Meier su","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 12","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70363","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145716438","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}
This article presents a case of a papillary fibroelastoma of the tricuspid valve discovered 18 months after tricuspid valve surgery. Through multimodal imaging, a relatively complete diagnosis and differential diagnosis of the tumor can be made.
{"title":"Detection of Tricuspid Valve Neoplasm 18 Months Post-Annuloplasty","authors":"Junyi Gao, Yafeng He, Xiaojing Ma, Juan Xia, Qian song, Chen chen","doi":"10.1111/echo.70315","DOIUrl":"https://doi.org/10.1111/echo.70315","url":null,"abstract":"<p>This article presents a case of a papillary fibroelastoma of the tricuspid valve discovered 18 months after tricuspid valve surgery. Through multimodal imaging, a relatively complete diagnosis and differential diagnosis of the tumor can be made.\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":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145686472","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}
Maria Riccarda Del Bene, Icro Meattini, Giuseppe Barletta
{"title":"Reply to “Effect of Cardioprotection on Right Ventricular Function in Breast Cancer Patients Receiving Potentially Cardiotoxic Therapy—A Letter to the Editor”","authors":"Maria Riccarda Del Bene, Icro Meattini, Giuseppe Barletta","doi":"10.1111/echo.70367","DOIUrl":"https://doi.org/10.1111/echo.70367","url":null,"abstract":"","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 12","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145686473","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":"Thinking Beyond the Plane: How Three-Dimensional Echocardiography Is Redefining Peri-Device Leak Assessment After Left Atrial Appendage Occlusion","authors":"Gianpiero D'Amico, Antonella Carvelli","doi":"10.1111/echo.70366","DOIUrl":"https://doi.org/10.1111/echo.70366","url":null,"abstract":"","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 12","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145686471","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":"Unveiling the Association Between Left Ventricular Conduction Disease and Hypertensive Mediated Organ Damage","authors":"Elisa Gherbesi, Andrea Faggiano, Cesare Cuspidi","doi":"10.1111/echo.70365","DOIUrl":"https://doi.org/10.1111/echo.70365","url":null,"abstract":"","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 12","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145666154","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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