{"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}
Leizhi Ku, Shengpeng Guo, Youping Chen, Xiaojing Ma
Metastatic intracardiac hepatoblastoma is an extremely rare entity. Metastasis pathways include lymphatic, hematogenous routes, direct, or transvenous spread. The multimodality imaging has enabled the identification of the etiology of intracardiac mass in many cases. The significant characteristics of indicating malignant cardiac tumors include irregular borders, vascular invasion, and rapid growth on echocardiography. Additionally, malignant cardiac tumors are characterized by heterogeneous enhancement, necrosis, and restricted diffusion on cardiac magnetic resonance (CMR).
{"title":"Multimodality Imaging Diagnosis of Metastatic Intracardiac Hepatoblastoma","authors":"Leizhi Ku, Shengpeng Guo, Youping Chen, Xiaojing Ma","doi":"10.1111/echo.70333","DOIUrl":"https://doi.org/10.1111/echo.70333","url":null,"abstract":"<div>\u0000 \u0000 <p>Metastatic intracardiac hepatoblastoma is an extremely rare entity. Metastasis pathways include lymphatic, hematogenous routes, direct, or transvenous spread. The multimodality imaging has enabled the identification of the etiology of intracardiac mass in many cases. The significant characteristics of indicating malignant cardiac tumors include irregular borders, vascular invasion, and rapid growth on echocardiography. Additionally, malignant cardiac tumors are characterized by heterogeneous enhancement, necrosis, and restricted diffusion on cardiac magnetic resonance (CMR).</p>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 12","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145666156","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}
Nathanael Tran, Mohammad Shaar, Hussein Al-Sudani, Ramy Sedhom, Hamza Akhtar, Kevin Bryan Lo, Gregg S. Pressman
Background
Echocardiography and right heart catheterization (RHC) are useful in the evaluation of heart failure with preserved ejection fraction (HFpEF). We compared the two among decompensated HFpEF patients to determine their relative value in predicting all-cause mortality and a composite of cardiovascular (CV) death and heart failure (HF) readmission at 1 year.
Methods
One hundred seventy-eight decompensated HFpEF patients who underwent both procedures and survived to hospital discharge were retrospectively identified. Hospital records and the National Death Index were queried to determine outcomes. Echocardiographic and invasive parameters were tested for significant associations with each outcome. Additionally, three predictive models were developed: Model-1: basic demographics and comorbidities, Model-2: adding echocardiographic parameters, and Model-3: adding invasive hemodynamic parameters.
Results
For mortality (n = 26; 15%), echocardiographic E/average e′, invasive mean pulmonary artery pressure (mPAP), and pulmonary capillary wedge pressure (PCWP) showed significant associations. Model-1 yielded a c-statistic of 0.65; 95% CI (0.54–0.76). Adding echocardiographic and hemodynamic variables produced a nonsignificant increase to 0.71; 95% CI (0.60–0.82), though mPAP remained an independent predictor (OR 1.05; 95% CI 1.01–1.09, p = 0.025). For the composite outcome (n = 31; 17%), significant associations were found for echocardiographic right atrial reservoir strain (RAsr), E/average e′, and invasive right atrial pressure, mPAP, and PCWP. Model-1 had a c-statistic of 0.70; 95% CI (0.60–0.79). Adding echocardiographic parameters significantly increased this to 0.81; 95% CI (0.73–0.88). Adding hemodynamic parameters (model-3) resulted in a nonsignificant increase to 0.83; 95% CI (0.76–0.90).
Conclusions
Among decompensated HFpEF patients, the addition of echocardiographic parameters significantly improved model prediction for the composite endpoint of CV death and HF hospitalization. Further addition of invasive hemodynamic variables did not.
超声心动图和右心导管（RHC）是评价保留射血分数（HFpEF）心力衰竭的有用方法。我们在失代偿HFpEF患者中比较了这两种方法，以确定它们在预测全因死亡率和1年心血管（CV）死亡和心力衰竭（HF）再入院的复合死亡率方面的相对价值。方法回顾性分析178例接受两种手术并存活至出院的失代偿性HFpEF患者。通过查询医院记录和国家死亡指数来确定结果。超声心动图和侵入性参数与每个结果的显著相关性进行了测试。此外，建立了三种预测模型：模型1：基本人口统计学和合并症，模型2：添加超声心动图参数，模型3：添加有创血流动力学参数。结果对于死亡率（n = 26; 15%），超声心动图E/平均E′、有创平均肺动脉压（mPAP）和肺毛细血管楔压（PCWP）有显著相关性。模型1的c统计量为0.65；95% ci（0.54-0.76）。加入超声心动图和血流动力学变量后，无显著性升高至0.71；95% CI(0.60-0.82)，尽管mPAP仍然是一个独立的预测因子（OR 1.05; 95% CI 1.01-1.09, p = 0.025）。对于复合结果（n = 31; 17%），超声心动图右心房储层应变（RAsr）、E/平均E′、侵入性右心房压、mPAP和PCWP之间存在显著相关性。模型1的c统计量为0.70；95% ci（0.60-0.79）。加入超声心动图参数后，该数值显著提高至0.81；95% ci（0.73-0.88）。加入血流动力学参数（模型3）后，无统计学意义升高至0.83；95% ci（0.76-0.90）。结论在失代偿HFpEF患者中，超声心动图参数的加入显著提高了模型对CV死亡和HF住院复合终点的预测。进一步添加有创血流动力学变量则没有。
{"title":"Comparative Value of Echocardiography vs. Right Heart Catheterization in Heart Failure With Preserved Ejection Fraction","authors":"Nathanael Tran, Mohammad Shaar, Hussein Al-Sudani, Ramy Sedhom, Hamza Akhtar, Kevin Bryan Lo, Gregg S. Pressman","doi":"10.1111/echo.70362","DOIUrl":"https://doi.org/10.1111/echo.70362","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Echocardiography and right heart catheterization (RHC) are useful in the evaluation of heart failure with preserved ejection fraction (HFpEF). We compared the two among decompensated HFpEF patients to determine their relative value in predicting all-cause mortality and a composite of cardiovascular (CV) death and heart failure (HF) readmission at 1 year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>One hundred seventy-eight decompensated HFpEF patients who underwent both procedures and survived to hospital discharge were retrospectively identified. Hospital records and the National Death Index were queried to determine outcomes. Echocardiographic and invasive parameters were tested for significant associations with each outcome. Additionally, three predictive models were developed: Model-1: basic demographics and comorbidities, Model-2: adding echocardiographic parameters, and Model-3: adding invasive hemodynamic parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For mortality (<i>n</i> = 26; 15%), echocardiographic <i>E</i>/average <i>e′</i>, invasive mean pulmonary artery pressure (mPAP), and pulmonary capillary wedge pressure (PCWP) showed significant associations. Model-1 yielded a <i>c</i>-statistic of 0.65; 95% CI (0.54–0.76). Adding echocardiographic and hemodynamic variables produced a nonsignificant increase to 0.71; 95% CI (0.60–0.82), though mPAP remained an independent predictor (OR 1.05; 95% CI 1.01–1.09, <i>p</i> = 0.025). For the composite outcome (<i>n</i> = 31; 17%), significant associations were found for echocardiographic right atrial reservoir strain (RAsr), <i>E</i>/average <i>e′</i>, and invasive right atrial pressure, mPAP, and PCWP. Model-1 had a <i>c</i>-statistic of 0.70; 95% CI (0.60–0.79). Adding echocardiographic parameters significantly increased this to 0.81; 95% CI (0.73–0.88). Adding hemodynamic parameters (model-3) resulted in a nonsignificant increase to 0.83; 95% CI (0.76–0.90).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Among decompensated HFpEF patients, the addition of echocardiographic parameters significantly improved model prediction for the composite endpoint of CV death and HF hospitalization. Further addition of invasive hemodynamic variables did not.</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":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70362","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145666155","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}
Ashwin Venkateshvaran, Thomas Lindow, Raluca Jumatate, Attila Kovacs, Annika Ingvarsson, Per Lindqvist, Anna Werther Evaldsson
The cover image is based on the article Prognostic Value of Right Ventricular Global Wasted Work in Precapillary Pulmonary Hypertension: A 3D Echocardiographic Study by Ashwin Venkateshvaran et al., https://doi.org/10.1111/echo.70344
{"title":"Cover Image, Volume 42, Issue 11","authors":"Ashwin Venkateshvaran, Thomas Lindow, Raluca Jumatate, Attila Kovacs, Annika Ingvarsson, Per Lindqvist, Anna Werther Evaldsson","doi":"10.1111/echo.70364","DOIUrl":"https://doi.org/10.1111/echo.70364","url":null,"abstract":"<p>The cover image is based on the article <i>Prognostic Value of Right Ventricular Global Wasted Work in Precapillary Pulmonary Hypertension: A 3D Echocardiographic Study</i> by Ashwin Venkateshvaran et al., https://doi.org/10.1111/echo.70344\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 11","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70364","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145625896","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}
Jelena Lovrić, Milena Pualić, Gorica Vidović, Vladimir Kovačević
Aortic dissection is a rare but life-threatening complication that can occur after endovascular aneurysm repair (EVAR). We report the case of a 72-year-old woman with a history of coronary artery bypass grafting and EVAR who presented with acute chest and lower limb pain. CT angiography revealed a Stanford type A dissection with collapse of the stent graft and iliac thrombosis. Shortly after imaging, she developed respiratory distress and cardiac arrest, with unsuccessful resuscitation. This case emphasizes the diagnostic value of multimodality imaging in recognizing fatal complications after EVAR.
{"title":"Acute Stanford Type A Aortic Dissection With Stent Graft Collapse and Bilateral Lower Limb Ischemia","authors":"Jelena Lovrić, Milena Pualić, Gorica Vidović, Vladimir Kovačević","doi":"10.1111/echo.70338","DOIUrl":"10.1111/echo.70338","url":null,"abstract":"<div>\u0000 \u0000 <p>Aortic dissection is a rare but life-threatening complication that can occur after endovascular aneurysm repair (EVAR). We report the case of a 72-year-old woman with a history of coronary artery bypass grafting and EVAR who presented with acute chest and lower limb pain. CT angiography revealed a Stanford type A dissection with collapse of the stent graft and iliac thrombosis. Shortly after imaging, she developed respiratory distress and cardiac arrest, with unsuccessful resuscitation. This case emphasizes the diagnostic value of multimodality imaging in recognizing fatal complications after EVAR.</p>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 11","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145598171","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}
Atrial arrhythmia is prevalent in patients with hypertrophic cardiomyopathy (HCM) and is prognostically deleterious. Catheter ablation (CA) has poor efficacy in HCM, making predictors of outcome valuable. Left atrial size is associated with morbidity and mortality, and E/e′ has been proposed. The current study evaluates whether these predict non-paroxysmal atrial arrhythmia, interventions for atrial arrhythmia and all-cause mortality.
Methods
233 patients from the echocardiography database were included; patients with any mitral annular calcification were excluded. Medical records were reviewed for sample characteristics. Survival analysis was performed for left atrial diameter (LAD), left atrial volume index (LAVi, by area-length method), and E/e′ with respect to endpoints, namely: non-paroxysmal atrial arrhythmia; atrial intervention (composite of CA and pace-and-ablate); and all-cause mortality. If LAD or LAVi were significant in multivariate analysis, ROC analysis and DeLong's test were performed to evaluate and compare their discriminative power.
Results
Over a median follow-up of 8 years (median age 53, 73% male), the overall prevalence of non-paroxysmal atrial arrhythmia was 31%. In multivariate models, LAVi was predictive of non-paroxysmal atrial arrhythmia and atrial intervention; LAD was only predictive of arrhythmia. LAVi demonstrated greater discriminative power for predicting atrial intervention. E/e′ was not predictive of any outcome. No echocardiographic variable predicted death in multivariate analysis.
Conclusion
LAVi may have greater clinical utility compared to two-dimensional measurements like LAD. Future work should clarify which measures of left atrial size are most appropriate in clinical practice.
背景：心房心律失常在肥厚性心肌病（HCM）患者中很常见，并且对预后有害。导管消融术（CA）治疗HCM的疗效较差，这使得预测预后的指标很有价值。左心房大小与发病率和死亡率有关，并提出了E/ E '。目前的研究评估这些指标是否能预测非阵发性心房心律失常、心房心律失常的干预措施和全因死亡率。方法：选取超声心动图数据库中的233例患者；排除任何二尖瓣环钙化的患者。对样本特征的医疗记录进行了审查。对左房内径（LAD）、左房容积指数（LAVi，面积长度法）和E/ E′进行生存分析，即：非阵发性心房心律失常；心房介入治疗（CA和起搏消融联合治疗）；以及全因死亡率。若LAD或LAVi在多变量分析中有显著性，则采用ROC分析和DeLong检验来评价和比较它们的判别能力。结果：中位随访8年（中位年龄53岁，73%为男性），非阵发性心房心律失常的总体患病率为31%。在多变量模型中，LAVi可预测非阵发性心房心律失常和心房干预；LAD仅能预测心律失常。LAVi在预测心房介入方面显示出更强的判别能力。E/ E '不能预测任何结果。在多变量分析中没有超声心动图变量预测死亡。结论：与LAD等二维测量相比，LAVi可能具有更大的临床应用价值。未来的工作应该明确在临床实践中哪种测量左心房大小最合适。
{"title":"Does Left Atrial Size and E/e′ Predict Outcomes in Hypertrophic Cardiomyopathy?","authors":"Brandon Tillson, Stephen Lord, Christopher Eggett","doi":"10.1111/echo.70345","DOIUrl":"10.1111/echo.70345","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Atrial arrhythmia is prevalent in patients with hypertrophic cardiomyopathy (HCM) and is prognostically deleterious. Catheter ablation (CA) has poor efficacy in HCM, making predictors of outcome valuable. Left atrial size is associated with morbidity and mortality, and E/e′ has been proposed. The current study evaluates whether these predict non-paroxysmal atrial arrhythmia, interventions for atrial arrhythmia and all-cause mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>233 patients from the echocardiography database were included; patients with any mitral annular calcification were excluded. Medical records were reviewed for sample characteristics. Survival analysis was performed for left atrial diameter (LAD), left atrial volume index (LAVi, by area-length method), and E/e′ with respect to endpoints, namely: non-paroxysmal atrial arrhythmia; atrial intervention (composite of CA and pace-and-ablate); and all-cause mortality. If LAD or LAVi were significant in multivariate analysis, ROC analysis and DeLong's test were performed to evaluate and compare their discriminative power.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over a median follow-up of 8 years (median age 53, 73% male), the overall prevalence of non-paroxysmal atrial arrhythmia was 31%. In multivariate models, LAVi was predictive of non-paroxysmal atrial arrhythmia and atrial intervention; LAD was only predictive of arrhythmia. LAVi demonstrated greater discriminative power for predicting atrial intervention. E/e′ was not predictive of any outcome. No echocardiographic variable predicted death in multivariate analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>LAVi may have greater clinical utility compared to two-dimensional measurements like LAD. Future work should clarify which measures of left atrial size are most appropriate in clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 11","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70345","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566134","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}
Joanne Eng-Frost, Rohanti Ravikulan, Nishant Juneja, Kedar Madan, Sam Lehman, Majo Joseph, Carmine G. De Pasquale
Background
Left ventricular ejection fraction (LVEF) is a widely used echocardiographic prognostic marker; however, its ability to reflect forward flow is limited. Left ventricular outflow tract velocity time integral (LVOT VTI) reflects stroke distance and has prognostic value in patients with cardiac and non-cardiac pathology, yet its incremental value beyond LVEF remains incompletely defined.
Objective
To determine whether LVOT VTI confers prognostic value beyond LVEF in a large real-world cohort of hospitalized patients.
Methods
Index echocardiograms performed between January and June 2021 at a single tertiary hospital were retrospectively analyzed. Demographics, echocardiographic parameters, biomarkers, and mortality data were collected. Patients were stratified by LVOT VTI (>13 and <13 cm) and LVEF (>40% and <40%). Associations with mortality were evaluated with Cox proportional hazard models.
Results
Altogether, 1325 patients (mean age 70 years) were included; 368 (28%) died over a median follow-up of 35.9 months (IQR 34.4–37.4). Both LVEF < 40% (HR 1.95, 95% CI 1.52–2.50; p < 0.001) and LVOT VTI < 13 cm (HR 1.91, 95% CI 1.41–2.59; p < 0.001) were associated with increased mortality. LVOT VTI < 13 cm remained predictive after adjustment for LVEF, although this was attenuated after adjustment for age. Mortality was greatest in patients with both LVEF < 40% and LVOT VTI < 13 cm (HR 2.37, 95% CI 1.63–3.46; p < 0.001).
Conclusion
LVOT VTI < 13 cm is independently associated with long-term mortality in hospitalized patients. Its incremental prognostic value beyond LVEF warrants prospective validation as a reproducible marker to enhance risk stratification in hospitalized patients.
{"title":"Incremental Prognostic Value of Left Ventricular Outflow Tract Velocity Time Integral (LVOT VTI) Beyond Ejection Fraction in a Large Cohort of Hospitalized Patients","authors":"Joanne Eng-Frost, Rohanti Ravikulan, Nishant Juneja, Kedar Madan, Sam Lehman, Majo Joseph, Carmine G. De Pasquale","doi":"10.1111/echo.70356","DOIUrl":"10.1111/echo.70356","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Left ventricular ejection fraction (LVEF) is a widely used echocardiographic prognostic marker; however, its ability to reflect forward flow is limited. Left ventricular outflow tract velocity time integral (LVOT VTI) reflects stroke distance and has prognostic value in patients with cardiac and non-cardiac pathology, yet its incremental value beyond LVEF remains incompletely defined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine whether LVOT VTI confers prognostic value beyond LVEF in a large real-world cohort of hospitalized patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Index echocardiograms performed between January and June 2021 at a single tertiary hospital were retrospectively analyzed. Demographics, echocardiographic parameters, biomarkers, and mortality data were collected. Patients were stratified by LVOT VTI (<span>></span>13 and <13 cm) and LVEF (<span>></span>40% and <40%). Associations with mortality were evaluated with Cox proportional hazard models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Altogether, 1325 patients (mean age 70 years) were included; 368 (28%) died over a median follow-up of 35.9 months (IQR 34.4–37.4). Both LVEF < 40% (HR 1.95, 95% CI 1.52–2.50; <i>p</i> < 0.001) and LVOT VTI < 13 cm (HR 1.91, 95% CI 1.41–2.59; <i>p</i> < 0.001) were associated with increased mortality. LVOT VTI < 13 cm remained predictive after adjustment for LVEF, although this was attenuated after adjustment for age. Mortality was greatest in patients with both LVEF < 40% and LVOT VTI < 13 cm (HR 2.37, 95% CI 1.63–3.46; <i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>LVOT VTI < 13 cm is independently associated with long-term mortality in hospitalized patients. Its incremental prognostic value beyond LVEF warrants prospective validation as a reproducible marker to enhance risk stratification in hospitalized patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 11","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566146","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}
Sifan Liu, Haocong Wang, Wen Xi, Yanbin Hu, Feilong Du, Hexiang Hou, Qiuping Zhao, Juan Cong
Purpose
To characterize subclinical changes in left atrial (LA) and right atrial (RA) volumetric and strain parameters in hypertension (HTN) comorbid with obstructive sleep apnea (OSA) and to identify the prognostic value of atrial mechanics for adverse cardiovascular events in the left ventricular (LV) function-preserved HTN with OSA patients.
Methods
A total of 177 HTN patients with preserved LV function were enrolled and underwent speckle tracking echocardiography. They were divided into two groups: 104 with OSA (HTN-OSA group, mild: 36; moderate: 35; severe: 33) and 73 without OSA controls (HTN-non OSA group). During the 1-year follow-up, adverse cardiovascular events, including heart failure, atrial fibrillation, stroke and cardiovascular death, were recorded.
Results
HTN-OSA group demonstrated larger LA phasic volumes (p < 0.05), lower LA strain and volumetric function during reservoir and conduit period than HTN-non OSA group (p < 0.05). RA size increased, RA reservoir and contraction strain decreased in HTN-OSA versus non-OSA cases (p < 0.05). LA reservoir (LASr), pump strain and RA strain (RASr) decreased progressively with worsening OSA (p < 0.05). LASr ≤17.5% and RASr ≤36.5% were the optimal cutoffs for independently predicting adverse events. Furthermore, their combination further enhanced predictive performance (AUC = 0.883).
Conclusion
Patients with HTN and OSA exhibit significant bi-atrial dilation and functional impairment compared to those with HTN alone. Moreover, in HTN-OSA patients with preserved LV function, LASr and RASr can detect cardiac functional alterations in different OSA stages and demonstrate robust predictive efficacy for adverse cardiovascular outcomes.
{"title":"Prognostic Value of Biatrial Mechanics in Hypertensive OSA Patients With Preserved Left Ventricular Function: A Speckle Tracking Echocardiography Study","authors":"Sifan Liu, Haocong Wang, Wen Xi, Yanbin Hu, Feilong Du, Hexiang Hou, Qiuping Zhao, Juan Cong","doi":"10.1111/echo.70358","DOIUrl":"10.1111/echo.70358","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To characterize subclinical changes in left atrial (LA) and right atrial (RA) volumetric and strain parameters in hypertension (HTN) comorbid with obstructive sleep apnea (OSA) and to identify the prognostic value of atrial mechanics for adverse cardiovascular events in the left ventricular (LV) function-preserved HTN with OSA patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 177 HTN patients with preserved LV function were enrolled and underwent speckle tracking echocardiography. They were divided into two groups: 104 with OSA (HTN-OSA group, mild: 36; moderate: 35; severe: 33) and 73 without OSA controls (HTN-non OSA group). During the 1-year follow-up, adverse cardiovascular events, including heart failure, atrial fibrillation, stroke and cardiovascular death, were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>HTN-OSA group demonstrated larger LA phasic volumes (<i>p</i> < 0.05), lower LA strain and volumetric function during reservoir and conduit period than HTN-non OSA group (<i>p</i> < 0.05). RA size increased, RA reservoir and contraction strain decreased in HTN-OSA versus non-OSA cases (<i>p</i> < 0.05). LA reservoir (LASr), pump strain and RA strain (RASr) decreased progressively with worsening OSA (<i>p</i> < 0.05). LASr ≤17.5% and RASr ≤36.5% were the optimal cutoffs for independently predicting adverse events. Furthermore, their combination further enhanced predictive performance (AUC = 0.883).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients with HTN and OSA exhibit significant bi-atrial dilation and functional impairment compared to those with HTN alone. Moreover, in HTN-OSA patients with preserved LV function, LASr and RASr can detect cardiac functional alterations in different OSA stages and demonstrate robust predictive efficacy for adverse cardiovascular outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 11","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566154","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}
Noninvasive myocardial work (MW), based on speckle-tracking technology and incorporating left ventricular (LV) afterload, significantly reduces the load dependency of parameters. MW has been widely used to assess LV function after TAVI in patients with aortic stenosis (AS); however, its application in this context for pure aortic regurgitation (AR) remains rare. This study aims to (1) assess the specific and overall trends of conventional echocardiographic and MW indices after TAVI in patients with pure AR, providing insight into the process and mid-term outcomes of post-TAVI LV functional improvement in this population; (2) evaluate the post-TAVI functional recovery patterns in patients with preserved vs. reduced left ventricular ejection fraction (LVEF); and (3) explore the relationship between MW indices and LV reverse remodeling (LVRR) following TAVI in patients with pure AR.
Methods
In this prospective cohort study, 43 patients with pure AR who underwent TAVI between January 2023 and July 2024 were enrolled. Serial transthoracic echocardiography was performed at baseline and at 1 week, 1 month, 3 months, and 6 months post-TAVI. Conventional echocardiographic parameters and noninvasive MW indices were analyzed offline.
Results
LVEF, LVGLS, LVGWI, LVGCW, and LVGWE exhibited an overall trend of initial decline followed by subsequent improvement after TAVI, whereas GWW showed an initial increase followed by a decrease. In contrast, LVEDD and LVEDV demonstrated a continuous decline throughout the follow-up period. At 6 months post-TAVI, LVGWI, LVGCW, and LVGWE were significantly reduced, while LVGWW was significantly increased compared with baseline (all p < 0.05). At baseline, post-TAVI, and at 6-month follow-up, LVGLS, LVGWI, and LVGCW were all significantly higher in the LVRR group compared to the non-LVRR group (p < 0.05).
Conclusion
TAVI effectively improves LV function in pure AR, irrespective of baseline LVEF. Noninvasive MW analysis proved to be an effective tool for assessing postoperative improvements in LV myocardial function. The reduction in MW indices at 6 months post-TAVI may reflect partial recovery rather than functional deterioration. Better MW indices at baseline may be associated with LVRR.
{"title":"Noninvasive Myocardial Work for Assessing Left Ventricular Function After TAVI in Pure Aortic Regurgitation: An Exploratory Study","authors":"Fushun Liao, Huan Lu, Qi Zeng, Huogen Zhang, Liangying Zou, Yuanyuan Liao, Songlin Peng, Yuguang You","doi":"10.1111/echo.70346","DOIUrl":"10.1111/echo.70346","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Noninvasive myocardial work (MW), based on speckle-tracking technology and incorporating left ventricular (LV) afterload, significantly reduces the load dependency of parameters. MW has been widely used to assess LV function after TAVI in patients with aortic stenosis (AS); however, its application in this context for pure aortic regurgitation (AR) remains rare. This study aims to (1) assess the specific and overall trends of conventional echocardiographic and MW indices after TAVI in patients with pure AR, providing insight into the process and mid-term outcomes of post-TAVI LV functional improvement in this population; (2) evaluate the post-TAVI functional recovery patterns in patients with preserved vs. reduced left ventricular ejection fraction (LVEF); and (3) explore the relationship between MW indices and LV reverse remodeling (LVRR) following TAVI in patients with pure AR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this prospective cohort study, 43 patients with pure AR who underwent TAVI between January 2023 and July 2024 were enrolled. Serial transthoracic echocardiography was performed at baseline and at 1 week, 1 month, 3 months, and 6 months post-TAVI. Conventional echocardiographic parameters and noninvasive MW indices were analyzed offline.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>LVEF, LVGLS, LVGWI, LVGCW, and LVGWE exhibited an overall trend of initial decline followed by subsequent improvement after TAVI, whereas GWW showed an initial increase followed by a decrease. In contrast, LVEDD and LVEDV demonstrated a continuous decline throughout the follow-up period. At 6 months post-TAVI, LVGWI, LVGCW, and LVGWE were significantly reduced, while LVGWW was significantly increased compared with baseline (all <i>p </i>< 0.05). At baseline, post-TAVI, and at 6-month follow-up, LVGLS, LVGWI, and LVGCW were all significantly higher in the LVRR group compared to the non-LVRR group (<i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>TAVI effectively improves LV function in pure AR, irrespective of baseline LVEF. Noninvasive MW analysis proved to be an effective tool for assessing postoperative improvements in LV myocardial function. The reduction in MW indices at 6 months post-TAVI may reflect partial recovery rather than functional deterioration. Better MW indices at baseline may be associated with LVRR.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 11","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566190","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}
Cordisco A, Lozza V, Filice ME, Chiappa E. First trimester prenatal diagnosis of a severe tricuspid valve regurgitation and pulmonary valve atresia. Echocardiography. 2021 Dec;38(12):2119-2121. doi: 10.1111/echo.15242
The first author's name contained an error. Her correct name is Adalgisa Cordisco (not Adalgisa Md Cordisco).
{"title":"Correction to “First trimester prenatal diagnosis of a severe tricuspid valve regurgitation and pulmonary valve atresia”","authors":"","doi":"10.1111/echo.70351","DOIUrl":"10.1111/echo.70351","url":null,"abstract":"<p>Cordisco A, Lozza V, Filice ME, Chiappa E. First trimester prenatal diagnosis of a severe tricuspid valve regurgitation and pulmonary valve atresia. <i>Echocardiography</i>. 2021 Dec;38(12):2119-2121. doi: 10.1111/echo.15242</p><p>The first author's name contained an error. Her correct name is Adalgisa Cordisco (not Adalgisa Md Cordisco).</p><p>We apologize for this error.</p>","PeriodicalId":50558,"journal":{"name":"Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques","volume":"42 11","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/echo.70351","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566097","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}
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