Journal Article Accepted manuscript Multiparametric imaging in Löffler's endocarditis Get access Yangjie Xiao, Yangjie Xiao Department of Ultrasound, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, 110004 Liaoning, China Search for other works by this author on: Oxford Academic PubMed Google Scholar Lu Sun, Lu Sun Department of Ultrasound, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, 110004 Liaoning, China Search for other works by this author on: Oxford Academic PubMed Google Scholar Xiaona Yu Xiaona Yu Department of Ultrasound, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, 110004 Liaoning, China Address correspondence to: Xiaona Yu, MD, Department of Ultrasound, Shengjing Hospital of China Medical University. No. 36 Sanhao St, Heping district, Shenyang, China. Zip code: 110004 Email: [email protected] Search for other works by this author on: Oxford Academic PubMed Google Scholar European Heart Journal - Cardiovascular Imaging, jeaf057, https://doi.org/10.1093/ehjci/jeaf057 Published: 14 February 2025 Article history Received: 10 February 2025 Revision received: 11 February 2025 Accepted: 12 February 2025 Published: 14 February 2025

BACKGROUND:A novel automated method for measuring left ventricular (LV) global longitudinal strain (GLS) along the endocardium has advantages in terms of its rapid application and excellent reproducibility. However, it remains unclear whether the available normal range for conventional GLS using the manual method is applicable to the automated GLS method. This study aimed to compare automated GLS head-to-head with manual layer-specific GLS, and to identify whether a specialized normal reference range for automated GLS is needed and explore the main determinants. METHODS:In total, 1683 healthy volunteers (men, 43%; age, 18-80 years) were prospectively enrolled from 55 collaborating laboratories. LV GLS was measured using both manual layer-specific and automated methods. RESULTS:Automated GLS was higher than endocardial, mid-myocardial, and epicardial GLS. Women had a higher automated GLS than men. GLS had no significant age dependency in men, but first increased and then decreased with age in women. Accordingly, sex- and age-specific normal ranges for automated GLS were proposed. Moreover, GLS appeared to have different burdens in relation to dominant determinants between the sexes. GLS in men showed no dominant determinants; however, GLS in women correlated with age, body mass index, and heart rate. CONCLUSIONS:Using the novel automated method, was LV GLS higher than when using the manual GLS method. The normal ranges of automated GLS stratified according to sex and age were provided, with dominant determinants showing sex disparities that require full consideration in clinical practice.

Abstract Aims Mitral annular plane systolic excursion (MAPSE) is a simple and reliable index for evaluating left ventricular (LV) systolic function, particularly in patients with poor image quality; however, the lack of reference values limits its widespread use. This study aimed to establish the normal ranges for MAPSE measured using motion-mode (M-mode) and two-dimensional speckle tracking echocardiography (2D-STE) and to explore its principal determinants. Methods and results This multicentre, prospective, cross-sectional study included 1952 healthy participants [840 men (43%); age range, 18–80 years] from 55 centres. MAPSE was measured using M-mode echocardiography and 2D-STE. The results showed that women had a higher MAPSE than men and MAPSE decreased with age. The age- and sex-specific reference values for MAPSE were established for these two methods. Multiple linear regression analyses revealed that MAPSE on M-mode echocardiography correlated with age and MAPSE on 2D-STE with age, blood pressure (BP), heart rate, and LV volume. Moreover, MAPSE measured by 2D-STE correlated more strongly with global longitudinal strain compared with that measured using M-mode echocardiography. Conclusion Normal MAPSE reference values were established based on age and sex. BP, heart rate, and LV volume are potential factors that influence MAPSE and should be considered in clinical practice. Normal values are useful for evaluating LV longitudinal systolic function, especially in patients with poor image quality, and may further facilitate the use of MAPSE in routine assessments.

Background Amniocentesis is an invasive prenatal diagnostic technique that can provide genetic information of fetus for pregnant women and give them a choice. A straightforward predictive tool can show pregnant women the need for amniocentesis prior to the procedure. Methods The information of patients who underwent amniocentesis from 2014 to 2019 at the Obstetrics Clinic, Shengjing Hospital of China Medical University was extracted, and important independent prognostic factors were determined by univariate and multivariate logistic regression analysis to construct nomograms with total abnormalities (TA) and chromosome number abnormalities (CNA). Results A total of 19,683 patients undergoing amniocentesis were included in this study. Among 1761 patients with abnormal results, 917 had abnormal chromosome numbers, 439 had abnormal chromosome structures, and 405 had polymorphic results. Nomograms of TA and CNA were created using data such as age, nuchal translucency value, ultrasound results, Oscar’s testing and/or non-invasive prenatal testing abnormalities, parental chromosomes, and information whether they were twins. The nomogram has good predictive power and clinical practicality through the analysis of area under curve and decision curve analysis. Internal verification was performed for nomograms of TA and CNA, suggesting that the nomogram’s predicted probability and actual probability of the two are consistent. Conclusion The nomogram constructed is a good predictor of TA and CNA, which can be used in clinical practice to screen high-risk patients of chromosomal abnormalities.

ObjectivesInterventricular septal geometry and motion reflect the interaction between the ventricles, and an abnormal shape and abnormal motion are always regarded as signs of increased right ventricular or pulmonary artery pressure. During the neonatal period, there are profound changes in the cardiac circulation. The aims of this study were to quantitatively analyze neonatal septal deformations under normal physiologic conditions and evaluate the changes in association with the hemodynamic changes occurring during the transitional period.MethodsThis was a retrospective study of 114 healthy full‐term neonates from birth to 14 days of age. Normalized septal curvatures were measured on left ventricular parasternal short‐axis views during end diastole and end systole. The interventricular pressure gradient, ratio of ventricular volumes, septal strain, thickness, and some clinical characteristics were assessed, along with the association of these parameters with septal curvature.ResultsAll 4 normalized septal curvatures were found to have a significant correlation with the trans‐septal pressure gradient (TSPG) and the end‐diastolic volume ratio of the left and right ventricles (P < .0001). The TSPG had the highest impact on septal curvature, and among the 4 curvatures, the middle end‐systolic normalized septal curvature had the highest correlation with the TSPG (r2 = 0.948; P < .0001).ConclusionsThere were significant correlations between septal curvature and the interventricular pressure gradient and ventricular volume ratio in healthy full‐term neonates. The normalized septal curvatures gradually increased with increasing age and could be good indicators of the hemodynamic changes occurring during the transitional period.

Background. Antiretroviral therapy transformed HIV infection into a chronic disease but accelerated cardiovascular disease (CVD). Both of epicardial adipose tissue (EAT) and pericardial fat (PCF) have close relationships with CVD. The associations between these two cardiac adipose tissue and HIV are unclear. Methods. Eligible studies were searched in PubMed, Embase, Web of Science, and Scopus from database inception to March 24, 2020. The summarized standard mean difference (SMD) or weighted mean difference (WMD) with 95% confidence intervals (CIs) was used to assess the association between EAT/PCF and HIV. Subgroup analysis was performed based on EAT types. Trial sequential analysis was conducted to estimate whether the evidence of the results is sufficient. Results. In total, 2561 HIV patients and 1767 non-HIV participants were included. Compared to the control group, EAT was significantly higher in the HIV overall group and subgroup with EAT thickness (SMD=0.59, 95% CI: 0.24–0.95, P=0.001; SMD=1.10, 95% CI: 0.41–1.79, P=0.002); however, the EAT volume and PCF volume were unchanged in the HIV group (SMD=0.16, 95% CI: -0.07–0.39, P=0.169; WMD=10.78, 95% CI: -14.11–35.67, P=0.396). Trial sequential analysis indicated that the available samples were sufficient in the HIV overall group and subgroup with EAT thickness, and more studies are needed for EAT volume and PCF volume. Conclusions. EAT thickness was significantly higher in patients with HIV. The association between EAT/PCF volume and HIV needs more studies to confirm.

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As the number of implanted biventricular pacemakers increases, the coronary sinus (CS) has evoked much interest amongst cardiologists. A dilated CS could prompt the existence of many diseases. The normal CS diameter is uncertain, especially in children. A total of 446 Chinese healthy children were prospectively enrolled in this study. The superior and inferior diameter of the CS was measured from the CS ostium 1 cm from the end of ventricular systole in the modified apical 4-chamber view. Seven models were tested to determine the relationships between parameters of body size and CS diameter. Heteroscedasticity was tested by the White and Breusch–Pagan tests. A multiple linear regression model should be gender as a covariate along with BSAStevenson, in order to evaluate the influence of gender on the measurements. The formula of Stevenson was best-fit. The predicted values and Z-score boundaries for measurement of the CS diameter were calculated. Bland–Altman plot regression showed that the 95 % limits of agreement for inter- and intra-observer measurements were not significantly different. We report new, reliable echocardiographic Z scores for the CS diameter derived from a large population of healthy Chinese children. The Z scores can be used in echocardiographic examinations.

An 8-month-old baby was admitted to our hospital because of prolonged fever and severe pneumonia. Clinical examination displayed mild hepatomegaly, protruding tongue and hypotonia ( Panel A ). Blood analysis showed increased ALT 144 U/L ( n = 0–40), AST 270 U/L ( n = 5–34) and CK 696 U/L ( n = 29–200). Chest X-ray …

A 23-year-old girl had been bloating with no obvious incentive for 2 months. Physical examination revealed the presence of abdominal distension, positive shifting dullness and umbilical hernia ( Panel A ). Computed tomographic scanning of the abdomen showed massive ascites and serious hepatic congestion ( Panel B ), therefore, a continued echocardiography was conducted. The echocardiography remarkably displayed the dilation of the right atrium with signs …