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Diagnostics
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Recent Advances in Echocardiography
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Recent Advances in Echocardiography

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (31 August 2024) | Viewed by 13334

Special Issue Editor

Dr. Giulia Elena Mandoli

E-Mail Website
Guest Editor
Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
Interests: echocardiography; heart failure; atrial fibrillation; chronic heart failure; cardiac function; clinical cardiology; hypertension; cardiac echocardiography; acute heart failure; cardiac imaging
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Echocardiography has undergone significant advancements in recent years, revolutionizing the diagnosis, management, and follow-up procedures for various cardiovascular conditions. One noteworthy achievement in echocardiography is the emergence of novel imaging technologies that enhance the visualization of cardiac structures and functions. These include three-dimensional echocardiography, speckle tracking echocardiography, and contrast-enhanced echocardiography, which have greatly improved the accuracy and diagnostic capabilities. Additionally, the integration of artificial intelligence and machine learning techniques has the potential to further enhance image analysis and interpretation, aiding in the early detection of cardiovascular diseases.

Recent developments in echocardiography have paved the way for its utilization in novel clinical scenarios, such as the assessment of myocardial strain, cardiac mechanics, and tissue characterization. These advancements have propelled echocardiography beyond the traditional role of evaluating structural abnormalities, enabling clinicians to learn about functional aspects of the heart. With ongoing research and technological advancements, it is expected that echocardiography will continue to evolve, delivering an even more exquisite imaging quality, greater diagnostic accuracy, and improved portability. By shedding light on the continual evolution of this invaluable imaging modality, we aim to inspire future research, collaboration, and innovation, ultimately nurturing better cardiovascular health outcomes for patients worldwide.

Dr. Giulia Elena Mandoli
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • standard echocardiography
  • speckle tracking echocardiography
  • strain
  • myocardial deformation
  • 3D echocardiography
  • valvular reconstruction
  • differential diagnosis
  • artificial intelligence
  • acute heart failure
  • chronic heart failure
  • heart failure diagnosis
  • heart failure therapy
  • heart failure prognosis

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Published Papers (7 papers)

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Research

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12 pages, 1405 KiB  
Article
Portal Vein Pulsatility: A Valuable Approach for Monitoring Venous Congestion and Prognostic Evaluation in Acute Decompensated Heart Failure
by Mihai Grigore, Andreea-Maria Grigore and Adriana-Mihaela Ilieșiu
Diagnostics 2024, 14(18), 2029; https://doi.org/10.3390/diagnostics14182029 - 13 Sep 2024
Viewed by 490
Abstract
Background: The severity of systemic congestion is associated with increased portal vein flow pulsatility (PVP). Aim: To determine the usefulness of PVP as a marker of decongestion and prognosis in acute decompensated heart failure (ADHF) patients. Methods: 105 patients, 60% of whom were [...] Read more.
Background: The severity of systemic congestion is associated with increased portal vein flow pulsatility (PVP). Aim: To determine the usefulness of PVP as a marker of decongestion and prognosis in acute decompensated heart failure (ADHF) patients. Methods: 105 patients, 60% of whom were men, were hospitalized with ADHF, and their PVP index (PVPI) was calculated (maximum velocity–minimum velocity/maximum velocity) × 100 on admission and before discharge, along with their EVEREST score, inferior vena cava diameter (IVC), NT-proBNP, serum sodium, and glomerular filtration rate. A PVPI ≥ 50% was defined as a marker of systemic congestion. After treatment with loop diuretics, a decrease in PVPI of >50% before discharge was considered a marker of decongestion The patients were classified into two groups (G): G1-PVPI decrease ≥ 50% (54 patients) and G2-PVPI decrease < 50% (51 patients). Results: At discharge, compared to G2, G1 patients had lower mean PVPI (14.2 vs. 38.9; p < 0.001), higher serum Na (138 vs. 132 mmol/L, p = 0.03), and a higher number of patients with a significant (>30%) NT-proBNP decrease (42 vs. 27, p = 0.007). PVPI correlated with IVC (r = 0.55, p < 0.001), NT-proBNP (r = 0.21, p = 0.04), and serum Na (r = −0.202, p = 0.04). A total of 55% of patients had worsening renal failure (G1 63% vs. G2 48%, p = 0.17). After 90 days, G2 patients had higher mortality (27.45% vs. 3.7 p = 0.001) and rehospitalization (49.01% vs. 33.33%, p < 0.001). In multivariate regression analysis, PVPI was an independent predictor of rehospitalization (OR 1.05, 95% CI 1.00–1.10, p = 0.048). Conclusions: Portal vein flow pulsatility, a meaningful marker of persistent subclinical congestion, is related to short-term prognosis in ADHF patients. Full article
(This article belongs to the Special Issue Recent Advances in Echocardiography)
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11 pages, 1126 KiB  
Article
Tricuspid Regurgitation Velocity and Mean Pressure Gradient for the Prediction of Pulmonary Hypertension According to the New Hemodynamic Definition
by Giulia Elena Mandoli, Federico Landra, Benedetta Chiantini, Carlotta Sciaccaluga, Maria Concetta Pastore, Marta Focardi, Luna Cavigli, Flavio D’Ascenzi, Sonia Bernazzali, Massimo Maccherini, Serafina Valente, Matteo Cameli and Michael Henein
Diagnostics 2023, 13(16), 2619; https://doi.org/10.3390/diagnostics13162619 - 8 Aug 2023
Cited by 1 | Viewed by 3941
Abstract
Background: The hemodynamic definition of PH has recently been revised with unchanged threshold of peak tricuspid regurgitation velocity (TRV). The aim of this study was to evaluate the predictive accuracy of peak TRV for PH based on the new (>20 mmHg) and the [...] Read more.
Background: The hemodynamic definition of PH has recently been revised with unchanged threshold of peak tricuspid regurgitation velocity (TRV). The aim of this study was to evaluate the predictive accuracy of peak TRV for PH based on the new (>20 mmHg) and the old (>25 mmHg) cut-off value for mean pulmonary artery pressure (mPAP) and to compare it with the mean right ventricular–right atrial (RV–RA) pressure gradient. Methods: Patients with advanced heart failure were screened from 2016 to 2021. The exclusion criteria were absent right heart catheterization (RHC) results, chronic obstructive pulmonary disease, any septal defect, inadequate acoustic window or undetectable TR. The mean RV–RA gradient was calculated from the velocity–time integral of TR. Results: The study included 41 patients; 34 (82.9%) had mPAP > 20 mmHg and 24 (58.5%) had mPAP > 25 mmHg. The AUC for the prediction of PH with mPAP > 20 mmHg was 0.855 for peak TRV and mean RV–RA gradient was 0.811. AUC for the prediction of PH defined as mPAP > 25 mmHg for peak TRV was 0.860 and for mean RV–RA gradient was 0.830. A cutoff value of 2.4 m/s for peak TRV had 65% sensitivity and 100% positive predictive value for predicting PH according to the new definition. Conclusions: Peak TRV performed better than mean RV–RA pressure gradient in predicting PH irrespective of hemodynamic definitions. Peak TRV performed similarly with the two definitions of PH, but a lower cutoff value had higher sensitivity and equal positive predictive value for PH. Full article
(This article belongs to the Special Issue Recent Advances in Echocardiography)
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11 pages, 1559 KiB  
Article
A Pilot Study Evaluating LV Diastolic Function with M-Mode Measurement of Mitral Valve Movement in the Parasternal Long Axis View
by Chan-Ho Park, Hee Yoon, Ik-Joon Jo, Sookyoung Woo, Sejin Heo, Hansol Chang, Guntak Lee, Jong-Eun Park, Taerim Kim, Se-Uk Lee, Sung-Yeon Hwang, Won-Chul Cha and Tae-Gun Shin
Diagnostics 2023, 13(14), 2412; https://doi.org/10.3390/diagnostics13142412 - 19 Jul 2023
Viewed by 1536
Abstract
This pilot study aimed to develop a new, reliable, and easy-to-use method for the evaluation of diastolic function through the M-mode measurement of mitral valve (MV) movement in the parasternal long axis (PSLA), similar to E-point septal separation (EPSS) used for systolic function [...] Read more.
This pilot study aimed to develop a new, reliable, and easy-to-use method for the evaluation of diastolic function through the M-mode measurement of mitral valve (MV) movement in the parasternal long axis (PSLA), similar to E-point septal separation (EPSS) used for systolic function estimation. Thirty healthy volunteers from a tertiary emergency department (ED) underwent M-mode measurements of the MV anterior leaflet in the PSLA view. EPSS, A-point septal separation (APSS), A-point opening length (APOL), and E-point opening length (EPOL) were measured in the PSLA view, along with the E and A velocities and e’ velocity in the apical four-chamber view. Correlation analyses were performed to assess the relationship between M-mode and Doppler measurements, and the measurement time was evaluated. No significant correlations were found between M-mode and Doppler measurements in the study. However, M-mode measurements exhibited high reproducibility and faster acquisition, and the EPOL value consistently exceeded the APOL value, resembling the E and A pattern. These findings suggest that visually assessing the M-mode pattern on the MV anterior leaflet in the PSLA view may be a practical approach to estimating diastolic function in the ED. Further investigations with a larger and more diverse patient population are needed to validate these findings. Full article
(This article belongs to the Special Issue Recent Advances in Echocardiography)
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Review

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17 pages, 1455 KiB  
Review
Echocardiography in Cardiac Arrest: Incremental Diagnostic and Prognostic Role during Resuscitation Care
by Alfredo Mauriello, Gemma Marrazzo, Gerardo Elia Del Vecchio, Antonia Ascrizzi, Anna Selvaggia Roma, Adriana Correra, Francesco Sabatella, Renato Gioia, Alfonso Desiderio, Vincenzo Russo and Antonello D’Andrea
Diagnostics 2024, 14(18), 2107; https://doi.org/10.3390/diagnostics14182107 - 23 Sep 2024
Viewed by 1083
Abstract
Background: Cardiac arrest (CA) is a life-critical condition. Patients who survive after CA go into a defined post-cardiac arrest syndrome (PCAS). In this clinical context, the role of the echocardiogram in recent years has become increasingly important to assess the causes of arrest, [...] Read more.
Background: Cardiac arrest (CA) is a life-critical condition. Patients who survive after CA go into a defined post-cardiac arrest syndrome (PCAS). In this clinical context, the role of the echocardiogram in recent years has become increasingly important to assess the causes of arrest, the prognosis, and any direct and indirect complications dependent on cardiopulmonary resuscitation (CPR) maneu-vers. Methods: We have conduct a narrative revision of literature. Results: The aim of our review is to evaluate the increasingly important role of the transthoracic and transesophageal echocardiogram in the CA phase and especially post-arrest, analyzing the data already present in the literature. Conclusion: Transthoracic and transesophageal echocardiogram in the CA phase take on important diagnostic and prognostic role. Full article
(This article belongs to the Special Issue Recent Advances in Echocardiography)
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22 pages, 8701 KiB  
Review
Echocardiography Imaging of the Right Ventricle: Focus on Three-Dimensional Echocardiography
by Andrea Ágnes Molnár, Attila Sánta and Béla Merkely
Diagnostics 2023, 13(15), 2470; https://doi.org/10.3390/diagnostics13152470 - 25 Jul 2023
Cited by 4 | Viewed by 2475
Abstract
Right ventricular function strongly predicts cardiac death and adverse cardiac events in patients with cardiac diseases. However, the accurate right ventricular assessment by two-dimensional echocardiography is limited due to its complex anatomy, shape, and load dependence. Advances in cardiac imaging and three-dimensional echocardiography [...] Read more.
Right ventricular function strongly predicts cardiac death and adverse cardiac events in patients with cardiac diseases. However, the accurate right ventricular assessment by two-dimensional echocardiography is limited due to its complex anatomy, shape, and load dependence. Advances in cardiac imaging and three-dimensional echocardiography provided more reliable information on right ventricular volumes and function without geometrical assumptions. Furthermore, the pathophysiology of right ventricular dysfunction and tricuspid regurgitation is frequently connected. Three-dimensional echocardiography allows a more in-depth structural and functional evaluation of the tricuspid valve. Understanding the anatomy and pathophysiology of the right side of the heart may help in diagnosing and managing the disease by using reliable imaging tools. The present review describes the challenging echocardiographic assessment of the right ventricle and tricuspid valve apparatus in clinical practice with a focus on three-dimensional echocardiography. Full article
(This article belongs to the Special Issue Recent Advances in Echocardiography)
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Other

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10 pages, 1009 KiB  
Brief Report
Left Ventricular and Atrial Deformation in Patients with Acute Decompensated Heart Failure: A Pilot Study
by Jakub Jurica, Martin Jozef Péč, Marek Cingel, Tomáš Bolek, Marianna Barbierik Vachalcová, Simona Horná, Peter Galajda, Marián Mokáň and Matej Samoš
Diagnostics 2024, 14(13), 1368; https://doi.org/10.3390/diagnostics14131368 - 27 Jun 2024
Viewed by 1183
Abstract
Aims: The aims of this study were to compare global longitudinal strain of the left ventricle (LV-GLS) and reservoir strain of the left atrium (R-LAS) values between patients with acute decompensation of chronic heart failure (HF) and a control group. Methods: Sixteen patients [...] Read more.
Aims: The aims of this study were to compare global longitudinal strain of the left ventricle (LV-GLS) and reservoir strain of the left atrium (R-LAS) values between patients with acute decompensation of chronic heart failure (HF) and a control group. Methods: Sixteen patients admitted to our ward for acute decompensation of HF were enrolled in this study. Transthoracic echocardiography (TTE) with two-dimensional speckle-tracking analysis (2D ST) was performed in each patient. The patients were divided into two subgroups according to the value of left ventricular ejection fraction (EF) using a cut-off value of ≤40% to distinguish heart failure with reduced ejection fraction (HFrEF) from heart failure with preserved ejection fraction (HFpEF). The control group consisted of 16 individuals without a history of cardiovascular disease, each of whom underwent 2D ST analysis as well. Results: We found that LV-GLS and R-LAS were significantly lower in both the HFrEF and HFpEF subgroups in comparison with the control group (LV-GLS: −13.4 ± 4.7% vs. −19.7 ± 2.5%, p ˂ 0.05; R-LAS: +12.2 ± 6.9% vs. +40.3 ± 7.4%, p ˂ 0.05). Furthermore, there was a significant difference in LV-GLS (−9.6 ± 3.2% vs. −15.2 ± 4.3%, p ˂ 0.05) but not in R-LAS (+13.7 ± 8.6% vs. +11.4 ± 6.2%) between the HFrEF and HFpEF subgroups. Conclusions: Our study demonstrated a significant difference in LV-GLS and R-LAS in all enrolled HF patients compared to the control group. There was also a significant difference in LV-GLS between the HFrEF and HFpEF subgroups. Full article
(This article belongs to the Special Issue Recent Advances in Echocardiography)
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5 pages, 617 KiB  
Interesting Images
Heart Metastases of Clear Cell Renal Cell Carcinoma
by Katarzyna Romejko, Adam Rytel, Tomasz Rozmyslowicz and Stanisław Niemczyk
Diagnostics 2023, 13(9), 1600; https://doi.org/10.3390/diagnostics13091600 - 30 Apr 2023
Viewed by 1697
Abstract
Renal cell carcinoma (RCC) is a common genitourinary cancer. Of the several histologic types of RCC, clear cell renal cell carcinoma (ccRCC) is the most frequent. Due to the development of imaging methods such as computed tomography (CT) or magnetic resonance imaging (MRI), [...] Read more.
Renal cell carcinoma (RCC) is a common genitourinary cancer. Of the several histologic types of RCC, clear cell renal cell carcinoma (ccRCC) is the most frequent. Due to the development of imaging methods such as computed tomography (CT) or magnetic resonance imaging (MRI), the incidence of ccRCC diagnosis has increased rapidly. However, up to one third of patients at prime diagnosis of ccRCC are at metastatic stadium of the disease. Metastases of ccRCC are found mostly in the lungs, bones and liver. Metastasis of ccRCC to the heart is an uncommon clinical situation. We present a rare case of metastatic stadium of ccRCC with metastases to heart tissue visualized in transthoracic echocardiography. Full article
(This article belongs to the Special Issue Recent Advances in Echocardiography)
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