Please subscribe my YouTube channel: bit.ly/2DWogkJ I would like to present my project (echocardiography step by step®). With my project, I want to take you into the world of echocardiography through the prism of my experience.

🫀 Is left ventricular untwisting really just passive recoil? A fascinating new speckle-tracking echocardiography study challenges a long-held concept in cardiac physiology, suggesting that papillary muscles actively contribute to left ventricular untwisting during diastole, rather than simply following ventricular motion. 🔍 Key findings: ✅ In 75 individuals with normal echocardiograms, papillary muscle mechanics were analysed using 2D speckle-tracking alongside LV torsion measurements. ✅ Both the anterolateral and posteromedial papillary muscles reached peak contraction later than peak LV torsion and GLS, indicating an active role during diastole rather than systole alone. ✅ Greater papillary muscle contraction was significantly associated with enhanced LV untwisting during early and mid-diastole through advanced time-dependent functional modelling. ✅ These findings suggest that papillary muscles may facilitate diastolic suction, providing a previously underappreciated contributor to normal ventricular filling. 💡 Clinical takeaway: This study reshapes our understanding of diastolic mechanics, proposing that papillary muscles are active participants in ventricular relaxation. The findings may open new avenues for studying diastolic dysfunction and diseases affecting papillary muscle mechanics. 📖 Read the full article: doi.org/10.1093/ehjimp/qyag1… #CardioX #Echocardiography #SpeckleTracking #DiastolicFunction #CardiacMechanics #PapillaryMuscles #CardiacImaging #Cardiology #MedTwitter #OpenScience

🫀 Not every LVOT obstruction is HOCM

Multimodality imaging in the evaluation and management of aortic stenosis: alignment with @escardio /@EACTS 2025 Guidelines   How are you applying the latest ESC/EACVI recommendations on aortic stenosis? To share how multimodality imaging is used in your daily practice and help identify current challenges and educational needs. surveymonkey.com/r/MQ9ZXCD?u… @rafavidalperez @YBououdina @MSBBrandao @ydaryani @Elizabeth_antos @pfelissamburu @CharlesFauvel @alexsfelixecho @galzeranod @andgiannopmd @hrt01a @WilliamKokFaiK1 @M_Marwan_ @drahmedmohsen85 @aniela_petrescu @benayozbay @slumberbell @senguptasp @ElizabetaK10533 @MihaiTrofenciuc @C_VanDeHeyning @drozgeozden @Giulia_Vinco @VazyurVasquez

🩺 Can AI enable high-quality cardiac ultrasound in places without expert sonographers? A new study explores whether artificial intelligence-guided point-of-care ultrasound (AI-POCUS) can help non-expert operators acquire diagnostic cardiac ultrasound images in rural and remote communities—bringing echocardiography closer to the patients who need it most. 🔍 Key findings: ✅ AI-guided POCUS enabled non-expert users to acquire diagnostic cardiac ultrasound images, supporting task-shifting in settings with limited access to expert sonographers. ✅ The study evaluated patient characteristics, image quality, and operator learning curves, providing real-world evidence on how AI-assisted scanning performs outside specialist centres. ✅ Image quality improved as operators gained experience, suggesting that AI guidance can accelerate skill acquisition while maintaining clinically useful examinations. ✅ AI-guided POCUS has the potential to expand access to cardiac imaging in underserved and remote communities by supporting frontline healthcare professionals rather than replacing expert echocardiographers. 💡 Clinical takeaway: AI is not just transforming image interpretation—it is also improving image acquisition. AI-guided POCUS could help bridge inequalities in cardiovascular care by making high-quality echocardiography accessible in resource-limited settings while keeping experts connected for interpretation and oversight. 📖 Read the full article: doi.org/10.1093/ehjimp/qyag1… #CardioX #ArtificialIntelligence #POCUS #Echocardiography #GlobalHealth #DigitalHealth #CardiacImaging #Cardiology #MedTwitter #OpenScience

On the left: 3D TTE of TV. By increasing FlexiLight intensity, image clarity & depth pop! 💡 "Post-processing is like makeup: no bad image, only inadequate makeup!" 💄✨ Want to create magic with 3D Echo? Join our Tasmania workshop! 🪄 👇 Register: lnkd.in/dDG-czTm

What is the congenital heart disease and Associations?

🫀 Can echocardiography reliably detect mitral valve abscess before surgery? Mitral valve abscess is a rare but life-threatening complication of infective endocarditis. This large contemporary study of 154 patients highlights the pivotal role of transoesophageal echocardiography (TEE) while revealing that advanced disease often requires complex surgical reconstruction despite modern imaging. 🔍 Key findings: ✅ TEE vastly outperformed transthoracic echocardiography (TTE) for detecting mitral valve abscess (55.8% vs. 3.9%), confirming its central role when periannular extension is suspected. ✅ 94% of patients underwent surgery, and more than one-quarter required highly complex procedures (including Commando-type reconstructions), reflecting the severity of this condition. ✅ Mitral valve abscess frequently involved extensive tissue destruction, including leaflet perforation, fistulae, pseudoaneurysms, and multivalvular disease, particularly in prosthetic valve endocarditis. ✅ Independent predictors of mortality included chronic kidney disease, Staphylococcus aureus infection, native valve involvement, and female sex, emphasizing the need for early diagnosis and multidisciplinary management. 💡 Clinical takeaway: When infective endocarditis is complicated by suspected periannular extension, early TEE—especially with 3D imaging—should be performed promptly. However, this study also reminds us that echocardiography may miss earlier stages of mitral valve abscess, making close collaboration between imaging specialists and cardiac surgeons essential. 📖 Read the full article: doi.org/10.1093/ehjimp/qyag1… #CardioX #Echocardiography #TEE #InfectiveEndocarditis #MitralValve #CardiacImaging #ValveDisease #CardiacSurgery #Cardiology #MedTwitter

An inpatient undergoes TEE. An echo density is seen in pulmonary artery. 1/2

🫀 Are we missing the most important component of right ventricular dysfunction in repaired Tetralogy of Fallot? A novel 3D echocardiography approach provides a more detailed assessment of right ventricular (RV) mechanics by separating RV contraction into longitudinal, radial, and anteroposterior (AP) components—revealing previously unrecognized patterns of RV remodelling in patients with repaired Tetralogy of Fallot (ToF). 🔍 Key findings: ✅ Anteroposterior (AP) contraction was the main contributor to RV dysfunction, showing the greatest reduction in ToF patients compared with healthy controls. ✅ Despite overall RV impairment, the relative contribution of longitudinal contraction increased, suggesting a compensatory mechanism rather than uniform deterioration of RV function. ✅ The anterior free wall mirrored the global remodelling pattern, highlighting regional heterogeneity and the importance of moving beyond conventional global RV indices. ✅ This novel software enables automated directional decomposition of RV ejection fraction, offering a more comprehensive assessment of RV mechanics that could improve future risk stratification in congenital heart disease. 💡 By looking beyond conventional measures such as TAPSE or global RVEF, 3D echocardiography may provide new insights into right ventricular remodelling and help identify earlier markers of disease progression in adults with repaired Tetralogy of Fallot. 📖 Read the full article: doi.org/10.1093/ehjimp/qyag1… #CardioX #TetralogyOfFallot #CongenitalHeartDisease #Echocardiography #3DE #RightVentricle #CardiacImaging #ACHD #Cardiology #MedTwitter #OpenScience

In AR think beyond LVEF - think LVOT SV 🆚 RVOT SV🫀#volumetrics #echomath In AR, LVOT SV > RVOT SV RegVol AR = LVOT SV - RVOT SV RegFr AR = RegVol AR / LVOT SV 📌 if no MR, LV SV ~ LVOT SV 📌 if no TR, RV SV ~ RVOT SV #echofirst @NMerke

A patient with severe left ventricular systolic dysfunction undergoes TEE for evaluation of mitral regurgitation. What are important anatomic findings, based on this clip?

Mitral Valve *ProlapSAM* @denisamuraru @alex1708ander @NMerke @eromerodorta @StellEkaterina @alexsfelixecho @echo_batman @echo_stepbystep @VerwerftJan @echotalk @drahmedmohsen85 @argulian @iamritu

🫀 Is the failing heart really "running out of fuel"? A comprehensive meta-analysis of 176 studies and 7,843 cardiac MR spectroscopy examinations provides the largest reference dataset to date on myocardial energetics, confirming that impaired cardiac energy metabolism is a common feature across multiple cardiovascular diseases. v 🔍 Key findings: ✅ The normal phosphocreatine-to-ATP (PCr/ATP) ratio in healthy hearts is 1.96, providing an important benchmark for future clinical and research studies. ✅ Cardiac energetics were significantly impaired in HFrEF (−21%) and HFpEF (−18%), with similar reductions also observed in hypertrophic cardiomyopathy, valvular heart disease, and diabetes. ✅ Lower PCr/ATP ratios were associated with higher BMI and natriuretic peptide levels, while better left ventricular ejection fraction correlated with improved myocardial energetics. ✅ Although acquisition methods (field strength, sequence, voxel location) influenced individual measurements, they had minimal impact on pooled estimates, supporting meaningful comparisons across studies. 💡 This work establishes robust reference values for cardiac energetics and reinforces the concept that metabolic dysfunction is a shared pathway across cardiovascular diseases, highlighting myocardial metabolism as an important therapeutic target. 📖 Read the full article: doi.org/10.1093/ehjimp/qyag1… #CardioX #CMR #CardiacMRI #MRSpectroscopy #HeartFailure #CardiacMetabolism #CardiacImaging #Cardiology #MedTwitter #OpenScience

Share an interesting case! Submit clinical cases on novel scenarios related to CV. Submit ~1K words w/ images/videos at journal.houstonmethodist.org… Or submit Multimodality Museum Images-see our Special Collections journal.houstonmethodist.org… #DeBakeyCVJournal @maquinonesmd @NadeenFaza

🫀 Ready to go beyond 2D? Join the 3D Advanced Echocardiography Workshop in Berlin: expert faculty, hands-on training with real 3D datasets, valve imaging, RV analysis & practical tips for daily practice. By @NMerke @dhzcharite 👉 dhzb-akademie.de/course/3d-w… #3DEcho #Echofirst

🫀 Stress CMR delivers powerful long-term risk stratification in hypertension without known CAD. In 2,019 patients, ischaemia predicted MACE >3-fold over 6.7 years (39% vs 12%; HR 4.1). Unrecognized MI: HR 3.6. Why stop at conventional risk factors ❓ ✅doi.org/10.1093/ehjci/jeag16…

🫀 Beyond GLS: Age- & sex-specific LV strain curves from 1,641 healthy participants in CCHS reveal marked age-related changes in diastolic strain morphology. Novel curve metrics may add prognostic value. Worth exploring—check out the paper! ✅doi.org/10.1093/ehjci/jeag15… @EHJCVIEiC

🤖 Is AI-powered 3D echocardiography truly automated? Artificial intelligence is transforming 3D echocardiography, but this editorial reminds us that automation is only as good as the images it receives. Without standardized acquisition and expert oversight, AI may deliver precise-looking—but potentially misleading—results. 🔍 Key messages: ✅ Image quality remains the single most important determinant of AI performance. Automation cannot compensate for poor image acquisition or non-standardized datasets. ✅ AI algorithms may suffer from "silent drift"—maintaining the appearance of accuracy while progressively losing reliability when applied to new scanners, patient populations, or disease phenotypes outside their training domain. ✅ In conditions such as hypertrophic cardiomyopathy, inaccurate automated LVEF measurements could directly influence treatment decisions, highlighting the need for phenotype-specific validation. ✅ The authors propose that AI should function as an expert-supervised assistant, supported by standardized acquisition protocols, quality control, and continuous validation—not as a replacement for clinical expertise. 💡 The future of AI in echocardiography is not about replacing experts—it's about combining high-quality image acquisition with intelligent automation to achieve more reliable and reproducible patient care. 📖 Read the full editorial: doi.org/10.1093/ehjimp/qyag1… #CardioX #ArtificialIntelligence #Echocardiography #3DE #CardiacImaging #DigitalHealth #PrecisionMedicine #Cardiology #MedTwitter #OpenScience

In Type A dissection, every link matters 🫀 Referring hospital → rapid CT diagnosis → immediate transfer to an experienced aortic center → urgent surgery Only a seamless chain from diagnosis to surgery can deliver good outcomes And in the OR, TEE tells you what’s happening

Cardiac inflammatory pseudotumors are very rare and were first described in 1975 as reminiscent of “plasma cell granulomas” located in the right atrium. Since then, fewer than 75 cases have been reported. Involvement of the mitral valve remains very rare. bit.ly/46SFlpr