JASE

PLEASE NOTE: Beginning today, JASE will be available online only.

🫀NEW GUIDELINE🫀 Read our newest #ASEGuideline, "Recommendations for the Identification and Mitigation of Cardiac Ultrasound Artifacts!" bit.ly/4tKDSvf

We've released a #new State-of-the-Art Review, "Left Atrial Strain in Pediatric Cardiology: Evidence to Date and Future Directions." Read our @JournalASEcho article: bit.ly/3OvhqHi

For this @JournalASEcho report, we sought to validate right ventricular stroke volumes and tricuspid regurgitant volumes measured by 3D echo. Then we compared the quantitative metrics used to assess TR severity. Read our JASE report: bit.ly/4cgMZh4

In ASE’s peer-reviewed @JournalASEcho, members address clinical challenges and publish cutting-edge research to share with colleagues and peers. bit.ly/31aWqJn #HeartofASE #ASEMemberDay #EchoFirst

We previously developed an algorithm to improve classification of interatrial communications (IACs) in newborns. This @JournalASEcho study aimed to evaluate the patency at preschool age of neonatal IACs classified using the algorithm. bit.ly/4cSU2x2

@NadeenFaza @JGrapsa @JiwonKimMD @PWesslyMD @ASE360 @DavidWienerMD @rajdoc2005 @purviparwani @iamritu @JournalASEcho @nishath_quader @EGarciaSayan ANSWER 4-DEFINITION LV DIASTOLIC DYSFUNCTION (DD) 3️⃣ hallmarks of LV DD: ⬇️ LV relaxation and ⬆️ LV diastolic stiffness +/- ⬆️LVFP. Echo parameters rely on markers of ⬇️ LV relaxation, chamber remodelling & ⬆️ LVFP/LAP (see figure). #ASEchoJC @SNagueh @dysanborn @ASE360

Thank you for joining #ASEchoJC tonight as we decoded the updated @ASE360 Diastology Guidelines & tackled the complexities of diastolic function! 🫀📊Grateful to our incredible guest authors @SNagueh @dysanborn @BonitaEcho, my fantastic co-moderators @HeartToProve @PWesslyMD & our engaged audience for such a lively, thoughtful, & high-yield discussion. 🙏💬 Until next time! ✨ #EchoFirst #Cardiotwitter #CardioX

tinyurl.com/y4kfsnsx 🫀 New multicenter study (n=951) validates a stepwise echo algorithm to estimate LV filling pressure (LVFP) in patients evaluated for dyspnea. • Uses e′, E/e′, PASP first, then LA strain, LAVI, IVRT & pulmonary vein flow if discordant • Indeterminate results: 2 vs 38 with 2016 guidelines • Accuracy: 86% (sens 86%, spec 86%) • Adds incremental value beyond natriuretic peptides A promising approach to reduce “indeterminate” diastology. #EchoFirst #HFpEF #CardioTwitter #ASEchoJC

Check out this paper! H₂FPEF score helps rule out HFpEF when probability is <30%. However, when probability is >30%, incorporating echocardiographic parameters from the 2025 @ASE360 diastolic guidelines to estimate mean LAPsignificantly improves diagnostic accuracy vs H₂FPEF alone. 🫀📊 tinyurl.com/2h4mv9xy 👉 #EchoFirst adds meaningful reclassification & discrimination for HFpEF diagnosis. #HFpEF #EchoFirst #CardioTwitter #ASEchoJC

@NadeenFaza @SNagueh @dysanborn @BonitaEcho @PWesslyMD @iamritu @SIwa23288585 RECOMMENDED READ ON THIS SUBJECT "Improving the Diagnosis of HFpEF: A Comparison of the H2FPEF Score and the 2025 ASE Diastolic Function Guideline Recommendations Using Invasive Hemodynamics as the Gold Standard" #ASEchoJC jacc.org/doi/abs/10.101… @SFNagueh

@NadeenFaza @SNagueh @dysanborn @BonitaEcho @PWesslyMD @iamritu @SIwa23288585 Remember that HFpEF is a clinical diagnosis. It can be complex. Integrate all the tools at hand to make the correct diagnosis. #ASEchoJC

🔑 HFpEF is not an echocardiographic diagnosis alone. It requires: 🔹 HF symptoms 🔹 Preserved EF 🔹 Objective evidence of elevated filling pressures from echo, biomarkers, or hemodynamics ⚠️ Always exclude HFpEF mimics: CAD, infiltrative disease, HCM, constriction, significant VHD Diagnosis requires integration of clinical, imaging, and laboratory data. #ASEchoJC #EchoFirst @ASE360 #HFpEF

@NadeenFaza @dysanborn @BonitaEcho @PWesslyMD @HeartToProve @iamritu @SIwa23288585 #HFpEF #ASEchoJC #EchoFirst

@NadeenFaza @SNagueh @dysanborn @BonitaEcho @HeartToProve @iamritu @SIwa23288585 🫀 How do we diagnose HFpEF? A stepwise clinical approach—from symptoms to invasive hemodynamics. Quick visual guide 👇 #ASEchoJC #EchoFirst @ASE360

@NadeenFaza @SNagueh @dysanborn @BonitaEcho @HeartToProve @ASE360 🫀 AF diastology tip 💡 Look at beat-to-beat variability in mitral inflow 📉 Less variability in E velocity across cycles → suggests elevated LV filling pressure Record multiple beats at sweep speed ~50 mm/s to assess this pattern. #ASEchoJC #EchoFirst @ASE360

#ASEchoJC Q 10. How are echocardiographic findings integrated with clinical and laboratory data in the diagnosis of HFpEF? @SNagueh @dysanborn @BonitaEcho @PWesslyMD @HeartToProve

@NadeenFaza @SNagueh @dysanborn @BonitaEcho @HeartToProve @ASE360 ⚠️ No single echo parameter reliably estimates LAP in AF. A multiparametric approach is required. #ASEchoJC #EchoFirst @ASE360

@NadeenFaza @SNagueh @dysanborn @BonitaEcho @HeartToProve @ASE360 🫀 Diastology in Atrial Fibrillation — key challenge AF complicates LV filling pressure assessment due to: 🔹 Variable cycle length 🔹 Loss of atrial contraction 🔹 Tachycardia 🔹 Frequent LA enlargement #ASEchoJC #EchoFirst @ASE360

#ASEchoJC #EchoFirst #RCM

🫀 Echo pearl in AFib When estimating LV filling pressure: 🔹 Average measurements from multiple cardiac cycles 🔹 Select cycles reflecting the average heart rate 📌 Dual Doppler (simultaneous E & e′ from the same beat) improves accuracy when calculating E/e′. #ASEchoJC #EchoFirst @ASE360