Abstract Over the last decade, transcatheter structural heart interventions (TSHIs) have revolutionized the management of patients with structural heart disease (SHD), particularly those deemed high-risk or inoperable for conventional surgery. This rapid evolution has been propelled by innovations in both device technology and cardiovascular imaging, with echocardiography emerging as a cornerstone for procedural planning, real-time guidance and post-procedural assessment. This review outlines the expanding role of echocardiography across the spectrum of TSHIs, highlighting the importance of multimodality imaging, including three-dimensional transoesophageal echocardiography (3D TEE), intracardiac echocardiography (ICE) and fusion imaging techniques, for comprehensive structural evaluation and intraprocedural navigation. As the field continues to evolve, the demand for imaging specialists with procedural expertise is growing. Challenges remain in optimizing workflow, minimizing radiation exposure and enhancing image-guided precision. This review aims to outline the development of interventional imaging and promote best practices for procedural success and patient safety.
N. Ktenopoulos, K. Vlasopoulou, P. Vlachakis et al.· European heart journal. Imag...· 0 citations
Chronic kidney disease-associated cardiomyopathy (CKD-CM) is a term that captures the spectrum of myocardial disease that begins early in chronic kidney disease (CKD) and progresses as kidney function declines. Historically described as uremic cardiomyopathy, the condition was associated with severe left ventricular hypertrophy and fibrosis in patients with kidney failure. However, functional abnormalities and myocardial injury have been shown to begin much earlier, with diffuse interstitial fibrosis preceding overt hypertrophy or reduced ejection fraction. Fibrosis drives heart failure with preserved ejection fraction (HFpEF)-like physiology and atrial fibrillation and increases arrhythmic risk. In this review, we describe the multiple interacting mechanisms, including abnormal loading, neurohormonal activation, metabolic and inflammatory stress, mineral bone disorder, and microvascular dysfunction. We summarize imaging findings across CKD stages and describe established and emerging therapeutic strategies. A better understanding of CKD-CM pathogenesis is likely to enable early intervention and prevention, with successful outcomes measured by reduced progression to severe cardiomyopathy and lower cardiovascular mortality in CKD.
Konstantinos Grigoriou, Vasileios Lamprou, Anastasios Chatzichidiroglou et al.· British journal of hospital...· 0 citations
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