Correlation Between Aortic Valve Area Measured by Cardiac Computed Tomography and Transthoracic Echocardiography in Patients with Aortic Stenosis

Journal of Community Hospital Internal Medicine Perspectives Journal of Community Hospital Internal Medicine Perspectives

Effect of Transthoracic Echocardiography on Prognosis Outcomes in Diabetic Patients With Various Cardiovascular Diseases: A Retrospective Cohort Study Based on the MIMIC-IV Database.

OBJECTIVE This study aimed to investigate the association between transthoracic echocardiography (TTE) and prognosis in diabetic patients without complications who present with seven types of cardiovascular diseases. METHODS Data were sourced from the Medical Information Mart for Intensive Care (MIMIC)-IV database (N = 5553). The included participants were divided into TTE examination (n = 2263) and non-TTE examination (n = 3290) groups. Clinical endpoints included survival time, initial Intensive Care Unit (ICU) admission, and hospital readmission. Logistic and Cox regression analyses were conducted to assess the relationship between TTE examination and these outcomes. Receiver operating characteristic (ROC) curves evaluated the predictive exploratory prognosis utility of TTE examination. The Kaplan-Meier (KM) and restricted mean survival time (RMST) analyses were used to compare the survival difference between the TTE examination and non-TTE examination groups. RESULTS Significant differences were observed in the distribution of the other three outcomes between the TTE examination and non-TTE examination groups (all p < 0.05). However, only the association between TTE and survival time was influenced by whether the patient had cardiovascular diseases (observed only in patients with cardiovascular diseases, all p < 0.05). KM and RMST analyses further showed that TTE examination was associated with dual benefits in longer survival time and extended event-free survival time compared with the non-TTE examination group (all p < 0.05). Cox regression analysis indicated a negative correlation in patients specifically with coronary heart disease, heart failure, cardiomyopathy, or hypertension (all p < 0.05), but observed an independent association only in subgroups with heart failure (p = 0.012) or cardiomyopathy (p = 0.035). Exploratory ROC analysis demonstrated the clinical significance of TTE, particularly in predicting long-term survival (exceeding the 75th percentile) among diabetic patients with heart failure (all DeLong test p < 0.05). CONCLUSION TTE was independently associated with survival time in diabetic patients with heart failure or cardiomyopathy, and exploratory analyses suggested more favorable performance in predicting the longer survival duration among those with heart failure.

Agreement Between Transthoracic Echocardiography and Digital Subtraction Angiography for the Detection of Right Atrial Thrombus in Patients Undergoing Maintenance Hemodialysis: A Retrospective Cohort Study

TTE is recommended as the first-line CRAT screening tool for MHD patients and combined TTE and DSA use improves diagnostic yield, and regular targeted surveillance for high-risk individuals reduces CRAT incidence.

Risk stratification and real-world management of pediatric AAORCA: discordance between anatomical features and clinical symptoms

Background Anomalous aortic origin of the right coronary artery (AAORCA) is increasingly identified in children, yet risk stratification remains controversial. This study aims to identify key anatomical predictors of clinical symptoms and evaluate real-world management patterns in a large pediatric cohort. Methods We conducted a single-center retrospective cohort study in pediatric patients ≤18 years diagnosed with AAORCA between November 2021 and December 2025. Clinical presentation, imaging findings, management strategies, and follow-up outcomes were analyzed. Integrated anatomical features were derived using a predefined hierarchical approach incorporating surgical findings, CTA, and echocardiography. Multivariable logistic regression analysis was performed to identify factors associated with symptomatic presentation. Results A total of 151 patients were included (mean age 7.40 ± 4.87 years; 60.9% male), of whom 51.7% presented with symptoms. High-risk anatomical features were frequently identified but showed incomplete concordance with clinical symptoms. In multivariable analysis, patient age was independently associated with symptom presentation. Although ostial stenosis showed a stronger unadjusted association with symptoms than other anatomical features, no anatomical variable remained independently associated with symptom status after adjustment. A real-world decision pathway revealed substantial heterogeneity in management strategies among patients with high-risk anatomical findings. No sudden cardiac death or major adverse cardiovascular events were observed during available follow-up. Conclusion Pediatric AAORCA demonstrates marked heterogeneity in clinical presentation, anatomical features, and management strategies. Clinical symptoms show incomplete concordance with high-risk anatomical features, highlighting the complexity of risk stratification in children. Among the evaluated clinical and anatomical characteristics, patient developmental age emerged as a strong independent predictor of symptoms, whereas ostial stenosis demonstrated the strongest unadjusted association with symptom status; however no anatomical variable remained independently associated with symptoms after multivariable adjustment. Real-world management strategies varied substantially and reflected individualized decision-making in the setting of limited pediatric evidence. Future studies may benefit from phenotype-oriented rather than anatomy-only risk classification frameworks.