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Echocardiography in Clinical Cardiac Imaging: Advances and Emerging Applications

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 20 July 2026 | Viewed by 1669

Editor


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Guest Editor
1. Shamir Medical Center, Ya'akov, Israel
2. Gray Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv 69978, Israel
Interests: echocardiography; myocardial strain imaging; left atrial function; speckle-tracking echocardiography; cardiac imaging

Special Issue Information

Dear Colleagues,

Echocardiography remains a cornerstone of contemporary cardiac imaging, offering a versatile, noninvasive, and widely accessible tool for the diagnosis, risk stratification, and management of cardiovascular diseases. Continuous technological advancements—including speckle-tracking echocardiography, three-dimensional imaging, the application of artificial intelligence, and integration with multimodality imaging—have significantly expanded its clinical capabilities.

This Special Issue aims to highlight recent advances and emerging clinical applications of echocardiography across a broad spectrum of cardiac conditions, including ischemic heart disease, cardiomyopathies, valvular heart disease, heart failure, and atrial pathology. Original research articles, state-of-the-art reviews, and clinically focused studies addressing novel echocardiographic parameters, methodological validation, prognostic implications, and practical implementation in routine clinical practice are particularly encouraged.

By bringing together innovative research and expert perspectives, this Special Issue seeks to emphasize the evolving role of echocardiography in precision cardiology and its contribution to improved patient care.

Prof. Dr. Marina Leitman
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 250 words) can be sent to the Editorial Office for assessment.

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-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine 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

  • echocardiography
  • cardiac Imaging
  • speckle-tracking echocardiography
  • artificial intelligence
  • myocardial function
  • valvular heart disease
  • precision cardiology

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Published Papers (2 papers)

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Research

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18 pages, 4896 KB  
Article
Longitudinal Displacement vs. Strain in Cardiac Amyloidosis: A Speckle Tracking Echocardiography Study
by Marina Leitman, Vladimir Tyomkin and Shmuel Fuchs
J. Clin. Med. 2026, 15(4), 1544; https://doi.org/10.3390/jcm15041544 - 15 Feb 2026
Viewed by 836
Abstract
Background: Longitudinal strain is central to the echocardiographic diagnosis of cardiac amyloidosis, typically showing reduced global values with relative apical sparing. Longitudinal displacement—an absolute measure of myocardial motion—may provide complementary diagnostic and physiological information. Methods: We retrospectively studied 24 patients with [...] Read more.
Background: Longitudinal strain is central to the echocardiographic diagnosis of cardiac amyloidosis, typically showing reduced global values with relative apical sparing. Longitudinal displacement—an absolute measure of myocardial motion—may provide complementary diagnostic and physiological information. Methods: We retrospectively studied 24 patients with cardiac amyloidosis and 24 age-, sex-, rhythm-, and ejection fraction–matched controls. Global and regional longitudinal strain and displacement were calculated. Diagnostic performance was evaluated using receiver-operating characteristic (ROC) analysis, and reproducibility was assessed using intraclass correlation coefficients (ICC), coefficient of variation (CV), and Bland–Altman analysis. Results: In amyloidosis, both global longitudinal strain (GLS) and global longitudinal displacement (GLD) were significantly reduced compared with controls (GLS: −10.2 ± 2.6% vs. −20.1 ± 2.4%, p < 0.0001; GLD: 6.6 ± 1.9 mm vs. 11.9 ± 1.4 mm, p < 0.0001). Amyloidosis was characterized by pronounced impairment of basal displacement (9.0 ± 4.4 vs. 17.0 ± 3.9 mm, p < 0.0001) and only modest reduction in absolute apical motion (3.0 ± 2.4 vs. 5.0 ± 2.3 mm, p < 0.0001), supporting the concept that apical sparing observed on strain reflects relative rather than absolute preservation of function. ROC analysis demonstrated strong discriminatory performance within this cohort for GLD (cutoff 8.8 mm), basal displacement (~13 mm), and GLS (absolute 15.8%), with areas under the curve approaching 1.0. GLD and GLS correlated with indices of diastolic burden and functional status (E/E′ and NYHA; |r| ≈ 0.32–0.41, all p ≤ 0.03). Reproducibility was good to excellent (ICC ≈ 0.84–0.89; CV 6–8%). Conclusions: Longitudinal displacement provides complementary and reproducible information alongside strain in cardiac amyloidosis. Combined assessment—reduced global or basal displacement together with reduced GLS and/or relative apical sparing—may refine the echocardiographic characterization of amyloid cardiomyopathy and link longitudinal mechanics to diastolic dysfunction and heart-failure burden. Full article
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27 pages, 2628 KB  
Systematic Review
Unmasking Risk in Mitral Regurgitation: Prognostic Value of Exercise Stress Echocardiography—A Systematic Review
by Andrea Sonaglioni, Massimo Baravelli, Giulio Francesco Gramaglia, Gian Luigi Nicolosi and Michele Lombardo
J. Clin. Med. 2026, 15(9), 3253; https://doi.org/10.3390/jcm15093253 - 24 Apr 2026
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Abstract
Background: Risk stratification of patients with mitral regurgitation (MR), including both primary (degenerative) and secondary (functional) forms, remains challenging, particularly in asymptomatic or minimally symptomatic stages, as clinical assessment and resting echocardiography may underestimate disease severity and functional impairment. Exercise stress echocardiography (ESE) [...] Read more.
Background: Risk stratification of patients with mitral regurgitation (MR), including both primary (degenerative) and secondary (functional) forms, remains challenging, particularly in asymptomatic or minimally symptomatic stages, as clinical assessment and resting echocardiography may underestimate disease severity and functional impairment. Exercise stress echocardiography (ESE) enables dynamic evaluation of regurgitation severity, ventricular performance, and cardiopulmonary response, potentially improving prognostic assessment. Methods: A systematic review was conducted according to PRISMA guidelines. PubMed, Scopus, and EMBASE were searched from inception to March 2026. Studies including adult patients with primary or secondary MR undergoing exercise-based stress echocardiography and reporting clinical outcomes were selected. Studies using exclusively pharmacological stress were excluded. Data were qualitatively synthesized, and continuous variables were summarized as weighted medians and interquartile ranges. In addition, emerging and non-conventional prognostic markers, including anatomical indices such as the modified Haller index (MHI), were explored to provide a more comprehensive risk stratification framework. Results: Nineteen studies were included, encompassing a heterogeneous population in terms of MR etiology, severity, and clinical presentation. During follow-up, a substantial proportion of patients experienced adverse events, including heart failure, mitral valve intervention, or death. Exercise-derived parameters consistently showed strong prognostic value. In particular, exercise-induced worsening of MR severity (increase in effective regurgitant orifice area and regurgitant volume), absence of contractile reserve, elevated filling pressures (E/e’), and exercise-induced pulmonary hypertension were associated with worse outcomes. Reduced functional capacity and impaired right ventricular–pulmonary arterial coupling provided additional prognostic information. Emerging markers, including chest wall configuration assessed by MHI, appeared to further refine risk stratification in selected patient subsets. In contrast, resting parameters were less consistently predictive. Conclusions: ESE provides incremental prognostic information in patients with MR by identifying dynamic abnormalities not evident at rest. Its integration into clinical evaluation, together with novel anatomical and functional markers, may improve risk stratification and support earlier identification of high-risk patients who could benefit from timely intervention. Further studies are needed to standardize methodologies and define clinically relevant thresholds. Full article
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