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Application of Echocardiography in the Diagnosis and Management of Cardiac Diseases

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

Deadline for manuscript submissions: 20 April 2026 | Viewed by 2483

Special Issue Editors

Faculty of Nursing and Health Sciences, “Iuliu Hațieganu” University of Medicine and Pharmacy in Cluj-Napoca, 400012 Cluj, Romania
Interests: echocardiography; coronary artery disease; heart failure; hypertension; intensive care in cardiology

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Guest Editor
Faculty of Medicine, University of Medicine and Pharmacy Iasi, Iasi, Romania
Interests: echocardiography; coronary artery disease; heart failure; acute pulmonary thromboembolism; intensive care in cardiology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

It is our honor to invite you to contribute to this Special Issue of the Journal of Clinical Medicine, entitled “Application of Echocardiography in the Diagnosis and Management of Cardiac Diseases”. Transthoracic echocardiography is the most effective, low-cost, minimally invasive, and readily available imaging modality for the assessment of patients exhibiting cardiac symptoms. It plays a central role in identifying or ruling out suspected acute and chronic cardiac diseases. Second, echocardiography is essential in follow-up on previously diagnosed valvular disease or heart failure. In those with heart failure, it would provide meaningful information to better treat the patient. In addition, novel techniques (transesophageal, stress, contrast, myocardial strain imaging, and three-dimensional (3D), intracardiac, echocardiography) have expanded the indications in a variety of ways and a wide range of clinical situations. Bedside echocardiography is routinely used now for patients who are critically ill with known or unknown cardiac diseases in order to elucidate the etiology of cardiovascular and respiratory failures. The role of echocardiography is increasing in patients who are asymptomatic and had, for example, a family history of sudden death, or in athletes. In this Special Issue, we aim to collect original articles and reviews focusing on the role of echocardiography on the whole spectrum of diagnosis and management of cardiac diseases. Multidisciplinary manuscripts are also welcomed.

Dr. Calin Pop
Dr. Antoniu Petris
Guest Editors

Manuscript Submission Information

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Keywords

  • echocardiography
  • cardiac diseases
  • 3D echo
  • stress
  • myocardial strain
  • intracardiac
  • subclinical cardiac disease

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Published Papers (3 papers)

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Research

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24 pages, 1419 KB  
Article
Myocardial and Atrial Strain Profiles in Pediatric Fontan Patients with Single Left Ventricle Using Two-Dimensional Speckle-Tracking Echocardiography: A Case–Control Study
by Carmen Corina Șuteu, Andreea Cerghit-Paler, Liliana Gozar, Amalia Fagarasan, Nicola Suteu and Mihaela Iancu
J. Clin. Med. 2025, 14(22), 8134; https://doi.org/10.3390/jcm14228134 - 17 Nov 2025
Viewed by 245
Abstract
Background/Objectives: Children with single left ventricle (SLV) anatomy following Fontan palliation are at high risk for subclinical ventricular dysfunction, which may not be detected by conventional echocardiographic measures. Our objectives are as follows: (1) to assess myocardial and atrial strain profiles in pediatric [...] Read more.
Background/Objectives: Children with single left ventricle (SLV) anatomy following Fontan palliation are at high risk for subclinical ventricular dysfunction, which may not be detected by conventional echocardiographic measures. Our objectives are as follows: (1) to assess myocardial and atrial strain profiles in pediatric Fontan patients with SLV using 2-dimensional speckle-tracking echocardiography (2D-STE), (2) to compare these findings with a healthy control group, (3) to investigate correlations with conventional echocardiographic and functional parameters. Methods: A single-center study of 66 pediatric patients, who underwent echocardiographic evaluation and a 6 min walk test (6 MWT). Conventional, 3D, and strain-based echocardiographic parameters were compared between groups. Correlations with clinical and functional indices were assessed using ANCOVA, analysis, generalized additive models, and Pearson’s correlation coefficient. Results: Fontan patients showed significantly reduced 6 MWT distances compared to controls (mean difference: 201.6 m, p < 0.0001). Post-test heart rate (HR) and oxygen saturation were significantly impaired (HR: 104.6 vs. 100.8 bpm, p = 0.0012; SaO2: 90.3% vs. 99.8%, p < 0.0001). Fontan patients showed statistically significant differences in nearly all the 2D parameters. Three-dimensional echocardiography revealed significantly lower left ventricular (LV) ejection fraction (p = 0.0020), higher end-diastolic (p = 0.0275) and end-systolic volumes (p = 0.0125) in the study group. Global longitudinal strain (LV_GLS) was reduced in Fontan patients compared to controls (p < 0.0001), with significant differences across nearly all LV segments. Left atrial (LA) reservoir and conduit strain were markedly decreased, while contractile strain remained similar. LV_GLS was negatively correlated with IVCT (r = −0.50, p = 0.0175). The LA reservoir strain (LASr_AC) significantly correlated with MAPSE (r = 0.43, p = 0.0461). Conclusions: In pediatric Fontan patients, myocardial and atrial strain imaging reveals subclinical dysfunction despite preserved conventional ejection fraction. Full article
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10 pages, 775 KB  
Article
The Role of Neutrophil-to-Lymphocyte Ratio and Right Ventricular Dysfunction in Indonesian Patients with COVID-19: A Retrospective Cohort Study
by Raksheeth Agarwal, Stanislaus Ivanovich Krishnanda, Oliver Emmanuel Yausep, Raka Aldy Nugraha, Gatut Priyonugroho, Siti Hertine, Sony Hilal Wicaksono, Prima Almazini, Dian Zamroni and Hary Sakti Muliawan
J. Clin. Med. 2025, 14(6), 2051; https://doi.org/10.3390/jcm14062051 - 18 Mar 2025
Cited by 1 | Viewed by 908
Abstract
Background/Objectives: The clinical impact of neutrophil-to-lymphocyte ratio (NLR) and right ventricular (RV) dysfunction on clinical outcomes in COVID-19 remains understudied in the Indonesian population. This study aims to investigate their prognostic value in hospitalized Indonesian adults with COVID-19. Methods: A retrospective [...] Read more.
Background/Objectives: The clinical impact of neutrophil-to-lymphocyte ratio (NLR) and right ventricular (RV) dysfunction on clinical outcomes in COVID-19 remains understudied in the Indonesian population. This study aims to investigate their prognostic value in hospitalized Indonesian adults with COVID-19. Methods: A retrospective cohort study was conducted at a COVID-19 referral hospital in Indonesia. We included all consecutive adults hospitalized between April 2020 and April 2021 who underwent transthoracic echocardiography (TTE) during admission. Clinical information was extracted from electronic medical records. TTE variables were defined according to the American Society of Echocardiography criteria. Statistical analyses were performed using SPSS. Ethical approval was obtained from the Institutional Review Board of Universitas Indonesia (#2022-01-135). Results: A total of 488 patients were included in this study—29 with and 459 without RV dysfunction. The mean age of the population was 54.8, with 42% being female. An NLR >4.793 was considered elevated. Elevated NLR was independently associated with RV dysfunction (OR: 3.38, p = 0.02). Older age (HR: 1.02, p = 0.01), obesity (HR: 1.85, p < 0.01), chronic kidney disease (HR: 1.69, p = 0.01), high NLR (HR: 2.75, p < 0.001), and RV dysfunction (HR: 2.07, p = 0.02) independently increased the risk of 30-day mortality by multivariate Cox regression analysis. Conclusions: In adult Indonesian patients hospitalized with COVID-19, an elevated NLR was associated with RV dysfunction, and both of these parameters increased the risk of 30-day mortality. This retrospective cohort study highlights the prognostic importance of NLR and RV dysfunction in hospitalized COVID-19 patients, providing physicians with tools to identify high-risk patients. Full article
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Other

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21 pages, 502 KB  
Perspective
Stress Echocardiography in Aortic Stenosis: From Diagnostic Challenges to Guideline-Endorsed Clinical Applications
by Roxana Hodas, Călin Pop and Antoniu Octavian Petris
J. Clin. Med. 2025, 14(20), 7424; https://doi.org/10.3390/jcm14207424 - 21 Oct 2025
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Abstract
Aortic stenosis (AS) is the most common valvular heart disease in industrialized countries. Stress echocardiography (SE), using either exercise or dobutamine protocols, has emerged as a critical tool to overcome limitations of resting echocardiography, refine risk stratification, and guide the timing of aortic [...] Read more.
Aortic stenosis (AS) is the most common valvular heart disease in industrialized countries. Stress echocardiography (SE), using either exercise or dobutamine protocols, has emerged as a critical tool to overcome limitations of resting echocardiography, refine risk stratification, and guide the timing of aortic valve replacement. This review synthesizes contemporary evidence on the diagnostic, prognostic, and therapeutic role of SE in AS. Studies from all main databases (2000–2025) were systematically analyzed including prospective studies, consensus statements, and international guidelines. We highlight the physiological rationale, key prognostic markers, applications in asymptomatic severe and low-flow, low-gradient AS, and integration with multimodality imaging. SE is now guideline-endorsed for risk stratification in asymptomatic severe AS and the diagnosis of true severe versus pseudo-severe AS in low-flow, low-gradient disease. Future directions include advanced strain imaging, artificial intelligence, and broader adoption in the transcatheter era. Full article
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