Abstract Mitral valve regurgitation is the most common valvular heart disease. In order to guide proper therapy, it is paramount to follow and use the guideline-recommended echocardiographic tools. The flow convergent method, which calculates the effective regurgitant orifice area and the regurgitant volume, plays an important role in the diagnostic workup and is widely used by echocardiographers and sonographers. Only by knowing the correct application and avoiding its pitfalls can we guarantee comprehensive and plausible values. This critical review will […]

Abstract Circulatory shock is characterized by a state of inefficient tissue oxygen supply and multiple organ dysfunction. Patients with circulatory shock require fast and assertive diagnosis and therapies to reduce its high lethality. Echocardiography has already been established as a fundamental method in managing patients with circulatory shock. It provides crucial assistance in etiological diagnosis, prognosis, hemodynamic monitoring, and volume estimation in these patients; its potential advantages include portability, absence of contrast or radiation, low cost, and real-time serial assessment. […]

Abstract Mitral annulus disjunction (MAD) is an abnormal insertion of the flexion line of the mitral annulus into the atrial wall. The annulus presents a separation (disjunction) between the posterior leaflet–atrial wall junction and the left ventricular myocardial crest.1 MAD was first described more than 30 years ago in an autopsy study and is reportedly related to mitral valve prolapse (MVP) in 92% of cases.2 Since then, several studies have been conducted, and reports on the prevalence of MAD in […]

Introduction Many vascular ultrasound articles were published in 2024, but certainly the most discussed in Brazil this year was “Carotid Plaque-RADS – A Novel Stroke Risk Classification System” by Saba et al. in JACC: Cardiovascular Imaging. The project brought together 51 specialists in different vascular imaging modalities from 10 countries. This new proposal for categorizing carotid plaque attracted the attention of physicians from various specialties, such as cardiologists, neurologists, radiologists, ultrasound specialists, and vascular surgeons. In this section, we will […]

Pulmonary hypertension (PH) is a complex multiorgan system disease defined as mean pulmonary artery pressure (mPAP) > 20 mmHg. The etiologies related to pathological changes in pulmonary vasculature leading to PH are wide. Hemodynamic categorization considers precapillary PH, represented by pulmonary arterial hypertension (PAH), pulmonary vascular resistance (PVR) > 3 Woods units (WU), and pulmonary arterial wedge pressure < 15 mmHg. Postcapillary PH, represented by left heart disease, involves PVR > 3 WU and pulmonary arterial wedge pressure > 15 […]

Abstract Coronary artery disease (CAD) is a common cause of chest pain, frequently seen in emergency departments and during elective consultations, and remains the leading cause of death worldwide. Coronary computed tomography angiography (CCTA) has become an established diagnostic tool for evaluating stable angina and acute chest pain in patients with low or intermediate risk. In this setting, CAD-RADS (Coronary Artery Disease-Reporting and Data System) was introduced as a CCTA reporting model, first published in 2016 and updated in 2022, […]

Abstract Background: Atrial Functional Mitral Regurgitation (FMR) is defined by mitral annular dilation and functional alterations without structural impairment of the leaflets or subvalvular apparatus. It is associated with higher cardiovascular mortality, being often characterized as an exclusion diagnosis due to the absence of more precise diagnostic criteria. Therefore, it is crucial to identify markers that distinguish it from other Mitral Regurgitation (MR) types. Objective: To assess the accuracy of the intercommissural diameter of the mitral annulus and its value […]

Abstract The use of non-invasive tools for analyzing systemic venous congestion in critically ill patients in the intensive care unit has been gaining increasing popularity for diagnosis, estimating the severity of congestion, and providing prognostic estimates. Patients with systemic congestion are more likely to develop renal dysfunction compared to those without congestion. In this review, the authors demonstrate how to perform systemic congestion analysis, its potential limitations, and its practical and objective applicability.

Abstract Left atrial (LA) strain, obtained using two-dimensional speckle tracking echocardiography (2DSTE), has emerged as an accurate method for evaluating LA function. Recently, it has gained prominence in clinical practice due to its significant prognostic value in various cardiovascular diseases, standing out due to its greater sensitivity compared to traditional methods of volumetric analysis and Doppler parameters. This review article addresses the complex function of the LA and its close interdependence with left ventricular (LV) function, highlighting its relevance in […]

Abstract Heart Failure with Preserved Ejection Fraction (HFpEF) is an increasing challenge in cardiology, marked by impairments in systolic and/or diastolic function. HFpEF patients often present with exercise intolerance, yet diagnosis is complicated by overlapping comorbidities, such as obesity and hypertension. Left ventricular Global Longitudinal Strain (GLS) enables the detection of subtle systolic dysfunction, with studies indicating a stronger correlation between GLS and exercise capacity than ejection fraction (EF). In exercise echocardiography, GLS displays a characteristic bimodal pattern due to […]