Carotid artery disease is one of the main global causes of disability and premature mortality in the spectrum of cardiovascular diseases. One of its main consequences, stroke, is the second biggest global contributor to disability and burden via Disability Adjusted Life Years after ischemic heart disease. In the last decades, B-mode and Doppler-based ultrasound imaging techniques have become an indispensable part of modern medical imaging of carotid artery disease. However, they have limited abilities in carotid artery plaque and wall characterization and are unable to provide simultaneous quantitative and qualitative flow information while the images are burdened by low framerates. UltraFast™ ultrasound is able to overcome these obstacles by providing simultaneous quantitative and qualitative flow analysis information in high frame rates via UltraFast™ Doppler. Another newly developed ultrasound technique, shear wave elastography, is based on the visualization of induced shear waves and the measurement of the shear wave propagation speed in the examined tissues which enables real-time carotid plaque and wall analysis. These newly developed ultrasound modalities have potential to significantly improve workflow efficiency and are able to provide a plethora of additional imaging information of carotid artery disease in comparison to conventional ultrasound techniques.

Shear wave elastography (SWE) is a type of ultrasound elastography with which the elastic properties of breast tissues can be quantitatively assessed. The purpose of this study was to determine the impact of different regions of interest (ROI) and lesion size on the performance of SWE in differentiating malignant breast lesions. The study included 150 female patients with histopathologically confirmed malignant breast lesions. Minimal (E_min), mean (E_mean), maximal (E_max) elastic modulus and elasticity ratio (e-ratio) values were measured using a circular ROI size of 2, 4 and 6 mm diameters and the lesions were divided into large (diameter ≥ 15 mm) and small (diameter < 15 mm). Highest E_min, E_mean and e-ratio values and lowest variability were observed when using the 2 mm ROI. E_max values did not differ between different ROI sizes. Larger lesions had significantly higher E_mean and E_max values, but there was no difference in e-ratio values between lesions of different sizes. In conclusion, when measuring the E_min, E_mean and e-ratio of malignant breast lesions using SWE the smallest possible ROI size should be used regardless of lesion size. ROI size has no impact on E_max values while lesion size has no impact on e-ratio values.

Background: Frailty strongly influences outcomes after transcatheter aortic valve implantation (TAVI), but conventional risk models insufficiently capture functional and cognitive vulnerability. We compared conventional surgical risk scores with multidimensional frailty assessment and a biological score. Methods: This observational registry included 528 consecutive patients with severe symptomatic aortic stenosis undergoing TAVI between January 2019 and November 2024. Frailty was assessed using the Essential Frailty Toolset (EFT), Katz Index, and cognitive screening, alongside French Aortic National CoreValve and Edwards 2 (FRANCE-2) and Age, Creatinine, and Ejection Fraction (ACEF) scores. HALP was calculated as (haemoglobin × albumin × lymphocytes) ÷ platelets. Primary endpoints were 30-day, 6-month, and 1-year all-cause mortality. Secondary outcomes included non-fatal major adverse cardiovascular events (MACE), complications, and quality-of-life improvement. Results: One-year mortality was 12.7%. EFT and Katz Index showed the strongest discrimination for 1-year mortality (AUC 0.72 and 0.75), outperforming EuroSCORE II and STS-PROM (AUC 0.66 and 0.68). After adjustment, EFT (HR 1.91, 95% CI 1.47–2.48), Katz Index (HR 0.57, 95% CI 0.47–0.70, and cognitive impairment (HR 2.24, 95% CI 1.34–3.75) independently predicted 1-year mortality. HALP was not associated with outcomes. FRANCE-2 independently predicted 1-year MACE (HR 1.24, p = 0.019). Conclusions: Functional frailty and cognitive impairment add prognostic value beyond conventional comparator models, whereas HALP does not. Brief functional and cognitive screening may help Heart Teams identify patients who need closer peri-procedural optimisation, rehabilitation planning, and discharge support rather than relying on surgical risk scores alone.

Aim: Renal artery disease is the most common cause of secondary hypertension worldwide. B-mode and Doppler ultrasound are considered the modalities of choice for the imaging of the renal arteries. However, an adequate examination can be plagued by difficulties in patients with unfavorable anatomy. UltraFast™ ultrasound is faster, performed with higher frame rates, and enables prospective and retrospective data analysis with quantification of flow data in the obtained image, so it may be able to resolve some of the difficulties encountered during conventional ultrasound examinations in patients with suspected renal artery disease. Material and methods: Comparison of the duration of conventional and UltraFast™ Doppler examinations of segmental renal arteries was performed on 52 young, healthy volunteers. Duration times were summarized using the median and interquartile range, and comparisons between the two methods were performed using the Wilcoxon test for paired samples. Results: The duration of UltraFast™ ultrasound examinations was significantly shorter in comparison to conventional ultrasound for both kidneys and in total (p <0.001, median difference in duration 65 s, median 64% shorter duration of analysis), while both conventional and UltraFast™ ultrasound examinations demonstrated consistent velocity measurements with very high correlation (Rho = 0.94, p <0.001). Conclusions: The study provides evidence that UltraFast™ ultrasound is faster than conventional Doppler ultrasonography for the assessment of renal artery disease in healthy adults without a history of renal disease. The findings have important implications for clinical practice, as they suggest that Ultra- Fast™ imaging could offer a more efficient and time-saving approach to vascular imaging in patients with suspected renal artery disease.