Right ventricular (RV) function has important prognostic value in a variety of cardiovascular diseases. Due to complex anatomy and mode of contractility, conventional two-dimensional echocardiography does not provide sufficient and accurate RV function assessment. Currently, three-dimensional echocardiography (3DE) allows for an excellent and reproducible assessment of RV function owing to overcoming these limitations of traditional echocardiography. This review focused on 3DE and discussed the following points: (i) acquisition of RV dataset for 3DE images, (ii) reliability, feasibility, and reproducibility of RV volumes and function measured by 3DE with different modalities, (iii) the clinical application of 3DE for RV function quantification.

We sought to identify preoperative cardiac abnormalities with routine preoperative transthoracic echocardiography (TTE) associated with postoperative mortality in elderly patients undergoing hip fractures surgery, in order to provide reference for focused TTE. In this retrospective study, a total of 669 elderly patients (age over 65 years) undergoing hip fractures surgery were included, of which 58 (8.7%) died within one-year after discharge. Cox regression analysis models were used to identify the prognostic cardiac abnormalities of postoperative mortality. Univariate analysis showed that age (HR 1.065, 95%CI 1.030-1.101; P<0.001), ASA score (III, IV vs. I, II) (HR 1.855, 95%CI 1.098-3.067; P=0.022), history of chronic obstructive pulmonary disease (COPD) (HR 4.446, 95%CI 1.909-10.355; P=0.001) and atrial fibrillation (AF) (HR 3.803, 95%CI 1.803-8.024; P<0.001), presence of left ventricular ejection fraction (LVEF)<50% (HR 5.009, 95%CI 2.151-11.665; P25mmHg (HR 4.388, 95%CI 2.492-7.725; P<0.001), moderate-severe aortic valve stenosis (AS) (HR 4.702, 95%CI 1.471-15.035; P=0.009) were the dominant predictors of mortality within one-year. The presence of LVEF<50%, left ventricular dilatation and elevated PASP were proved to be the independent predictors of one-year mortality in elderly patients in multivariate analysis. Cardiac abnormalities derived from preoperative TTE, namely LVEF<50%, AS, left ventricular dilatation and elevated PASP had prognostic value for elderly patients undergoing hip fracture surgery. We consider that these indices would be clinically important regarding the preoperative cardiac risk assessment of elderly hip fracture, which may be assessed in the focused TTE.

Mitral annular calcification (MAC) has been associated with coronary artery disease in population-based studies, but its relationship with preoperative cor

Background: Ultrasound-based risk models provide a valuable tool to support non-expert clinicians in evaluating adnexal masses, potentially reducing unnecessary surgeries for benign conditions. However, their implementation in clinical practice across China remains suboptimal, and direct comparisons of their diagnostic accuracy within this specific population are still needed. Objective: To evaluate and compare the diagnostic performance of three ultrasonography-based risk models—the International Ovarian Tumor Analysis (IOTA) Simple Rules (with expert adjudication for inconclusive cases), the IOTA Assessment of Different Neoplasias in the Adnexa (ADNEX) model, and the Ovarian-Adnexal Reporting and Data System (O-RADS)—for distinguishing benign from malignant adnexal lesions in a Chinese cohort. Methods: This retrospective diagnostic study was conducted at a single Chinese academic medical center and included consecutive patients aged 18 to 89 years with adnexal masses that were managed surgically between January 2023 and December 2024. Each adnexal lesion was systematically evaluated using the IOTA Simple Rules, ADNEX model, and O-RADS classification. The diagnostic performance of these models was quantified by the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, positive and negative predictive values, and likelihood ratios, using surgical pathology as the reference standard. A secondary analysis evaluated the models’ performance stratified by menopausal status. An additional analysis was to evaluate the supplementary value of tumor markers for the O-RADS model. Results: A total of 459 female patients with a 15.5% malignant tumor prevalence were included. Mean age was 43.0 (15.2) years overall, with 40.7 (14.4) in benign and 55.3 (13.3) in malignant cases. Overall, 121 (26.4%) patients were postmenopausal. The AUCs for discriminative performance of the ADNEX and O-RADS models were 0.95 (95%CI, 0.93-0.97) and 0.96 (95%CI, 0.94-0.97), respectively. After converting the ADNEX continuous individualized risk into the discrete ordinal categories of O-RADS, the ADNEX performance was reduced to an AUC of 0.92 (95%CI, 0.90-0.95). The AUC of the Simple Rules was 0.95 (95%CI, 0.93-0.97) and yielded a sensitivity of 95.8% (95%CI, 88.1%-99.1%), specificity of 94.3% (95%CI, 91.5%-96.4%). For a binary comparison of all models (benign vs malignant), a uniform 10% risk threshold (O-RADS score of 4-5) was used. The sensitivity and NPV of all models were above 91% and 98%, respectively. The O-RADS model exhibited the highest sensitivity (97.2%; 95%CI, 90.2%-99.7%), whereas the Simple Rules model demonstrated superior specificity 94.3% (95%CI, 91.5%-96.4%) and the highest PPV (75.6%; 95%CI, 65.4%-84.0%). The sensitivities were higher for menopausal groups, while the specificities were higher for premenopausal patients for the ADNEX and O-RADS model. The addition of tumor markers did not improve the diagnostic sensitivity or specificity of the O-RADS model. Conclusion: In this diagnostic study of a Chinese cohort, the Simple Rules, ADNEX, and O-RADS models demonstrated effective performance in distinguishing benign from malignant adnexal lesions, consistent with previous reports from European and American populations. The use of such risk-stratification models can enhance the accuracy and reproducibility of adnexal mass assessment, particularly for non-specialist clinicians, and may support clinical decision-making and potentially reduce avoidable surgical interventions.