{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T06:12:03Z","timestamp":1793945523680,"version":"4.8.0"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,9,15]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Current risk stratification for veno\u2010arterial extracorporeal membrane oxygenation relies on static assessments, ignoring dynamic cardiac evolution. We aimed to identify longitudinal echocardiographic trajectory phenotypes and evaluate their association with in\u2010hospital mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We analyzed 2034 adults receiving veno\u2010arterial extracorporeal membrane oxygenation for cardiogenic shock from a multicenter registry. Latent class mixed models and probabilistic template\u2010matching were applied to serial echocardiographic data (left ventricular ejection fraction, end\u2010diastolic diameter, right ventricular parameters) to identify trajectory phenotypes. Associations with mortality were evaluated using multivariable Cox and Fine\u2010Gray competing risk models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Four dynamic phenotypes were identified: Dyn\u2010A (\u201cRefractory Stagnation,\u201d 17.0%), featuring persistent systolic suppression and progressive dilation; Dyn\u2010B (\u201cIsolated LV Recovery,\u201d 14.9%); Dyn\u2010C (\u201cBiventricular Failure,\u201d 6.1%); and Dyn\u2010D (\u201cGradual Recovery,\u201d 61.9%). Static baseline phenotyping failed to stratify survival. Conversely, dynamic phenotypes were independently associated with mortality. The high\u2010risk Dyn\u2010A phenotype exhibited significantly higher mortality compared with the Dyn\u2010B profile (adjusted hazard ratio 1.71, 95% CI 1.35\u20132.16), remaining significant after adjusting for baseline illness severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Dynamic echocardiographic trajectories identify distinct phenotypes reflecting divergent cardiac responses to veno\u2010arterial extracorporeal membrane oxygenation, ranging from recovery to progressive maladaptation. Longitudinal monitoring provides essential prognostic utility beyond static admission assessments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.126.049942","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T14:49:53Z","timestamp":1788965393000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Dynamic Echocardiographic Trajectory Phenotypes During Veno\u2010Arterial Extracorporeal Membrane Oxygenation and Their Association With In\u2010Hospital Mortality: A Multicenter Cohort Study"],"prefix":"10.1161","volume":"15","author":[{"given":"Zhe","family":"Li","sequence":"first","affiliation":[{"name":"The People's Hospital of Guangxi Zhuang Autonomous Region, Research Center of Cardiovascular Disease, Guangxi Academy of Medical Sciences","place":["Nanning, 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