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Purpose: Left atrial (LA) phasic functions in various subgroups of subjects with obesity are differently impaired, suggesting that obesity may have diverse effects in dissimilar subgroups of subjects with obesity. We aimed to compare the effects of obesity on LA phasic functions in patients suffering from chronic ischemic heart disease with a preserved left ventricular ejection fraction and without a recent myocardial infarction. Methods: In our cross-sectional study, 145 consecutive candidates for isolated coronary artery bypass graft (CABG) surgery were divided according to the presence of obesity into 2 groups: obese (36 patients) and nonobese (103 patients), and LA phasic functions were evaluated by two-dimensional speckle-tracking echocardiography (2D STE). Results: The longitudinal strain rate during the reservoir phase (3.0 ± 0.7 s−1 vs 2.7 ± 0.6 s−1; P = 0.032), longitudinal strain during the contraction phase (19.2 ± 4.7% vs 17.2 ± 4.1%; P = 0.022), and the longitudinal strain rate during the contraction phase (4.4 ± 1.2 s−1 vs 3.9 ± 1.2 s−1; P = 0.036) decreased in the obese group compared with the nonobese group. The other longitudinal 2D STE-derived markers of the LA phasic functions were not different between the 2 groups. Conclusions: Among patients suffering from chronic ischemic heart disease with a preserved left ventricular ejection fraction and without a recent myocardial infarction, LA reservoir and contraction functions as measured by 2D STE were impaired in patients with obesity compared with those without it. [ABSTRACT FROM AUTHOR]

Purpose: Previous studies have indicated that right ventricular (RV) function is damaged in diabetes mellitus (DM); however, it is not clear whether in the presence of chronic ischemia, RV function is different between patients with and without DM (DM + and DM − , respectively). Methods: This cross-sectional study enrolled 90 consecutive candidates for coronary artery bypass graft surgery and allocated them to 3 groups: 24 DM − patients with the absence of stenosis of more than 50% in the proximal and mid parts of the right coronary artery (the DM − RCA − group [control]), 33 DM − patients with the presence of significant stenosis (> 70%) in the proximal part of RCA (the DM − RCA + group), and 33 DM + patients with RCA + (the DM + RCA + group). RV function was evaluated based on longitudinal deformation markers, measured via the 2D speckle-tracking echocardiographic examination of right ventricular free wall (RVFW). Results: The systolic strain value, systolic strain rate, and late diastolic strain rate of RVFW were not statistically significantly different between the three groups. Our adjusted post hoc analysis showed that the early diastolic strain rate of RVFW in the DM + RCA + group was lower than that in the DM − RCA + and DM − RCA − groups (1.5 s−1 ± 0.4 vs 1.7 s−1 ± 0.5 vs 1.7 s−1 ± 0.4). Conclusions: Diastolic function in the presence of DM was impaired irrespective of RCA − or RCA +. Additionally, RCA + had no effect on systolic and diastolic RV functions at rest in our DM − patients. [ABSTRACT FROM AUTHOR]

A coronary artery aneurysm is defined as the dilation of a coronary artery segment that is 1.5-fold the diameter of the neighboring normal segments. A patient with a history of aortic valve replacement and coronary artery bypass graft surgery, transthoracic echocardiography revealed a large mass with an echolucent center in the left atrioventricular groove. Transesophageal echocardiography showed that the left atrial appendage was free of thrombosis, and there was a mass with an echolucent center beneath the left atrial appendage, suggestive of aneurysmal dilation in the left circumflex artery with thrombosis formation Coronary artery computed tomography angiography confirmed this finding. In patients with or without a history of coronary aneurysms, the presence of a mass in the atrioventricular groove on echocardiography should alert clinicians about the presence of a coronary artery aneurysm with thrombosis formation as a probable etiology. [ABSTRACT FROM AUTHOR]

A right atrial (RA) mass was incidentally found by transthoracic echocardiography in a 79-year-old man with atrial fibrillation rhythms but without a history of anticoagulation. Transesophageal echocardiography revealed a pedunculated immobile mass in the RA appendage. In addition, some calcification was detected in computed tomography. The mass was excised, and pathological examinations revealed organized thrombosis. Accordingly, in the presence of predisposing factors, thrombi, which may mimic some imaging features of tumors, should be considered in the differential diagnosis of RA masses. [ABSTRACT FROM AUTHOR]

Background: The coronary slow flow phenomenon (CSFP) is the slow passage of the angiographic contrast agent to the distal portion of the coronary artery in the absence of significant stenosis. We evaluated the left atrial (LA) function in patients with the CSFP using two-dimensional speckle-tracking echocardiography (2DSTE). Methods: The LA function was compared through 2DSTE between 36 patients with the CSFP and 36 participants with a normal coronary flow. The two groups were matched for age, sex, hypertension, diabetes mellitus, and the left ventricular function. Results: There were no statistically significant differences between the CSFP group and the control group regarding longitudinal systolic strain, early and late diastolic strains, and the strain rate of the LA myocardium. Conclusions: The LA function as evaluated with 2DSTE was not different between the CSFP group and the normal coronary flow group when they were matched for age, sex, hypertension, diabetes, and the left ventricular function. [ABSTRACT FROM AUTHOR]

A round, well-defined mass was incidentally detected at follow-up transthoracic echocardiography in an asymptomatic 36-year-old man with a history of Bentall operation 8 months earlier. Computed tomography angiography of the aorta demonstrated a mediastinal hematoma below the pulmonary artery in the mid-mediastinum. Although mediastinal hematomas are hard to detect after cardiac surgery via transthoracic echocardiography, the probable presence of this complication should be kept in mind during echocardiography. [ABSTRACT FROM AUTHOR]

Myocardial noncompaction (NC) is a disorder of the embryonic endomyocardial morphogenesis frequently associated with congenital cardiac abnormalities. NC predominantly affects the left ventricle (LV). Right ventricle (RV) NC may occur in association with LV involvement or in isolation. A 47-year-old woman was admitted for atrial septal defect closure. Transthoracic echocardiography revealed hypertrabeculation of the RV apex, consisting of multiple deep recesses with the entrance of blood flow in color Doppler imaging, suggestive of isolated RV hypertrabeculation/NC. The RV and right atrium (RA) were enlarged, and systolic pulmonary arterial pressure was slightly increased. Our patient’s associated abnormalities were atrial septal defect (superior sinus venosus type), anomalous connection of the right upper pulmonary vein to the junction of the superior vena cava and the RA, and large patent foramen ovale. Association between atrial septal defect and partial anomalous pulmonary vein connection and isolated hypertrabeculated/noncompacted RV should be considered by cardiologists. [ABSTRACT FROM AUTHOR]