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Atherosclerotic lesions in the great arteries are frequent findings in the elderly. Numerous studies have shown their strong predictive value for cardiovascular disease, embolic events, and mortality. We sought to determine the risk of all-cause mortality depending on the localization of plaques in the thoracic aorta evaluated by transesophageal echocardiography (TEE). A total of 2,054 patients (median age 65 years, interquartile range 52–73; 58% men) who underwent a TEE examination between 01/2007 and 03/2015 were retrospectively analyzed. For each patient, the presence of atherosclerotic lesions in the ascending aorta, the aortic arch, and in the descending aorta, as well as cardiovascular risk factors and survival were documented. Median follow-up period was 48 months (interquartile range 38–58). Multivariate Cox regression analysis indicated plaque in the ascending aorta (HR of 1.36, 95% CI 1.01–1.83, P = 0.046), the aortic arch (HR of 1.78, 95% CI 1.29–2.45, P

Echocardiographic assessment of diastolic dysfunction depends on surrogate parameters. In recent years, guideline committees attempted to combine these parameters to diagnostic flowcharts allowing for correct classification of left ventricular filling pressures (LVFP). The value of these diagnostic tools is limited if the applied surrogate parameters are elevated due to other reasons as is the case with maximal tricuspid regurgitation velocity. We aimed to compare the accuracy of the 2009 and the 2016 guideline recommendations in patients with pulmonary hypertension (PH). We included 101 consecutive patients who underwent right heart catheterization and transthoracic echocardiography for suspicion of PH. For the final analysis, only patients with PH were considered. The 2009 and 2016 recommendations for the assessment of diastolic function by echocardiography were applied on each patient. A total of 63 PH patients were included in the final analysis, 43% had elevated LVFP. By using the 2009 recommendations, sensitivity for correct classification of diastolic dysfunction was 67%, specificity was 82%, area under the curve (AUC) was 0.74. By using the 2016 recommendations, sensitivity for correct classification of diastolic dysfunction was 84%, specificity was 80%, AUC was 0.82. In ROC comparison, the AUC for the 2016 recommendations with 0.82 was significantly better compared to the AUC of 0.74 for the 2009 recommendations (p = 0.04). Our study demonstrates that the 2016 recommendations for echocardiographic evaluation of diastolic function are superior to the 2009 recommendations in estimating left ventricular filling pressures in patients with PH. Electronic supplementary material The online version of this article (10.1007/s10554-019-01528-6) contains supplementary material, which is available to authorized users.