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Predicting left ventricular (LV) recovery after acute ST-elevation myocardial infarction (STEMI) is challenging and of prognostic importance. To evaluate the usefulness of non-invasive myocardial work (MW), a new index of global and regional myocardial performance, to predict LV recovery and in-hospital complications after STEMI. In total, 93 consecutive patients with anterior STEMI (mean age, 59 ± 12 years) treated by primary percutaneous intervention (PCI) underwent transthoracic echocardiography (TTE) within 24–48 hours after angioplasty and a median of 92 days at follow-up. MW is derived from the non-invasive strain-pressure loop obtained from the 2D strain data, integrating in its calculation the non-invasive brachial arterial pressure. Segmental LV recovery was defined as a normalization of segmental wall motion abnormalities of the affected segments and global recovery as an absolute improvement of left ventricular ejection fraction (LVEF) greater than 5% in patients with baseline LVEF < 50%. In-hospital complications were defined as a composite of death, reinfarction, heart failure, and LV apical thrombus. In total, 1642 segments were studied and MW was impaired in infarct segments, more severely in no recovering versus recovering segments (MW index, constructive MW, MW efficiency, all, P < 0.01). Furthermore, global MW was significantly correlated to acute and follow-up LVEF and global longitudinal strain (GLS) (all, P < 0.01). Constructive MW was the best index to predict segmental (P < 0.01 versus MW index, MW efficiency, and wasted work), and global recovery (P < 0.05 versus GLS) with an independent association (all, P < 0.01). Moreover, global constructive MW was independently associated to in-hospital complications, which occurred in 18 patients (P < 0.01). In patients with anterior STEMI treated by PCI, acute constructive MW is an independent predictor of segmental and global LV recovery, as well as in-hospital complications. [ABSTRACT FROM AUTHOR]

Background Left atrial (LA) function is increasingly used to assess cardiovascular diseases. Objective We tested the relationship between LA distensibility (Lad), LA strain (Las) and left ventricular dysfunction and prognosis in aortic stenosis (AS). Methods Transthoracic Doppler echocardiography was performed prospectively in 98 consecutive patients with AS (63 with severe, 35 with moderate AS, mean age 77 ± 10 years, 49% women, mean aortic valve area 0.5 ± 0.15 cm 2 , mean LVEF 63 ± 13%). LA volume was calculated by the area-length method in apical four-and two-chamber views, at two points: immediately before mitral valve opening (Vol max) and at mitral valve closure (Vol min). LA distensibility was defined as (Vol max − Vol min) × 100%/Vol min. Las (mean of maximal strain from the 4-2-3 chamber views) was conducted using a dedicated software package, using R-R gating. The end-point was hospitalisation for heart failure and death from any cause. Results Las, Lad, and LA vol/m 2 were significantly correlated to E/A, E/e’, and pulmonary artery systolic pressure (all, P < 0.05). However, Lad and Las but not LA vol/m 2 were significantly correlated to comorbidities index (Charlson, Euroscore), LVEF, stroke volume/m 2 , as well as to peak aortic jet velocity (all, P < 0.05). At a median follow-up of 25 months, 48 patients had an event. Las, Lad, LA volume/m 2 , as well as Charlson index, diabetes, and DTI parameters were associated to events (all, P < 0.05). In multivariate analysis, Lad, Las, (all, P < 0.01) and Charlson index ( P < 0.05) remained independently associated to events. Using a ROC curve analysis, a LAd < 70% (AUC = 0. 76 ± 0.05, P < 0.001), and Las < 17% (AUC = 0.73 ± 0.05) were the best cut-off to predict an event at follow-up. Conclusion In patients with moderate to severe AS, Lad and LAs are associated with LV diastolic and systolic dysfunction, AS severity, and are independently linked to events. [ABSTRACT FROM AUTHOR]