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Background Impaired right ventricular ( RV ) function indicates RV involvement in patients with hypertrophic cardiomyopathy ( HCM ). We aimed to assess RV function at rest and during exercise in HCM patients and to examine the association between impaired RV mechanics and exercise capacity. Methods and Results A total of 76 HCM patients (48 without and 28 with RV hypertrophy) and 30 age- and sex-matched controls were prospectively recruited. RV function was evaluated at rest and during semisupine bicycle exercise by conventional echocardiography and 2-dimensional speckle-tracking imaging. Exercise capacity was measured by metabolic equivalents. RV functional reserve was calculated as the difference of functional parameters between peak exercise and rest. Compared with controls, HCM patients had significantly higher RV free wall thickness, lower RV global longitudinal strain and RV free wall longitudinal strain at rest and during exercise, and reduced RV systolic functional reserve. Compared with those with HCM without RV hypertrophy, patients with HCM with RV hypertrophy had lower metabolic equivalents. Among HCM patients, an effective correlation was seen between exercise capacity and peak exercise RV global longitudinal strain and peak exercise RV free wall longitudinal strain. A binary logistic regression model revealed several independent predictors of exercise intolerance in HCM patients, but receiver operating characteristic curve analysis indicated exercise RV global longitudinal strain had the highest area under the curve for the prediction of exercise intolerance in HCM patients. Conclusions HCM patients have RV dysfunction and reduced contractile reserve. Exercise RV global longitudinal strain correlates with exercise capacity and can independently predict exercise intolerance. In addition, patients with HCM with RV hypertrophy exhibit more reduced exercise capacity, suggesting more severe disease and poorer prognosis.

Background: Reduced metabolic equivalents (METs) are an indicator of exercise intolerance, which predicts poor prognosis in hypertrophic cardiomyopathy (HCM) patients. We sought to evaluate the changes in left ventricular (LV) mechanics and functional reserves, as well as their association with functional capacity in HCM patients., Methods: Seventy HCM patients and thirty controls were included in this study. LV mechanics were evaluated at rest and during exercise by echocardiography and two-dimensional speckle-tracking imaging to obtain parameters of functional reserve, LV global longitudinal strain (LVGLS), strain rate (SR), and circumferential strain., Results: Hypertrophic cardiomyopathy (HCM) patients had lower LVGLS, systolic SR, early and late diastolic SR at rest and during exercise, and reduced absolute and relative systolic and diastolic reserve compared to controls. LV circumferential strain was significantly higher at rest but lower during exercise in HCM patients. Exercise capacity was markedly reduced in HCM patients, and peak exercise LVGLS (LVGLS-exe) significantly correlated with exercise capacity. Multivariate regression analyses showed that LVGLS-exe, LV filling pressure during exercise (E/e'-exe), and LV mass index (LVMI) were independent predictors of exercise capacity. Moreover, LVGLS-exe displayed incremental predictive value over E/e'-exe and LVMI for exercise intolerance. Receiver operating characteristic curve analysis showed LVGLS-exe had optimal accuracy for predicting exercise intolerance in HCM patients., Conclusions: Hypertrophic cardiomyopathy (HCM) patients have reduced LV mechanics at rest and during exercise and impaired mechanical reserve. LVGLS-exe is associated with exercise capacity and is an optimal predictive value for reduced exercise capacity in HCM patients., (© 2019 Wiley Periodicals, Inc.)

Objective: The objective of this study was to evaluate the feasibility of online real time three-dimensional transesophageal echocardiography (RT3DTEE) in the measurement of left atrial appendage (LAA) orifice size. We also analyzed the correlation between LAA ejection fraction (EF) and its peak empty velocity (PEV)., Methods: There were 91 subjects enrolled in this study, with 46 patients with AF and 45 individuals with sinus rhythm (SR). RT3DTEE was performed by four methods including iSlice and iCrop online and QLAB software 3DQ and GI-3DQ off-line which were used to measure LAA orifice area, long diameter, short diameter, depth in the largest LAA, and number of LAA lobes. These LAA parameters achieved by the four methods were compared, respectively. GI-3DQ off-line was used to measure LAA end-diastolic and end-systolic volumes to calculate EF of LAA. Two-dimensional (2D) TEE was applied to measure PEV of LAA. The correlation between EF and PEV was analyzed., Results: There were no significant differences in all LAA parameters between any two RT3DTEE methods (All P > .05). There was a significant and positive correlation between PEV and EF (r = .423, P = .000). There were statistical differences in LAA EF and PEV between patients with AF and SR individuals (0.38 ± 0.12 vs 0.61 ± 0.07, 35.7 ± 12.1 vs 49.5 ± 10.0 cm/s, P = .000)., Conclusion: Using online RT3DTEE for measuring LAA orifice size is feasible, and online RT3DTEE is more convenient than offline RT3DTEE. EF is positively correlated with PEV. LAA function is significantly decreased in patients with AF., (© 2018 Wiley Periodicals, Inc.)

The title compound, [Zn(SO(4))(C(12)H(10)N(2))](n), features a layered structure based on [Zn(SO(4))](n) spirals linked by 1,2-di-4-pyridylethylene (bpe) ligands, with the tetrahedral Zn and S atoms lying on twofold axes. The bpe ligands are centrosymmetric. The layers are linked by weak C-H...O interactions.

The crystal structure of the title compound, [Zn(C(5)H(5)NS)(4)](NO(3))(2), consists of a [Zn(C(5)H(5)NS)(4)](2+) (C(5)H(5)NS is pyridinium-2-thiolate) cation and two nitrate anions. The central Zn(II) atom lies at a site with imposed -4 symmetry and is surrounded by four S atoms [Zn-S = 2.3371 (5) A] from four symmetrical pyridinium-2-thiolate ligands in a distorted tetrahedral geometry. There are N-H.O hydrogen-bonding interactions between the pyridinium-2-thiolate ligands and nitrate O atoms. In addition, pi-pi interactions via aromatic N-containing ligands are discussed.

The title compound, [Ag(2)(NO(3))(2)(C(5)H(5)NS)](n), was obtained from the reaction of silver nitrate with bis(4-pyridyl) disufide (4-PDS) in a mixture of ethanol and water, which suggests that the disulfide bond of 4-PDS can be cleaved under mild conditions. The structure of the title compound is a two-dimensional infinite array in which the asymmetric unit contains two Ag atoms, a pyridinium-4-thiolate molecule and two nitrate groups. Each pyridinium-4-thiolate molecule acts as a mu(4) bridge, linking four Ag atoms, with Ag-S bond distances of 2.4870 (19), 2.5791 (19), 2.5992 (19) and 2.848 (2) A. The Ag.Ag distances lie in the range 2.889 (2)-3.049 (1) A.

The title compound, [ZnCl(2)(bpp)](n) (where bpp is 1,3-di-4-pyridylpropane, C(13)H(14)N(2)), has been prepared by the hydrothermal reaction of ZnCl(2) and bpp at 433 K. The Zn, Cl and central propyl C atom lie on the mirrors of the P2(1)/m space group. The molecular structure shows a weave-like polymeric chain. Each Zn atom is coordinated by two N atoms and two Cl atoms in a distorted tetrahedral geometry, with the Zn-N distance being 2.055 (5) A and the Zn-Cl distances being 2.239 (3) and 2.247 (2) A.