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Aims: In a large proportion of heart failure with reduced ejection fraction (HFrEF) patients, echocardiographic estimation of left atrial pressure (LAP) is not possible when the ratio of the peak early left ventricular filling velocity over the late filling velocity (E/A ratio) is not available, which may occur due to several potential causes. Left atrial reservoir strain (LASr) is correlated with LV filling pressures and may serve as an alternative parameter in these patients. The aim of this study was to determine whether LASr can be used to estimate LAP in HFrEF patients in whom E/A ratio is not available. Methods and results: Echocardiograms of chronic HFrEF patients were analysed and LASr was assessed with speckle tracking echocardiography. LAP was estimated using the current ASE/EACVI algorithm. Patients were divided into those in whom LAP could be estimated using this algorithm (LAPe) and into those in whom this was not possible because E/A ratio was not available (LAPne). We assessed the prognostic value of LASr on the primary endpoint (PEP), which comprised the composite of hospitalization for the management of acute or worsened HF, left ventricular assist device implantation, cardiac transplantation, and cardiovascular death, whichever occurred first in time. We studied 153 patients with a mean age of 58 years of whom 76% men and 82% who were in NYHA class I‐II. A total of 86 were in the LAPe group and 67 in the LAPne group. LASr was significantly lower in the LAPne group as compared with the LAPe group (15.8% vs. 23.8%, P < 0.001). PEP‐free survival at a median follow‐up of 2.5 years was 78% in LAPe versus 51% in LAPne patients. An increase in LASr was significantly associated with a reduced risk of the PEP in LAPne patients (adjusted hazard ratio: 0.91 per %, 95% confidence interval 0.84–0.98). An abnormal LASr (<18%) was associated with a five‐fold increase in reaching the PEP. Conclusions: In HFrEF patients in whom echocardiographic estimation of LAP is not possible due to due to unavailability of E/A ratio, assessing LASr potentially carries added clinical and prognostic value. [ABSTRACT FROM AUTHOR]

Objective: Microcirculatory visualization has already been used to investigate buccal and cutaneous microcirculatory alterations in neonates. Still, the reproducibility of these microvascular measurements has never been studied in (premature) neonates. This study aimed to determine the reproducibility of microvascular vessel density in cutaneous and buccal SDF clips in one-day-old term newborns., Methods: Buccal and cutaneous microcirculations were measured using SDF imaging. Vessel density was independently assessed by two investigators. Reproducibility was assessed from the ICC and Bland-Altman analysis., Results: Reproducibility of vessel density assessment in the buccal area was good, with ICCs for total and PVD of 0.93 (0.88-0.97) and 0.93 (95% CI 0.85-0.97), respectively, and a near zero bias and acceptable limits of agreement in the Bland-Altman analysis. Reproducibility of assessment of the cutaneous microcirculation was poor with ICCs for total and PVD of 0.31 (0-0.70) and 0.37 (0-0.74), respectively, and large biases (3.09 and 2.53) in the Bland-Altman analysis., Conclusions: Evaluation of buccal microvascular vessel density in SDF-derived images in term newborns is reproducible in contrary to the cutaneous vessel density., (© 2014 John Wiley & Sons Ltd.)