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Prediabetes is a dysglycemic state that affects many around the world and is a known risk factor for the occurrence of type 2 diabetes mellitus in the future, accompanied by vascular complications. Evidence abounds regarding myocardial involvement in prediabetes. We herein review studies having applied tissue Doppler imaging or speckle‐tracking echocardiography to evaluate myocardial function in subjects with prediabetes to depict a picture of cardiac mechanics in individuals with prediabetes in comparison with patients suffering from diabetes mellitus and individuals in the normoglycemic state. Finally, we present the detrimental effects of prediabetes on cardiac mechanics. [ABSTRACT FROM AUTHOR]

Background: The right heart thrombus (RHT) embolizes from deep venous thrombi and sits in the right atrium or the right ventricle. We aimed to determine the occurrence and prognosis of the RHT in patients with pulmonary embolism. Methods: We reviewed the cohort data of622 patients with acute pulmonary embolism obtained from the registry of Tehran Heart Center. Demographic, physiological, clinical, and echocardiography data, as well as clinical outcomes, were compared between patients with and without the RHT. Results: The study population comprised 622 patients, including 329 men (52.8%). The mean age of the patients was 60.2±'7.0 years. Thirty patients (4.8%) had echocardiographically proven RHT. Baseline demographic and clinical characteristics were not different between the 2 groups. Right ventricular dysfunction was more prevalent in the RHT (+) group, and more patients in this group were treated with thrombolysis (P=0.0'3 and P<0.00', respectively). Overall, 3 out of 2' patients ('4.2%) in the RHT (+) group vs 29 out of306patients (9.4%) in the RHT (-) group died at 1 month (P=0.445) and 5 out of 21 patients (23.8%) in the RHT (+) group vs 56 out of307patients (18.2%) in the RHT (-) group died at 1 year (P=0.562). Conclusion: The RHT is an influential complication in patients with pulmonary emboli, and it seems to increase the mortality rate of patients with acute pulmonary embolism. [ABSTRACT FROM AUTHOR]

Objectives: Vitamin D deficiency with its high global prevalence is associated with some pathological changes in the myocardium. The aim of our study was to assess the longitudinal deformation of the left ventricular (LV) myocardium in subjects with vitamin D deficiency. Methods: This cross‐sectional study recruited 98 consecutive nondiabetic subjects (45 subjects with vitamin D deficiency and 53 subjects without vitamin D deficiency) without significant epicardial coronary artery stenosis. The longitudinal subendocardial deformation indices of the LV myocardium were evaluated with 2D speckle‐tracking echocardiography. Results: The end‐systolic strain, the systolic strain rate, and the early and late diastolic strain rates were not statistically significantly different between the subjects with and without vitamin D deficiency. Conclusions: The global longitudinal subendocardial deformations of the LV, including the systolic strain rate and the systolic and diastolic strain rates, as evaluated with 2D speckle‐tracking echocardiography were not statistically significantly correlated with the presence or absence of vitamin D deficiency. [ABSTRACT FROM AUTHOR]

Aim: We intended to assess the left atrial deformation parameters, using two‐dimensional speckle tracking (2DSTE) and transesophageal echocardiography (TEE), and determine the correlation between these two techniques in order to recognize the patients at risk for cardioembolic events. Method: Strain and strain rate were measured using 2DSTE among 26 patients in sinus rhythm, with isolated moderate to severe mitral stenosis. Left atrial (LA) volume parameters (maximum, minimum and preatrial contraction) were measured. Among 26 patients, TEE was performed to detect left atrial thrombosis or spontaneous echo contrast. Left atrial appendage velocity (LAAV) was also assessed. Results: A significant correlation was observed between LAAV and the average value of left atrial peak systolic strain (LA‐RES) (r = 0.638, P = 0.001). The sensitivity and specificity of mean LA‐RES (cutoff = 16.75%) for detecting LAAV < 25 cm/s were 88.9% and 80%, respectively. The sensitivity and specificity of mean LA‐RES (cutoff = 18.14%) for detecting LAAV < 25 cm/s and/or dense smoky pattern were 77.8% and 83.3%, respectively, and those of left atrial maximum volume indexed for body surface area(cutoff = 50.75 cc/m2), for discriminating LAAV < 25 cm/s and/or dense smoky pattern, were 73.3% and 83.3%, respectively. A meaningful correlation was witnessed between mean LA‐RES and left atrial ejection fraction (r = 0.736, P < 0.001), and left atrial expansion index (r = 0.743, P < 0.001). Conclusion: The average value of left atrial reservoir function using 2DSTE can be used as a predictive factor for detecting LAAV < 25 cm/s and/or dense SEC and thus recognizing high‐risk patients for cardioembolic events with moderate to severe mitral stenosis. In addition, assessment of LA function and LA volume can also be helpful. [ABSTRACT FROM AUTHOR]

Objectives Coronary artery ectasia ( CAE) is defined as the dilation of at least one segment of the coronary arteries that reaches at least 1.5 times the size of a normal neighboring segment. It has been shown that left ventricular ( LV) diastolic function is impaired in patients with CAE. Also, it has been shown that LV function is impaired in vitamin D-deficient subjects compared with vitamin D-sufficient subjects and vitamin D deficiency is prevalent in CAE patients. We hypothesized that LV function is impaired in patients with CAE so we evaluated longitudinal LV myocardial function by 2D speckle tracking echocardiography (2 DSTE) in patients with CAE and vitamin D deficiency without significant coronary artery stenosis and compared the results with those of subjects with vitamin D deficiency and near-normal coronary arteries. Methods Our study population comprised 21 consecutive patients with CAE and without significant coronary artery stenosis (<50%) and 31 control subjects with near-normal coronary arteries. All subjects had vitamin D deficiency. Results All 2 DSTE-derived indices of longitudinal LV function, comprised of the absolute values of systolic strain (14.0±2.7% vs 15.4±2.3%, P=.039), systolic strain rate (1.2±0.2/s vs 1.3±0.2/s, P=.015), early diastolic strain rate (1.1±0.3/s vs 1.3±0.3 s−1, P=.030), and late diastolic strain rate (0.8±0.2/s vs 1±0.2/s, P=.005), were reduced in the patients with CAE and vitamin D deficiency. Conclusions The systolic and diastolic functions of the LV in the patients with CAE and vitamin D deficiency were impaired as evaluated by 2 DSTE. [ABSTRACT FROM AUTHOR]

A ruptured sinus of Valsalva aneurysm rarely accompanies the aortic and tricuspid valve endocarditis. A 36-year-old woman presented with low-threshold dyspnea on exertion and fever. Transthoracic and transesophageal echocardiography showed a ruptured noncoronary sinus of Valsalva aneurysm with large vegetations on the tricuspid and aortic valves, resulting in moderately severe tricuspid regurgitation and severe aortic regurgitation. Blood culture was negative. The patient was initially treated with antibiotics and then subjected to the surgical repair of the sinus of Valsalva aneurysm and the tricuspid and aortic valve replacement. The patient's postoperative period was uneventful, and she was discharged healthy. [ABSTRACT FROM AUTHOR]

Purpose: We compared left atrial function as assessed by two-dimensional speckle-tracking echocardiography (2DSTE) between patients with type 2 diabetes and coronary artery disease (CAD) with or without albuminuria, nondiabetic patients without CAD, and CAD patients without type 2 diabetes.Methods: This cross-sectional study was performed on 112 consecutive patients with CAD (28 nonalbuminuric patients without diabetes, 40 nonalbuminuric patients with type 2 diabetes, and 44 albuminuric patients with type 2 diabetes) and 30 consecutive patients with no CAD, no diabetes, and no albuminuria. Spot urine analysis was performed to measure the urine level of creatinine and albumin. Atrial mechanical variables were measured by 2DSTE.Results: Although systolic strain and the absolute value of early diastolic strain rate were lower in the CAD groups than in the non-CAD group, there were no significant differences between the CAD groups. Early diastolic strain was lower in the diabetic patients with CAD than in the nondiabetic non-CAD group. There were, however, no significant differences between the CAD groups.Conclusions: In our CAD patients, there was no significant association between the presence of type 2 diabetes mellitus and albuminuria and left atrial function, but the reservoir and conduit function of the left atrium were lower in the CAD patients. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:561-570, 2016. [ABSTRACT FROM AUTHOR]

Pre-diabetes is a common condition associated with cardiovascular changes. The aim of our study was to evaluate the right ventricular (RV) function as assessed by 2-D speckle tracking echocardiography in pre-diabetic patients. This study recruited 94 patients (33 normal patients, 31 pre-diabetic patients and 30 diabetic patients). The absolute amount of the global peak systolic strain, the systolic strain rate and the early diastolic strain rate of the RV free wall (RVFW) was higher in the control group than in the pre-diabetic and diabetic groups. These indices were not different between the pre-diabetic and diabetic groups. The global late diastolic strain rate of RVFW was the same between the three groups. Also, pre-diabetes and diabetes were the independent predictors of the RVFW global peak systolic strain, systolic strain rate and diastolic strain rate. Our study demonstrated that the RV systolic and diastolic functions were impaired in the pre-diabetic and diabetic patients without obstructive coronary artery disease. Also, pre-diabetes and diabetes were independent predictors of systolic and diastolic functions of the RV. [ABSTRACT FROM AUTHOR]