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Purpose: Two-dimensional speckle tracking echocardiography is a novel ultrasound technique, which can detect early subclinical myocardial dysfunction with high sensitivity. The purpose of this study was to explore the value of speckle tracking echocardiography in the evaluation of subclinical myocardial injury in patients with Cushing's syndrome. Methods: 35 patients with Cushing's syndrome and 29 healthy controls matched for age, sex, BMI, and systolic blood pressure were included in the study. All subjects were assessed using both conventional Doppler echocardiography and speckle tracking echocardiography. Among patients, they were further divided into inactive group (n = 7) and active group (n = 28) based on cortisol levels. Trend analysis was used among patients in different disease activity. Correlation analysis and linear regression analysis were used to explore influence factors related to subclinical myocardial dysfunction. Results: Left ventricular ejection fraction value showed no statistical difference between patients Cushing's syndrome and control group. However, GLS and LVSD, show significant differences in Cushing's syndrome group. Also, among active Cushing's syndrome group, inactive Cushing's syndrome group and control group, GLS (−15.4 ± 3.0 vs −18.1 ± 3.1 vs-19.4 ± 2.4, P < 0001) and LVSD (48.9 ± 21.5 vs 43.5 ± 17.9 vs 28.5 ± 8.3, P < 0001) changed significantly with the disease activity status. In addition, GLS and LVSD were both linearly corrected with 24-hour urinary cortisol level. Conclusion: GLS and LVSD are sensitive parameters in detecting and monitoring subclinical myocardial systolic dysfunction in patients with Cushing's syndrome. Myocardial injury is linearly correlated with cortisol level, which can be partially reversed after the biochemical control of cortisol. [ABSTRACT FROM AUTHOR]

Background: Graft choices other than left anterior descending artery (LAD)–internal thoracic artery (ITA) anastomosis in coronary artery bypass grafting (CABG) surgery are still controversial. Although 2-dimensional transthoracic echocardiography (2D TTE) is still the most commonly used method, more is needed to diagnose myocardial dysfunction. Ventricular strain values obtained by speckle tracking echocardiography (STE) or tissue Doppler imaging (TDI) methods can much better detect subclinical changes. This study aims to detect early postoperative myocardial function changes compared to single ITA/Bilateral Internal Thoracic Artery (BITA) use by measuring 3-dimensional ejection fraction (3D EF) and ventricular strain values and comparing them according to graft preference. Methods: The study included 35 isolated CABG patients. All patients underwent on-pump CABG via sternotomy. The patients were divided into two groups using single ITA and BITA. Preoperative and postoperative 1st-week 3D EF and ventricular strain values of the patients were calculated using semi-automatic software. The recorded data were compared and evaluated between the two groups. Results: Of The 35 patients participating in the study, 74.3% (n = 26) were male, 25.7% (n = 9) were female, and their average age was 62.7 ± 7.9 years. Preoperative 3D EF values of the patients were 54.4 ± 8.3% and postoperative 49.5 ± 8.2%. The mean preoperative Apical Long Axis Longitudinal Strain (APLAX LS) was calculated as − 16.2 ± 5.0%, 4 Chambers Longitudinal Strain (4CH LS)–16.8 ± 4.6%, 2 Chambers Longitudinal Strain (2CH LS) − 17.0 ± 4.9%, and Global Longitudinal Ventricular Strain (GLVS) − 16.7 ± 4.2%. Postoperative strain values were measured as − 15.1 ± 4.8%, − 14.7 ± 4.9%, − 14.6 ± 5.6% and − 14.8 ± 4.6%, respectively. When the groups were evaluated within themselves, the mean preoperative 3D EF of the patients in the single ITA group was 52.5 ± 8.8%, while the postoperative mean was 47.7 ± 6.0%. In the BITA group, preoperative 3D EF was 56.3 ± 7.5 and postoperative 51.4 ± 9.8. A decrease in strain values was detected in all groups except APLAX planes. Conclusions: In our study, no statistically significant difference was observed in terms of myocardial function changes according to the use of ITA/BITA. However, the decline in postoperative strain values of patients in the BITA group was more remarkable, and it was thought that this may be due to prolonged aortic cross clamp (CC) and cardiopulmonary bypass (CPB) times. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion Coronavirus disease 2019 (COVID‐19) was declared a global pandemic in 2019. It remains uncertain to what extent COVID‐19 effects the heart in heathy individuals. To evaluate the effect of the COVID‐19 on cardiac structure and function in middle‐aged and older individuals.A single‐centre prospective observational study enroled a total of 124 participants (84 with history of COVID‐19 [COVID‐19 group] and 40 without a history of COVID‐19 [non‐COVID group]). All participants underwent echocardiography with speckle tracking to assess cardiac structure and function at rest and during peak exercise.There were no differences in left and right ventricular diastolic function (p ≥ 0.05) between the COVID‐19 and non‐COVID‐19 groups. Participants in COVID‐19 group demonstrated higher left ventricular mass (130 ± 39.8 vs. 113 ± 27.2 g, p = 0.008) and relative wall thickness (0.38 ± 0.07 vs. 0.36 ± 0.13, p = 0.049). Left ventricular global longitudinal strain was reduced in the COVID‐19 group at rest and at peak‐exercise (rest: 18.3 ± 2.01 vs. 19.3 ± 1.53%, p = 0.004; peak exercise: 19.1 ± 2.20 vs. 21.0 ± 1.58%, p ≤ 0.001). However, no difference was seen in resting left ventricular ejection fraction (58 ± 2.89 vs. 59 ± 2.51%, p = 0.565) between groups. Right ventricular fractional area change was reduced in the COVID‐19 group (p = 0.012).Cardiac structural and functional remodelling was observed in middle‐aged and older otherwise healthy individuals with a history of COVID‐19. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusions We aimed to detect subclinical cardiac impairment in children with ulcerative colitis (UC) and test the association between absolute monocytic count (AMC) and lymphocyte‐to‐monocyte ratio (LMR) with disease activity.A group of children with UC and a comparable group as healthy controls were included. All children underwent history‐taking, clinical examination and blood testing for complete blood counts with white blood cell differentials, LMR and erythrocyte sedimentation rate (ESR). Disease severity was assessed using the Paediatric UC Activity Index score. We used echocardiography for tissue Doppler, M‐Mode, two‐dimensional and three‐dimensional (3D) speckle tracking echocardiography (STE) for left ventricular function assessment.Forty children were included, 20 with UC as cases, and 20 healthy controls. Disease activity was mild in 75% cases and moderate in 25% cases. Cases had significantly higher ESR than the control group (P < 0.001). Among cases, positive correlations were observed between monocytic, and platelet counts with left ventricular end‐diastolic diameter (r = 0.5, P = 0.02; r = 0.5, P = 0.03). Children with UC had significantly lower ejection fraction and impaired left ventricular systolic function compared to the control group (P < 0.001) assessed by 3D STE, yet this observation was not reached by the conventional method (P = 0.3).In children with UC, 3D STE could detect subclinical left ventricular systolic dysfunction that conventional echocardiography could not. AMC and LMR showed no significant difference between children with UC and controls. [ABSTRACT FROM AUTHOR]

Background: Left ventricle (LV) volume overload is observed with hemodynamically significant PDA as it causes left to right shunting, leading to increased pulmonary blood flow. This overload causes LV remodeling as LV increases stroke volume in trial for compensation, but in larger shunts, patients may develop symptoms of congestive heart failure. Two-dimensional (2D) speckle-tracking echocardiography has emerged as a technique for objective and quantitative evaluation of global and regional myocardial function, independent of the angle of myocardial insonation. Aim of the work: This study aimed to evaluate left ventricular function by 2-dimensional speckle tracking in children with hemodynamically significant PDA. Methods: This prospective controlled study was performed on 54 children divided into two groups (34 as cases and 20 as controls) to compare echocardiographic measurements. Conventional Echocardiography, tissue Doppler, and Speckle tracking were done for all patients, and measurements were compared. Results: There was a statistically significant difference (p value < 0.001) in global longitudinal strain (GLS) in the PDA group indicating a decrease in LV function in PDA patients. This difference was observed in several conventional echocardiographic parameters but not in tissue Doppler in our study. Conclusion: Left ventricle global strain is an important predictor of the myocardial performance index of the Left ventricle in patients with hemodynamically significant PDA and outweighs other conventional echocardiographic parameters and tissue Doppler indices. [ABSTRACT FROM AUTHOR]

Background: Hematologic cancers and solid tumors are frequently treated with anthracyclines. In approximately 9% of patients, they may cause cardiac dysfunction associated to cancer therapy (CTRD). Two-dimensional speckle tracking echocardiography (STE) with global longitudinal strain (GLS) and left atrial strain (LAS) have been developed as a significant and established tools for predicting subsequent CTRD during anthracycline therapy. CTRD is traditionally defined as a decreased left ventricular ejection fraction (LVEF) of less than 50% or ≥ 5% absolute reduction in symptomatic patients or ≥10% in asymptomatic patients. Methods: A cohort prospective study was carried out in the Cardiology department from February 2023 to May 2024. Prior to receiving chemotherapy, 143 patients had evaluations. Serial echocardiography was carried out at 0, 3, 6, and up to a year's follow-up, with 2D-STE conducted at 0 and 3 months. Results &Conclusion: This one-year cohort research comprised 143 patients receiving anthracycline chemotherapy (mean age of 56 years, 77.6% women). We evaluated the predictive relevance of LV GLS, LAs, brain natriuretic peptide (BNP), and troponin (TnT). Cardiotoxcity was consistently associated with proportionate reductions in LV GLS, LASct, and LASr, as well as 3-month increases in BNP levels. Multivariate Cox Regression Analysis showed that at 3 months after treatment, the development of cardiotoxicity was highly accurately and independently linked with Δ LV GLS ≥ 18.4%. [ABSTRACT FROM AUTHOR]

Background: Obesity is a prevalent health issue associated with an increased risk of cardiovascular diseases. While obesity's link to various cardiovascular conditions is well-documented, its specific impact on global longitudinal strain (GLS) requires further investigation. This study aims to explore the relationship between obesity and GLS in an adult population. Materials and Methods: This cross-sectional study included 91 adult participants, categorized into obese (n=59) and non-obese (n=32) groups based on body mass index (BMI). GLS was measured using speckle-tracking echocardiography. Chi-square tests and odds ratios (OR) were used to assess the association between obesity and abnormal GLS. Results: Among the non-obese group, 25.0% had abnormal GLS compared to 20.3% in the obese group. The chi-square test indicated no significant difference in the prevalence of abnormal GLS between the groups (p = 0.60). The odds ratio for abnormal GLS in obese versus non-obese participants was 1.3 (95% CI: 0.4-3.6), indicating no significant association. Conclusion: The study found no significant association between obesity and abnormal GLS, suggesting that BMI alone may not be a reliable predictor of subclinical myocardial dysfunction. These findings highlight the need for a comprehensive approach to cardiovascular risk assessment that includes multiple factors beyond BMI. [ABSTRACT FROM AUTHOR]

Background/Objectives: Myocardial involvement has been observed in athletes following SARS-CoV-2 infection. It is unclear if these changes are due to myocardial damage per se or to an interruption in training. The aim of this study was to assess cardiac function and structure in elite athletes before and after infection (INFAt) and compare them to a group of healthy controls (CON). Methods: Transthoracic echocardiography was performed in 32 elite athletes, including 16 INFAt (median 21.0 (19.3–21.5) years, 10 male) before (t0) and 52 days after (t1) mild SARS-CoV-2 infection and 16 sex-, age- and sports type-matched CON. Left and right ventricular global longitudinal strain (LV/RV GLS), RV free wall longitudinal strain (RV FWS) and left atrial strain (LAS) were assessed by an investigator blinded to patient history. Results: INFAt showed no significant changes in echocardiographic parameters between t0 and t1, including LV GLS (−21.8% vs. −21.7%, p = 0.649) and RV GLS (−29.1% vs. −28.7%, p = 0.626). A significant increase was observed in LA reservoir strain (LASr) (35.7% vs. 47.8%, p = 0.012). Compared to CON, INFAt at t1 had significantly higher RV FWS (−33.0% vs. −28.2%, p = 0.011), LASr (47.8% vs. 30.5%, p < 0.001) and LA contraction strain (−12.8% vs. −4.9%, p = 0.050) values. Conclusions: In elite athletes, mild SARS-CoV-2 infection does not significantly impact LV function when compared to their pre-SARS-CoV-2 status and to healthy controls. However, subtle changes in RV and LA strain may indicate temporary or training-related adaptions. Further research is needed, particularly focusing on athletes with more severe infections or prolonged symptoms. [ABSTRACT FROM AUTHOR]

The relationship between cardiac deformation by 2D speckle tracking, hypertrophy, and the extent of late gadolinium enhancement (LGE) in patients with hypertrophic cardiomyopathy remains uncertain. Our study aims to compare left ventricular global longitudinal strain (GLS) with the extent of LGE and to determine a relationship between GLS and hypertrophy. We conducted a descriptive cross-sectional single-center study that included patients aged 16 or above. Participants underwent echocardiography and cardiac MRI. GLS was assessed through 2D speckle tracking. LV mass index and LGE extent (LGE% = LGE volume/ LV mass) were calculated from MRI. Patients were divided into three groups based on LGE extent for analysis (LGE extent = 0; < 15%; ≥ 15%), Forty-two patients were included, 15 having a LGE extent ≥ 15%, 16 having an extent < 15%, and 11 having no LGE. Patients with LGE ≥ 15% had significantly lower global longitudinal strain, higher LV mass index, and higher maximal wall thickness compared to those without LGE (p= 0.016, p=0.025, and p=0.003, respectively). A GLS cutoff value of -13.95 % predicted a LGE extent ≥15% with a specificity of 63% and sensitivity of 66.7%. Area Under the Curve (AUC) of 0.691 (95% CI 0.515 - 0.868) p=0.042. Patients with higher LV mass index had lower GLS (p<0.0001). The study suggests a correlation between GLS, LGE extent, and hypertrophy in HCM patients. These findings indicate that GLS could be a promising tool for sudden death risk stratification as the LGE extent. [ABSTRACT FROM AUTHOR]

The role of immune system components in the development of myocardial remodeling in chronic kidney disease (CKD) and kidney transplantation remains an open question. Our aim was to investigate the associations between immune cell subpopulations in the circulation of CKD patients and kidney transplant recipients (KTRs) with subclinical indices of myocardial performance. We enrolled 44 CKD patients and 38 KTRs without established cardiovascular disease. A selected panel of immune cells was measured by flow cytometry. Classical and novel strain-related indices of ventricular function were measured by speckle-tracking echocardiography at baseline and following dipyridamole infusion. In CKD patients, the left ventricular (LV) relative wall thickness correlated with the CD14++CD16− monocytes (β = 0.447, p = 0.004), while the CD14++CD16+ monocytes were independent correlates of the global radial strain (β = 0.351, p = 0.04). In KTRs, dipyridamole induced changes in global longitudinal strain correlated with CD14++CD16+ monocytes (β = 0.423, p = 0.009) and CD4+ T-cells (β = 0.403, p = 0.01). LV twist and untwist were independently correlated with the CD8+ T-cells (β = 0.405, p = 0.02 and β = −0.367, p = 0.03, respectively) in CKD patients, whereas the CD14++CD16+ monocytes were independent correlates of LV twist and untwist in KTRs (β = 0.405, p = 0.02 and β = −0.367, p = 0.03, respectively). Immune cell subsets independently correlate with left ventricular strain and torsion-related indices in CKD patients and KTRs without established CVD. [ABSTRACT FROM AUTHOR]

Cancer and cardiovascular disease are the leading causes of death for Canadian women. One in eight Canadian women will receive the life-changing diagnosis of breast cancer (BC) in their lifetime, with 1 in 34 dying from the disease. Although doxorubicin (DOX) and trastuzumab (TRZ) have significantly improved survival in women diagnosed with human epidermal growth factor receptor 2 (HER2)-positive BC, approximately one in four women who receive this treatment are at risk of developing chemotherapy-induced cardiotoxicity. Cardiotoxicity is defined as a decline in left ventricular ejection fraction (LVEF) of >10% to an absolute value of <53%. Current guidelines recommend the serial monitoring of LVEF in this patient population using non-invasive cardiac imaging modalities including transthoracic echocardiography or multi-gated acquisition scan; however, this will only allow for the detection of established cardiotoxicity. Recent studies have demonstrated that a reduction in global longitudinal strain by speckle tracking echocardiography can identify pre-clinical systolic dysfunction prior to a decline in overall LVEF. Implementation of early detection techniques would allow for the prompt initiation of cardioprotective strategies. In addition to the early detection of chemotherapy-mediated cardiotoxicity, the prophylactic use of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, β-blockers, statins, exercise, and nutraceutical therapies have been studied in the setting of cardio-oncology. [ABSTRACT FROM AUTHOR]

Objectives: The persistence and outcomes following myocardial injury subsequent to coronavirus disease-2019 (COVID-19) infection has not been properly elucidated. We assessed sub-clinical bi-ventricular dysfunction using speckle tracking echocardiography (STE) in post COVID-19 patients. Methods: A total of 189 subjects following recovery from COVID-19 infection were enrolled. Detailed echocardiography including STE along with clinical, hematological, biochemical and inflammatory parameters were assessed for all. Patients were divided into four groups (asymptomatic, mild, moderate and severe) based on severity of COVID-19 infection. Additionally, 90 healthy individuals were enrolled as controls. All these patients were followed up for one year following enrolment. Results: Subclinical LV and right ventricle (RV) dysfunction were seen in 58 (30.7 %) and 55 (29.1 %) patients respectively at baseline. Significant difference was observed in mean LVGLS values among the three groups (mild: −21.5 ± 2.8 %; moderate: −17 ± 7.1 %; severe: −12.1 ± 4 %; P

Abstract Background Cardiovascular diseases are leading causes of morbidity and mortality in patients with systemic lupus erythematosus (SLE). Cardiac involvement in SLE can often go undetected. Three-dimensional (3D) speckle tracking echocardiography (STE) is a noninvasive imaging technique that can assess the function of the heart’s ventricles in an accurate and reproducible way. This makes it an attractive option for detecting early signs of heart disease in SLE patients. By identifying these subclinical cardiac abnormalities, 3D-STE may help reduce the negative impact of cardiovascular diseases in SLE population. Therefore, this study aimed to compare the left ventricular (LV) function between patients with SLE compared to age- and gender-matched controls using two-dimensional (2D) and 3D-STE. Results The current study found no significant differences in left ventricle ejection fraction, left ventricle end-diastolic volume, left ventricle end-systolic volume, left ventricle end-diastolic mass, and left ventricle end-systolic mass between the two groups. However, the SLE group exhibited a significantly lower LV global longitudinal strain (GLS) compared to the control group according to all types of echocardiographic assessments, including 3D and 2D long-axis strain, apical 2-chamber, and apical 4-chamber assessments (all P values

Background: In recent years, many advances have been made in the treatment of hereditary transthyretin amyloidosis (ATTRv). Patisiran is a small-interfering RNA used to treat ATTRv with only polyneuropathy or polyneuropathy and cardiomyopathy. The aim of our study was to assess the effect of patisiran on cardiac function in ATTRv patients using speckle tracking echocardiography (STE) analysis. Methods: A single-center prospective study was performed enrolling 21 patients with ATTRv (11 M—52% of the population; 10 F—48% of the population; median age 66 ± 8.4 years old). A total of 7 patients had cardiac amyloidosis and polyneuropathy, and 14 patients had only polyneuropathy without cardiac involvement. Cardiological evaluation including electrocardiograms, echocardiography with STE, and assessment of myocardial work parameters was performed in all patients before starting patisiran and after 9–18 months. Functional capacity was assessed using the 6 min walk test; quality of life was assessed using the Kansas City Cardiomyopathy Questionnaire (KCCQ). Results: We did not find a significant difference in gender prevalence of ATTR amyloidosis in all of the population (p-value 0.79), but we found that cardiac amyloidosis significantly predominated in the male sex compared to patients with only neuropathy. In all patients, we found a slight improvement in functional capacity and quality of life. We did not find significant changes in left ventricular ejection fraction (LVEF), but we found a significant improvement in left ventricular global longitudinal strain (GLS), global work waste (GWW), and global work efficiency (GWE), especially in patients with cardiac amyloidosis; E/e' average and left atrial stiffness also improved significantly in patients with cardiac amyloidosis. Conclusions: Our study confirms a positive effect of patisiran on cardiac function, particularly the absence of signs of subclinical deterioration as detected by very sensitive STE parameters such as GLS, MW, and atrial stiffness during follow up in patients treated with patisiran. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Global longitudinal strain (GLS) and atrial voltage are acknowledged markers for worse rhythm outcome after ablation of persistent atrial fibrillation (PeAF). The majority of research efforts have been directed towards the left atrium (LA), with relatively fewer studies focusing on the right atrium (RA). The aim of this study was to investigate the effect of the biatrial substrate on the outcome following radiofrequency catheter ablation (RFCA).All patients underwent two‐dimensional speckle tracking echocardiography (2D‐STE) and high‐density mapping (HDM) on LA and RA in preoperative and postoperative stages of RFCA. Atrial substrate was assessed by GLS, average voltage, and low voltage zone (LVZ).This retrospective study enrolled 48 patients. With a follow‐up of 385.98 ± 161.78 days, 22.92% (11/48) of all patients had AF recurrence and 63.64% in low strain group. Left atrial‐low voltage zone (LA‐LVZ) prior to RFCA was 67.52 ± 15.27% and 54.21 ± 20.07%, respectively, in the recurrence group and non‐recurrence group. Multivariate regression analysis showed that preoperative LA‐GLS (OR 0.047, 95%CI 0.002–0.941, p = .046) was independent predictors of AF recurrence. Biatrial average voltage in preoperative and postoperative stages were positively correlated (preoperative: r = 0.563 p < .001; postoperative: r = 0.464 p = .002). There was no significant difference in the proportion of RA in the recurrence group except the septum in preoperative and postoperative stages.Low LA‐GLS and high LA‐LVZ may be predictors of RFCA recurrence in PeAF patients. Biatrial average voltage were positively correlated in preoperative and postoperative stages. [ABSTRACT FROM AUTHOR]

Aim: There is a complex relationship between asthma and cardiac functions. According to speckle-tracking echocardiography studies, asthma, especially severe asthma, was associated with left and right ventricular subclinical dysfunction. The literature lacks data comparing the cardiac functions during exacerbations and stable periods in patients with asthma. In this study, we aimed to investigate cardiac functions using speckle-tracking echocardiography during exacerbations and in the stable phase in female patients with asthma. Material and method: A total of 51 female adult asthma patients who were admitted to our center due to asthma exacerbations were included in this study. All participants had a previous diagnosis of asthma. Transthoracic echocardiography was performed both during hospitalization and after the asthma exacerbation was stabilized. Echocardiographic findings, including left ventricular longitudinal strain, in the two periods were compared. All patients were discharged in good condition after their asthma attacks stabilized. Results: White blood cell count (WBC) and C-reactive protein (CRP) levels were significantly higher during exacerbation than in the stable phase. Regarding echocardiographical findings, isovolumetric contraction time (IVCT) was significantly longer and left ventricular global longitudinal strain (LVGLS) was significantly lower during exacerbation compared to the stable phase [median (IQR), 70 (61–76) msec vs. 66 (57–72) msec, p=0.011 and -12.9 (-13.8 – -12.1) vs. -14.2 (-14.8 – -13.2), p<0.001, respectively]. According to the multivariate analysis, IVCT, LVGLS, and WBC were independently associated with asthma exacerbation. Conclusion: Our study showed that asthma exacerbations might have an oppressive and adverse impact on cardiac functions, particularly when analyzed by STE. [ABSTRACT FROM AUTHOR]

(1) Background: Pregnancy induces significant physiological adaptations with substantial impacts on the cardiovascular system. Hypertensive disorders of pregnancy (HDPs) are connected to significant risks of maternal and fetal complications, contributing significantly to morbidity and mortality across the globe. This study focuses on evaluating autonomic dysfunction by analyzing heart rate variability (HRV) and assessing cardiac performance through global longitudinal strain (GLS) using speckle tracking echocardiography, as well as examining diastolic function in pregnant women with HDP compared to healthy pregnant controls. (2) Methods: A case–control study was conducted involving pregnant women diagnosed with gestational hypertension (GH), preeclampsia (PE), or severe preeclampsia (SPE) as the case group, and healthy pregnant women as the control group. HRV was measured to evaluate autonomic function, GLS was assessed using speckle tracking echocardiography, and diastolic function was evaluated through standard echocardiographic parameters. Data were analyzed to compare cardiac performance and autonomic regulation between the HDP and control group, as well as among the different HDP subgroups. (3) Results: The HDP group exhibited significantly reduced HRV parameters compared to healthy controls, indicating notable autonomic dysfunction. Speckle tracking echocardiography revealed lower GLS among women with HDP, particularly in those with SPE, compared to the control group. Diastolic dysfunction was also present in the HDP group. (4) Conclusions: HRV and GLS are valuable non-invasive tools for detecting autonomic dysfunction and cardiac performance impairments in pregnant women with hypertensive disorders. These findings suggest that autonomic and cardiac dysfunctions are prevalent in HDP. [ABSTRACT FROM AUTHOR]

Hypertrophic cardiomyopathy (HCM) is a genetic disease characterized by unexplained left ventricular hypertrophy (LVH), diastolic dysfunction, and increased sudden-death risk. Early detection of the phenotypic expression of the disease in genetic carriers without LVH (Gen+/Phen−) is crucial for emerging therapies. This clinical study aims to identify echocardiographic predictors of phenotypic development in Gen+/Phen−. Sixteen Gen+/Phen− (one subject with troponin T, six with myosin heavy chain-7, and nine with myosin-binding protein C3 mutations), represented the study population. At first and last visit we performed comprehensive 2D speckle-tracking strain echocardiography. During a follow-up of 8 ± 5 years, five carriers developed LVH (LVH+). At baseline, these patients were older than those who did not develop LVH (LVH−) (30 ± 8 vs. 15 ± 8 years, p = 0.005). LVH+ had reduced peak global strain rate during the isovolumic relaxation period (SRIVR) (0.28 ± 0.05 vs. 0.40 ± 0.11 1/s, p = 0.048) and lower global longitudinal strain (GLS) (−19.8 ± 0.4 vs. −22.3 ± 1.1%; p < 0.0001) than LVH- at baseline. SRIVR and GLS were not correlated with age (overall, p > 0.08). This is the first HCM study investigating subjects before they manifest clinically significant or relevant disease burden or symptomatology, comparing at baseline HCM Gen+/Phen− subjects who will develop LVH with those who will not. Furthermore, we identified highly sensitive, easily obtainable, age- and load-independent echocardiographic predictors of phenotype development in HCM gene carriers who may undergo early preventive treatment. [ABSTRACT FROM AUTHOR]

Background: The main cardiovascular risk factor related to higher likelihood of heart failure is hypertension [HTN]. There are plenty of researches on the pathological effects of HTN on the morphology and structure of the left ventricle [LV], but research investigating right ventricle [RV] mechanics in patients with hypertension have just recently emerged. So we aimed to assess whether blood pressure controlled or not had an impact on the systolic function of the RV. Methods: One hundred seventy two participants were assessed by 2D echocardiography for LV function m-mode, right ventricle RV including tissue doppler imaging[TDI] to evaluate RV myocardial performance index [MPI], RV s wave, tricuspid annular plane systolic excursion[TAPSE]. Speckle tracking study was done for global longitudinal strain [GLS] of LV RV and free wall strain. Results: Total of 172 participants were divided into, 86 were hypertensive in group I and 86 were normotensive in group II. TAPSE, MPI, RV s wave, PASP, LV-GLS, GLS of RV, and free wall strain were lower in group I. Subgroup analysis showed lower RVGLS in uncontrolled hypertensive patients. Conclusions: Uncontrolled hypertensive patients had lower RV-GLS in comparison to controlled hypertensive patients. The predictors of impaired RV GLS in uncontrolled BP patients were BMI, RV MPI, and LVGLS [ABSTRACT FROM AUTHOR]

Background: COVID-19, triggered by the SARS-CoV-2 virus, was shown to have a profound effect on cardiac function. However, the long-term implications of myocardial damage in individuals who have recovered from the infection are not yet fully understood. Aim: This study aimed to identify the early changes in right ventricular (RV) function three months after recovery from COVID-19 using Speckle Tracking Echocardiography (STE) and Global Longitudinal Strain (GLS). Methods: This study was designed as a cross-sectional descriptive analysis and included 104 patients who had recovered from COVID-19 pneumonia during a three-month timeframe. The participants have been categorized into two groups based on the severity of their illness: mild cases and moderate/severe cases. Results: The demographic characteristics of the two groups broadly were similar with no statistically significant differences. The average age of the participants was 48.8 ± 10.7 years, with males representing 55.8% of the study population. The average body mass index (BMI) was 23.6 ± 0.71 kg/m². Furthermore, 45% of the participants had diabetes, and 34% were diagnosed with hypertension. Significant statistical differences were observed in right ventricular function parameters between the moderate/severe group and the mild group. The moderate/severe group showed a marked early reduction in both RV-GLS and RV-FWLS compared to the mild group. However, no early impairment was detected in right ventricular longitudinal function as measured by TAPSE. Conclusion: Speckle-tracking echocardiography proved to be a valuable tool for early detection of abnormalities that are not easily identified by conventional echocardiography, particularly in assessing strain on the right ventricle. [ABSTRACT FROM AUTHOR]

Background: With the increased prevalence of obesity worldwide, even in young adults with a lack of data on its effect on cardiac function in these age groups, the need to detect the possible changes in cardiac function with different degrees of obesity has emerged. Objective: We aimed to use 2-dimensional (2D) deformation imaging to evaluate the potential changes in cardiac function in variable degrees of obesity. Patients and methods: Our study is a single-center observational study. During the study period between September 2022 and September 2023, 323 volunteers without evidence of metabolic syndrome in their first decade of adulthood (18 to 30 years of age) with a BMI more than 25 kg/m2 were evaluated at the Cardiology Department, Faculty of Medicine, Benha University. 123 cases were excluded due to the presence of significant valvular disease (n=53), atrial fibrillation (n= 36), systolic heart failure (n= 27), and poor image quality (n=7). Finally, the study included 200 patients as follows: Overweight (n=100) and obese (n=100). Forty participants were enrolled (n=40) as a control group. Conventional and speckle-tracking echocardiography evaluated the right (RV) and the left ventricle (LV) function and global longitudinal strain (GLS). Results: No noticeable differences were detected among the groups regarding conventional functional and dimensional echocardiographic parameters. However, significant differences between the groups were noticed regarding 2D speckle tracking of RV global longitudinal strain (GLS), RV free-wall strain, and LV GLS (p<0.001), with worse deformation in obese subjects. Conclusion: Obesity, even in younger ages without metabolic syndrome, is hazardous to LV and RV function, represented by worse myocardial deformation. This finding could be used in risk stratification of obese young individuals. [ABSTRACT FROM AUTHOR]

Background: Rheumatoid arthritis (RA) is associated with increased cardiovascular morbidity and mortality, attributed in part to myocardial dysfunction. Global longitudinal strain (GLS) measured by speckle-tracking echocardiography is a sensitive marker of myocardial function. This study aimed to investigate the association between RA serology markers, including rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies, and GLS in RA patients. Materials and Methods: This one-year cross-sectional study was conducted at Imam Hossein Hospital in Tehran, Iran, focusing on patients diagnosed with RA. Rheumatoid arthritis serology markers, including RF and anti-CCP antibodies, were assessed. GLS was measured using speckle-tracking echocardiography. The association between RA serology markers and GLS categories was analyzed using chi-square tests with IBM SPSS Statistics version 26. Results: A total of 71 patients were included in the study, with a mean age of 52.31 years. Among the RA patients, 28 individuals (71.8%) with negative RA serology exhibited abnormal GLS values, while 11 (28.2%) had normal GLS values. Conversely, all 21 (100%) RA patients with positive serology showed abnormal GLS values. Statistical analysis revealed no significant association between RA serology markers and GLS category (χ2 = 0.313, P>0.05). Conclusion: In this study, RA serology markers, including RF and anti-CCP antibodies, were not significantly associated with GLS abnormalities in RA patients. Further research is needed to elucidate other factors contributing to myocardial dysfunction in RA. [ABSTRACT FROM AUTHOR]

Objective: In this study, we aimed to evaluate the relationship between blood pressure, left ventricular (LV) mass, and systolic function in American football (AF) players in Türkiye using deformation imaging and to compare it with conventional echocardiographic methods. Methods: AF players admitted to the Gazi University, Cardiology Unit between January 2021 and May 2023 were included in our study. The players were grouped as linemen or non-linemen according to their field positions. LV mass and ejection fraction (EF) were assessed using blood pressure measurements and conventional methods. Deformation analysis was performed by two-dimensional speckle tracking echocardiography, and LV torsion and global longitudinal strain values were calculated. Deformation analyses were compared with blood pressure and LV EF. Results: Players in the lineman position had higher blood pressure measurements. Although both groups of players had similar and intact LV EF values, players in the lineman position had significant changes in LV mass, LV global longitudinal strain, and LV torsion in relation to blood pressure measurements. Conclusion: AF players are at risk of hypertension. LV hypertrophy due to hypertension causes systolic dysfunction. Deformation analysis methods can detect subclinical myocardial damage even if the EF is intact. [ABSTRACT FROM AUTHOR]

Aims/Introduction: To assess the effect of empagliflozin treatment on left ventricular (LV), right ventricular (RV) and left atrial (LA) functions in diabetes patients with normal ejection fraction. Materials and Methods: The study included a total of 128 diabetes patients with multiple cardiovascular risk factors who were subjected to a 6‐month follow up from the initiation of empagliflozin treatment. Before and after treatment with empagliflozin, LV, RV and LA strain, and noninvasive myocardial work parameters were evaluated by speckle tracking echocardiography. Results: In 128 diabetes patients (mean age 56 ± 8 years, 85 men) with multiple cardiovascular risk factors, myocardial strain and work parameters were impaired, despite the absence of significant clinical symptoms of heart failure. After 6‐month treatment with empagliflozin, the absolute value of LV strain in all directions increased, represented by LV global longitudinal strain (−18.0 ± 1.7% to −19.2 ± 1.7% [mean ± SD]). The same trend in LV global work efficiency (93 [91–94] % to 94 [93–95] % [median (IQR)]), RV free‐wall longitudinal strain (−24.0 ± 2.7% to −25.0 ± 2.8%), LA reservoir (31 ± 5% to 34 ± 5%) and conduit strain (−14 ± 4% to −16 ± 4%) was also observed. LV mass index (106.9 ± 16.8–103.6 ± 16.4 g/m2) and LV global wasted work (143 [111–185] mmHg% to 108 [88–141] mmHg%) decreased after treatment (P < 0.05 for all). LV volume and LA volume index remained unchanged after treatment. In the multivariable analysis, the change in LA reservoir strain (β = 0.050, P = 0.035) and baseline global longitudinal strain (β = −0.488, P < 0.001) were independent predictors of improvement in LV global longitudinal strain. Conclusions: This study suggests that 6‐month treatment with empagliflozin improved LV, RV and LA functions in diabetes patients with normal ejection fraction. [ABSTRACT FROM AUTHOR]

Background: The presence of a relative apical sparing (RAS) echocardiographic strain pattern raises a suspicion of underlying cardiac amyloidosis (CA). However, it is also increasingly observed in patients with aortic stenosis (AS). We aimed to evaluate the prevalence, dynamics, and clinical characteristics of the RAS strain pattern in severe AS patients who had been referred for surgical aortic valve replacement (SAVR). Methods: A total of 77 patients with severe AS and without CA were included with a mean age of 70 (62–73) years, 58% female, a mean aortic valve area index of 0.45 ± 0.1 cm2/m2, and a mean gradient of 54.9 (45–70) mmHg. Results: An RAS strain pattern was detected in 14 (18%) patients. RAS-positive patients had a significantly higher LV mass index (125 ± 28 g/m2 vs. 91 ± 32, p = 0.001), a lower LV ejection fraction (62 ± 12 vs. 68 ± 13, p = 0.040), and lower global longitudinal strain (–14.9 ± 3 vs. –18.7 ± 5%, p = 0.002). RAS strain pattern-positive patients also had higher B-type natriuretic peptide (409 (161–961) vs. 119 (66–245) pg/L, p = 0.032) and high-sensitivity troponin I (15 (13–29) vs. 9 (5–18) pg/L, p = 0.026) levels. Detection of an RAS strain pattern was strongly associated with increased LV mass index (OR 1.03, 95% CI 1.01–1.06, p < 0.001). The RAS strain pattern had resolved in all patients by 3 months after SAVR. Conclusions: Our findings suggest that the RAS strain pattern can be present in patients with severe AS without evidence of CA. The presence of an RAS strain pattern is associated with adverse LV remodeling, and it resolves after SAVR. [ABSTRACT FROM AUTHOR]

Aims: The aims of this study were to compare global longitudinal strain of the left ventricle (LV-GLS) and reservoir strain of the left atrium (R-LAS) values between patients with acute decompensation of chronic heart failure (HF) and a control group. Methods: Sixteen patients admitted to our ward for acute decompensation of HF were enrolled in this study. Transthoracic echocardiography (TTE) with two-dimensional speckle-tracking analysis (2D ST) was performed in each patient. The patients were divided into two subgroups according to the value of left ventricular ejection fraction (EF) using a cut-off value of ≤40% to distinguish heart failure with reduced ejection fraction (HFrEF) from heart failure with preserved ejection fraction (HFpEF). The control group consisted of 16 individuals without a history of cardiovascular disease, each of whom underwent 2D ST analysis as well. Results: We found that LV-GLS and R-LAS were significantly lower in both the HFrEF and HFpEF subgroups in comparison with the control group (LV-GLS: −13.4 ± 4.7% vs. −19.7 ± 2.5%, p ˂ 0.05; R-LAS: +12.2 ± 6.9% vs. +40.3 ± 7.4%, p ˂ 0.05). Furthermore, there was a significant difference in LV-GLS (−9.6 ± 3.2% vs. −15.2 ± 4.3%, p ˂ 0.05) but not in R-LAS (+13.7 ± 8.6% vs. +11.4 ± 6.2%) between the HFrEF and HFpEF subgroups. Conclusions: Our study demonstrated a significant difference in LV-GLS and R-LAS in all enrolled HF patients compared to the control group. There was also a significant difference in LV-GLS between the HFrEF and HFpEF subgroups. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular diseases are leading causes of morbidity and mortality in patients with systemic lupus erythematosus (SLE). Cardiac involvement in SLE can often go undetected. Three-dimensional (3D) speckle tracking echocardiography (STE) is a noninvasive imaging technique that can assess the function of the heart's ventricles in an accurate and reproducible way. This makes it an attractive option for detecting early signs of heart disease in SLE patients. By identifying these subclinical cardiac abnormalities, 3D-STE may help reduce the negative impact of cardiovascular diseases in SLE population. Therefore, this study aimed to compare the left ventricular (LV) function between patients with SLE compared to age- and gender-matched controls using two-dimensional (2D) and 3D-STE. Results: The current study found no significant differences in left ventricle ejection fraction, left ventricle end-diastolic volume, left ventricle end-systolic volume, left ventricle end-diastolic mass, and left ventricle end-systolic mass between the two groups. However, the SLE group exhibited a significantly lower LV global longitudinal strain (GLS) compared to the control group according to all types of echocardiographic assessments, including 3D and 2D long-axis strain, apical 2-chamber, and apical 4-chamber assessments (all P values < 0.05). Furthermore, a good inter-rater reliability and intra-rater reliability were observed regarding the LVGLS measurement with 3D-STE. Additionally, the study identified a significant correlation between LVGLS and SLE duration (r (50) = 0.46, P < 0.001). The use of prednisolone and nephrology disorders was also found to impact LVGLS measurements. Conclusions: Despite a normal LVEF in patients with SLE, LVGLS measurements indicated that LV systolic dysfunction was observed more frequently in SLE patients compared to their healthy counterparts. Therefore, advanced 3D-STE techniques may be useful in identifying subtle abnormalities in LV function in SLE patients. [ABSTRACT FROM AUTHOR]

Objectives: To investigate whether two-dimensional speckle-tracking echocardiography (2DSTE) can be considered a criterion for early left ventricular (LV) systolic impairment in patients with systemic lupus erythematosus (SLE) and to further explore the association with each other. Methods: We included 38 patients with SLE and assessed the degree of disease activity according to the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) 2000 scoring criteria, together with 38 healthy controls who were matched by sex and age. Routine LV systolic function evaluation parameters were obtained by echocardiography as well as 2DSTE measurement of LV strain parameters to obtain global longitudinal strain (GLS) values, respectively. Results: (I) On routine LV function parameters such as ejection fractions (EF) and left ventricular end-diastolic internal diameter (LVIDd), the SLE group and the control group did not reflect differences. In contrast, on the LV strain parameter obtained from 2DSTE measurements, the GLS values in all cardiac planes were lower in the SLE group than in the control group and showed statistically significant differences. (II) Correlation analysis showed that there was a correlation between SLEDAI and GLS, especially a meaningful correlation with GLS Avg and GLS A4C, with correlation coefficients of 0.35 and 0.47, respectively. Conclusions: The use of 2DSTE can detect early impaired LV systolic function in SLE patients, and GLS is progressively gaining attention as an indicator of subclinical myocardial injury and LV function in SLE patients. The correlation that exists between GLS and SLEDAI might contribute to a better assessment of cardiac involvement in SLE patients. Key Points • Cardiac involvement has become one of the major factors in the poor prognosis of SLE patients, which directly affects the mortality of SLE patients. Traditional echocardiography is difficult to detect early left ventricular function impairment, thus affecting clinicians' judgment and diagnosis. • 2DSTE can recognize subclinical myocardial injury in SLE patients at an early stage, and its derived strain parameters may be used as an indicator to evaluate myocardial involvement and reflect disease activity in SLE patients [ABSTRACT FROM AUTHOR]

In systemic sclerosis (SSc), pulmonary hypertension remains a significant cause of morbidity and mortality. Although conventionally classified as group 1 pulmonary arterial hypertension, systemic sclerosis-related pulmonary hypertension (SSc-PH) is a heterogeneous disease. The contribution of left-sided cardiac disease in SSc-PH remains poorly understood. How often does left ventricular (LV) dysfunction occur in SSc among patients undergoing right heart catheterization and how does coexistent LV dysfunction with SSc-PH affect all-cause mortality in this patient population? We conducted a retrospective, observational study of 165 patients with SSc who underwent both echocardiography and right heart catheterization. LV dysfunction was identified using LV global longitudinal strain (GLS) on speckle-tracking echocardiography based on a defined threshold of > −18%. SSc-PH was defined by a mean pulmonary artery pressure > 20 mmHg. Among patients with SSc who have undergone right heart catheterization, LV dysfunction occurred in 74.2% with SSc-PH and 51.2% without SSc-PH. The median survival of patients with SSc-PH and LV dysfunction was 67.9 (95% CI, 38.3-102.0) months, with a hazard ratio of 12.64 (95% CI, 1.73-92.60) for all-cause mortality when adjusted for age, sex, SSc disease duration, and FVC compared with patients with SSc without pulmonary hypertension with normal LV function. LV dysfunction is common in SSc-PH. Patients with SSc-PH and LV dysfunction by LV GLS have increased all-cause mortality. This suggests that LV GLS may be helpful in identifying underlying LV dysfunction and in risk assessment of patients with SSc-PH. [Display omitted] [ABSTRACT FROM AUTHOR]

Myocardial injury in open-heart surgery is related to several factors including ischemia–reperfusion injury, generation of reactive oxygen species, increased production of inflammatory mediators, and enhancement of apoptosis of cardiomyocytes. The aim of this study was to study the effect of L-carnitine on myocardial injury in children undergoing open-heart surgery. This clinical trial was performed on 60 children with congenital heart disease (CHD) who underwent open-heart surgery. They were randomized into two groups: L-carnitine group who received L-carnitine 50 mg\kg\day once daily for 1 month before cardiac surgery and control group who received placebo for 1 month before cardiac surgery. Left ventricular cardiac function was assessed by conventional echocardiography to measure left ventricular ejection fraction (LVEF) and two-dimensional speckle tracking echocardiography (2D-STE) to determine left ventricular global longitudinal strain (2D-LV GLS). Blood samples were obtained pre-operatively at baseline before the administration of L-carnitine or placebo and 12 h post-operatively to measure the level of malondialdehyde (MDA), superoxide dismutase (SOD), fas, caspase-3, creatinine kinase-MB (CK-MB), and troponin I. L-carnitine group had significantly lower post-operative level of oxidative stress marker (MDA), apoptosis markers (fas and caspase-3), and myocardial injury markers (CK-MB and troponin I), but they had significantly higher SOD post-operative level compared to the control group. In addition, post-operative LVEF and 2D-LVGLS were significantly lower in the control group compared to L-carnitine group. Conclusion: L-carnitine can reduce myocardial injury, improve post-operative left ventricular cardiac function, and may provide myocardium protection in children with CHD who underwent open-heart surgery. Trial registration: The clinical trial was registered at www.pactr.org with registration number PACTR202010570607420 at 29/10/2020 before recruiting the patients. What is Known: • Myocardial injury in open-heart surgery is related to several factors including ischemia–reperfusion injury, generation of reactive oxygen species, increased production of inflammatory mediators, and enhancement of apoptosis of cardiomyocytes. • L-carnitine was reported to have myocardial protective effects in rheumatic valvular surgery and coronary artery bypass graft (CABG) in adults; however, there is no evidence on its effectiveness in children undergoing open-heart surgery. What is New: • L-carnitine significantly lowered the post-operative level of oxidative stress marker (MDA), apoptosis markers (fas and caspase-3), and myocardial injury markers (CK-MB and troponin I) in the treatment group. • L-carnitine can reduce myocardial injury, improve post-operative left ventricular cardiac function, and may provide myocardium protection in children with CHD who underwent open-heart surgery. [ABSTRACT FROM AUTHOR]

Cardiac dysfunction is associated with mortality in children with hypoplastic left heart syndrome (HLHS). We evaluated the ability of qualitative and quantitative RV functional parameters to predict outcomes in HLHS patients. In this retrospective, single-center study, echocardiograms from 3 timepoints (pre-stage 1 palliation, 4–8 weeks post-stage 1 palliation, and pre-Glenn) were analyzed in infants with HLHS. Patients were stratified into two groups based on outcome of transplant-free survival post-Glenn (survivors) versus mortality or transplantation prior to Fontan (non-survivors). Images were retrospectively reviewed to obtain RV global longitudinal strain (RVGLS), RV-free wall strain (RVFWS), fractional area change (FAC), tricuspid annular systolic plane excursion (TAPSE), tissue motion annular displacement of the tricuspid valve (TMAD-TV) and qualitative systolic function assessment during the predetermined timepoints. An equal variance t-test and chi-square were used to determine significant differences and ROC curve analysis was performed to derive optimal cutoff values to predict mortality/transplant. A total of 47 patients met inclusion criteria, of which, 21 patients met composite endpoint. There were no significant differences in any RV functional parameter during the pre- or post-stage 1 palliation timepoints. The absolute values of RVFWS, RVGLS, and TMAD-TV were significantly greater in survivors than non-survivors during the pre-Glenn timepoint. A pre-Glenn RVGLS > −15.6 (AUC 0.79), RVFWS > −18.6 (AUC 0.75), and TMAD-TV < 12.6% (AUC 0.82) were sensitive and specific for predicting death or need for transplantation prior to Fontan completion. RVGLS, RVFWS, and TMAD-TV may help identify higher-risk HLHS patients during the interstage period. [ABSTRACT FROM AUTHOR]

Early detection of cardiac involvement in Juvenile Dermatomyositis (JDM) is difficult due to the absence of clinical signs and symptoms, with systolic dysfunction often emerging in late stages and associated with a poor prognosis. This study aimed to employ two-dimensional speckle-tracking echocardiography (STE) for subclinical assessment of left ventricular (LV) systolic failure in JDM and explore potential associations between impaired LV systolic function (LV-GLS) and disease activity. A prospective study enrolled 20 healthy volunteers and 26 JDM patients (< 18 years old) without cardiac symptoms. Clinical data were collected from medical records, and echocardiograms were conducted by a pediatric cardiologist. Our study cohort demonstrated similar age to controls (13.5 ±.6 vs. 13.8 ± 4.7; p = 0.465). Median illness duration at echocardiography was 5 (1.5–17.5) years, and conventional echocardiography indicated normal LV ejection fraction (> 55%) in all participants. However, STE revealed lowered LV GLS in JDM patients (− 22.2 ± 4.1% vs. − 26.5 ± 5.3% p = 0.022). Pulse steroid users displayed lower GLS average values compared to non-users (β = 4.99, 95% CI 1.34–8.64, p = 0.009). Negative correlations existed between LV-GLS and age at diagnosis (r = − 0.499; p = 0.011), diastolic parameters (E/E′ ratio) and age at diagnosis (r = − 0.469; p = 0.018), as well as RV global strain and age at diagnosis (r = − 0.443; p = 0.024). Employing STE in JDM patients facilitated the identification of preclinical cardiac dysfunction. Given JDM patients' younger age, early myocardial damage detection through STE may impact treatment decisions and long-term cardiovascular prognosis. [ABSTRACT FROM AUTHOR]

Multisystem inflammatory syndrome in children (MIS-C), is a rare but severe, hyperinflammatory complication of COVID-19, in which cardiovascular abnormalities are frequently detected. In this prospective study, we describe the echocardiographic findings in patients with MIS-C, with the use of conventional Echocardiography and Speckle-Tracking Echocardiography (STE) with Left Ventricular (LV) Global Longitudinal Strain (GLS) analysis, in the acute and follow-up phase. In total, 25 MIS-C patients [64% females, mean (± SD) age: 8.3 (± 3.72) years] were included. In the acute phase, median (IQR) Troponin and NT-proBNP and mean heart rate, were 8.07 (14.52) pg/mL, 2875.00 (7713.00) pg/mL, and 102.87 (± 22.96) bpm, respectively. Median (IQR) LV Ejection Fraction (LVEF) was 66 (8)% and LVEF impairment was detected in 2/25 (8%) patients. On follow-up (mean time interval:9.50 ± 4.59 months), heart rate was significantly lower, with a mean value of 90.00 (± 14.56) bpm (p-value = 0.017). Median (IQR) LVEF was 66.00 (6.70)% (p-value = 0.345) and all 25 participants had normal LVEF. In 14/25 patients, additional LV-GLS analysis was performed. During the acute phase, mean LV-GLS was − 18.02 (± 4.40)%. LV-GLS was abnormal in 6/14 patients (42.9%) and among them, only one patient had reduced LVEF. On follow-up (median (IQR) time interval:6.93 (3.66) months), mean LV-GLS was -20.31 (± 1.91)% (p-value = 0.07) and in 1/14 patient (7.1%), the LV-GLS impairment persisted. In conclusion, in the acute and follow-up phase, we detected abnormal LV-GLS values in some patients, in the presence of normal LVEF, indicating that STE-GLS is a valuable tool for identifying subclinical myocardial injury in MIS-C. [ABSTRACT FROM AUTHOR]

Objectives: In this study, we aimed to analyze the layer-specific strain values obtained by speckle tracking echocardiography (STE) method in the determination of subclinical cardiac dysfunction in rheumatoid arthritis (RA) patients. Patients and methods: Between February 2019 and October 2019, a total of 63 female RA patients (mean age: 51.82±6.07 years; range, 40 and 65 years) who had a confirmed diagnosis were included. Thirty-one age-matched female healthy individuals (mean age: 50.71±5.37 years; range, 40 and 65 years) were selected as the control group. The patients were divided into three groups according to the duration of disease as <5 years, 5-10 years and >10 years. The Disease Activity Score in 28 joint - C-reactive protein (CRP) was used to determine disease activation. The standard assessment included complete serum CRP, anti-cyclic citrullinated peptide, rheumatoid factor, N-terminal pro B-type natriuretic peptide (NT-proBNP), and homocysteine. Global longitudinal strain (GLS) analysis was performed with STE. Results: The NT-proBNP values were found to be higher in RA patients compared to the control group (p=0.044). In terms of conventional echocardiographic parameters, a significant difference between E/A and E/E' ratios was observed (p<0.001 and p=0.015). Endocardium, transmural, and epicardium GLS values obtained by STE were found to be lower in RA patients (p<0.05). The left ventricular (LV) GLS values worsened, as the duration of disease increased (p<0.05). There was a significant correlation between RA disease activity and LV GLS values, showing that increasing levels of disease activity was associated with worse LV GLS (r=0.583, p<0.01 and r=0.681, p<0.01 and r=0.689, p<0.01 for endocardium, transmural and epicardium, respectively). Conclusion: Our study results suggest that the layer-specific GLS values obtained by STE decrease in RA patients. [ABSTRACT FROM AUTHOR]

This letter to the editor published in Acta Cardiologica discusses the cardiac response to pharmacological stress in patients with heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF). The study compares echocardiographic parameters in HFpEF and HFrEF patients in response to pharmacological stress. The results show that there were no significant changes in left ventricular ejection fraction and stroke volume from rest to peak dobutamine stress in either group, but cardiac output and cardiac power output increased in both groups. Additionally, there were differences in atrial mechanics and stiffness indices between HFpEF and HFrEF patients after dobutamine stress. The article provides a table with various measurements related to cardiac function, which can be useful for researchers studying cardiac health and function. The study highlights the differences in response to stress between HFpEF and HFrEF and suggests the need for further research to better understand the pathophysiology of different types of heart failure. [Extracted from the article]

A recent study published in the Journal of Cardiovascular Imaging explores the use of speckle tracking echocardiography (STE) as a reliable tool for evaluating right ventricle (RV) function in patients with severe tricuspid regurgitation (TR). Traditional echocardiographic methods for assessing RV function have limitations, and cardiac magnetic resonance imaging (CMR) is considered the gold standard but is expensive and time-consuming. The study found that RV free-wall longitudinal strain (RVFWLS) demonstrated the best correlation with CMR-derived RV ejection fraction (RVEF) and had superior discrimination of RV dysfunction. The use of RVFWLS could enhance clinical practice by providing a more accessible and frequent evaluation of RV function in patients with severe TR. However, there are challenges that need to be addressed before RV strain can be widely adopted in clinical practice, such as establishing normal reference values, addressing intervendor variability, and conducting prospective studies. Overall, this study advances our understanding of RV function assessment and highlights a practical and cost-effective alternative for routine clinical use. [Extracted from the article]

This article discusses the evaluation of myocardial strain using cardiovascular magnetic resonance imaging (CMR) in patients with β-thalassemia major. β-thalassemia major is a hereditary blood disorder that leads to abnormal hemoglobin production and chronic hemolytic anemia. Patients with β-thalassemia major often require regular blood transfusions, which can lead to myocardial iron overload (MIO) and subsequent cardiac dysfunction. CMR is a useful tool for detecting and quantifying MIO, and CMR feature tracking (FT) can be used to evaluate myocardial strain. This study found that CMR-FT strain parameters were significantly lower in patients with β-thalassemia major compared to healthy controls, and there was a correlation between strain values and T2* CMR values. However, there were no significant differences in global longitudinal strain (GLS) values between patients and controls. The study suggests that CMR-FT strain parameters can be used as markers for early detection of left ventricular systolic dysfunction in patients with β-thalassemia major. However, the study has limitations, including a small sample size and single-center design. Further research is needed to explore these findings in larger patient populations. [Extracted from the article]

Background: The premature-born adult population is set to grow significantly, and prematurity has emerged as an important cardiovascular risk factor. We aimed to comprehensively assess cardiac mechanics and function in a cohort of ex-preterm preschoolers. Methods: Ex-preterm children (<30 weeks of gestation), aged 2 to 5 years, underwent transthoracic 2D, speckle-tracking, and 4D echocardiography. The findings were compared with 19 full-term children. Results: Our cohort of 38 children with prematurity history showed a normal morpho-functional echocardiographic assessment. However, compared to controls, the indexed 3D end-diastolic volumes of ventricular chambers were reduced (left ventricle 58.7 ± 11.2 vs. 67.2 ± 8.5 mL/m2; right ventricle 50.3 ± 10.4 vs. 57.7 ± 11 mL/m2; p = 0.02). Left ventricle global and longitudinal systolic function were worse in terms of fraction shortening (32.9% ± 6.8 vs. 36.5% ± 5.4; p = 0.05), ejection fraction (59.2% ± 4.3 vs. 62.3% ± 3.7; p = 0.003), and global longitudinal strain (−23.6% ± 2.4 vs. −25.5% ± 1.7; p = 0.003). Finally, we found a reduced left atrial strain (47.4% ± 9.7 vs. 54.9% ± 6.8; p = 0.004). Conclusions: Preschool-aged ex-preterm children exhibited smaller ventricles and subclinical impairment of left ventricle systolic and diastolic function compared to term children. Long-term follow-up is warranted to track the evolution of these findings. [ABSTRACT FROM AUTHOR]

Background: Chronic kidney disease (CKD) is associated with higher incidence of cardiovascular death. Screening for coronary artery disease in asymptomatic or mildly symptomatic patients is challenging. Objective: The aim of this study was to investigate the incremental value of resting deformation analysis in predicting positive results for myocardial ischemia during stress transthoracic echocardiography in patients with end‐stage CKD. Methods: Sixty‐one patients (mean age: 62.3 ± 11.8, 65.7% men) with end‐stage CKD were included in the study. Patients underwent a resting transthoracic echocardiogram and a dobutamine stress contrast echo (DSE) protocol. Positive results of DSE were defined as stress‐induced left ventricular (LV) wall motion abnormalities. Results: The study cohort had normal or mildly impaired systolic function: mean LV ejection fraction (EF) was 49.2% (±10.4) and mean LV global longitudinal strain (GLS) was 14.4% (±4.5). Half of our population had impaired left atrial (LA) strain: mean LA reservoir, conduit, and contractile reserve were 24.1% (±12.6), 10.6% (±5.9), and 13.6% (±9.2), respectively. DSE was positive for ischemia in 55.7%. A significant negative association with DSE results was found for LV EF, LV GLS and the conduit phase of LA strain. Both LV and LA dimensions showed positive correlation with presence of ischemia in DSE. Multivariate logistic regression analysis showed that LV GLS was independently associated with DSE (p = 0.007), after controlling for covariates, with high diagnostic accuracy. Conclusion: Resting LV deformation could predict positive results during DSE, thus may be useful to better identify renal patients who might benefit from coronary artery screening. [ABSTRACT FROM AUTHOR]

A post hoc analysis of the SURMOUNT-1 trial found that tirzepatide treatment significantly reduced the 10-year predicted risk of atherosclerotic cardiovascular disease (ASCVD) in individuals with obesity or overweight without diabetes. The study also showed a rapid reduction in waist circumference (WC), indicating that tirzepatide acts on abdominal fat. Another study explored the relationship between global longitudinal strain (GLS), a measure of left ventricular deformability, and WC. The findings revealed a strong linear association between GLS and WC, even after adjusting for relevant variables. These results suggest that abdominal fat reduction may improve cardiovascular risk. Further research is needed to confirm these findings and determine if GLS can be used as a surrogate endpoint for cardiovascular events. [Extracted from the article]

Background:Identification of significant coronary artery disease (CAD)in NSTEMI/UA/CSA patients without invasive methodsremains a clinical challenge. Severe CAD is known to cause LV dysfunction. However, the LV ejection fraction is usually normal at a relatively early stage. Therefore, establishing a more sensitive index for the detection of early-stage LV dysfunction is of utmost importance. Methods: This was a cross sectional observational study conducted on 136 patients with NSTEMI/UA/CSAto evaluate the value of global longitudinal strain (GLS) at rest to predict the presence of significant CAD and to determine the severity of CAD. The patients underwent transthoracic echocardiography (TTE) to measure 2DSTE to measure GLS. Results: Overall, Left Anterior Descending artery(43.38%) was the commonest vessel involved. Study revealed that mean GLS value was significantly lower in significant CAD (>70% stenosis)i.e. -15.95+ 2.78 than those with non-significant CAD (<70% stenosis) i.e. -20 + 1.73 with p < 0.001. The sensitivity and specificity for SVD, DVD and TVD were67.53% andTVD were67.53% and 89.83%, 88.90% and 82.60%, 85.30% and 70.40% respectively. Conclusion:Global longitudinal strain (GLS) assessed by 2D speckle tracking echocardiography at rest has good sensitivity and specificity to predict the presence, extent and severity of CAD in patients. [ABSTRACT FROM AUTHOR]

Background: Fetal two-dimensional speckle tracking echocardiography (2D-STE) is an emerging technique for assessing fetal cardiac function by measuring global longitudinal strain. Alterations in global longitudinal strain may serve as early indicator of pregnancy complications, making 2D-STE a potentially valuable tool for early detection. Early detection can facilitate timely interventions to reduce fetal and maternal morbidity and mortality. Therefore, the aim of this study was to investigate the feasibility of performing 2D-STE at 16 weeks gestational age. Methods: This pilot study utilized 50 ultrasound clips of the fetal four-chamber view recorded between 15+5 and 16+2 weeks gestational age from a prospective cohort study. A strict protocol assessed three parameters essential for 2D-STE analysis: fetal four-chamber view ultrasound clip quality, region of interest, and frame rates. Two independent researchers measured global longitudinal strain in all adequate fetal four-chamber view ultrasound clips to determine inter- and intra-operator reliability. Results: Out of the 50 ultrasound clips, 37 (74%) were feasible for 2D-STE analysis. The inter-operator reliability for global longitudinal strain measurements of the left and right ventricles was moderate (ICC of 0.64 and 0.74, respectively), while the intra-operator reliability was good (ICC of 0.76 and 0.79, respectively). Conclusions: Our findings demonstrate that fetal 2D-STE analysis at 16 weeks gestational age is feasible when adhering to a strict protocol. However, further improvements are necessary to enhance the inter- and intra-operator reliability of 2D-STE at this gestational age. [ABSTRACT FROM AUTHOR]

Objective: Sleep is a complex event involving various physiological processes. Recent studies during the last few years have shed light on the effects of sleep duration on health. We investigated the cardiac effects of sleep duration on speckle-tracking echocardiography. We divided the patients into 2 groups who slept more or less than 7 hours and evaluated all of them with transthoracic echocardiography. Methods: This study was a retrospective study was conducted to investigate the cardiac effects of sleep duration. Between June 2021 and February 2022, 129 individuals who were admitted to our hospital for routine check-up with no known chronic disease and with normal and good quality echocardiographic examination were included in the study. The patients who were eligible for the study design were called by the investigator to obtain information on average sleep duration, and two groups were defined by the self-reported sleep duration (=7 hours, >7 hours per day) and were used in the statistical analyses. Results: A total of 129 patients [=7 hours (n=80), >7 hours (n=49) per day] were enrolled in this study. All echocardiographic parameters were compared with sleep duration. Among these parameters, left ventricular (LV) global longitudinal strain (GLS) was found to be greater in the group who slept less. (-21.5±2.6 vs. -20.3±2.2 p=0.005). However, being within normal limits, LV end diastolic diameter and right heart chambers were found to be more enlarged in those who slept 7 hours or less than 7 hours. It was also observed that the right atrial volume was higher in the less sleeper group. Conclusion: As a result, GLS, which is one of the parameters showing LV function, was found to be less in healthy people with a sleep time above a certain period, and we believe that this may be a hypothesis to explain the relationship of long sleep time with cardiovascular events. [ABSTRACT FROM AUTHOR]

There is minimal information available regarding the early effects of bronchial asthma (BA) and its treatment on cardiac function in children. We used two-dimensional speckle-tracking echocardiography (2D-STE) to evaluate cardiac function before and after the treatment of childhood BA. We enrolled 44 children with moderate and severe BA who had not been treated over the preceding 3 months or who were newly diagnosed. All children received the same treatment (that recommended by the Global Initiative for Asthma [GINA] in 2017). All children also underwent transthoracic 2D-STE before treatment and 6 months later. Clinical data were compared before and after treatment. After treatment, significant increases were evident in right ventricular (RV) systolic and diastolic strain, as well as the systolic strain rate. Before and after treatment, the RV global longitudinal systolic strains were − 22.8 ± 3.6 and − 25.1 ± 4.5, respectively (p = 0.036); the RV global longitudinal diastolic strains were − 18.5 ± 6.0 and − 21.5 ± 5.2, respectively (p = 0.038); and the RV systolic strain rates were − 1.26 ± 0.4 and − 1.12 ± 0.3, respectively (p = 0.025). After treatment, significant increases were observed in the right atrial (RA) peak longitudinal strain and strain rate. Before and after treatment, the RA peak atrial longitudinal strains were 32.5 ± 10.8 and 44.7 ± 11.2, respectively (p = 0.042) and the RA longitudinal strain rates were − 1.6 ± 0.3 and − 2.0 ± 0.5, respectively (p = 0.041). RV and RA subclinical dysfunction may develop in children with early-stage BA. However, asthma treatment appears to improve such dysfunction. In children with BA, clinical and subclinical changes in cardiac functions can be easily detected via 2D-STE. [ABSTRACT FROM AUTHOR]

Aims Permanent pacemaker (PM) implantation is common after transcatheter aortic valve implantation (TAVI). Left ventricular mechanical dispersion (MeDi) by speckle tracking echocardiography is a marker of fibrosis that causes alterations in the conduction system. We hypothesized that MeDi can be a predictor of the need for PM implantation after TAVI. Methods and results Consecutively, 200 TAVI patients were enrolled. Transthoracic echocardiography and electrocardiography examinations were recorded before TAVI to evaluate global longitudinal strain (GLS), MeDi, and conduction disturbances. PM implantation information was obtained 3 months after TAVI. Patients were stratified into PM or no PM group. Mean age was 80 + 7 years (44% women). Twenty-nine patients (16%) received PM. MeDi, QRS duration, existence of right bundle branch abnormality (RBBB), and first-degree atrioventricular (AV) block were significantly different between groups. MeDi was 57 ± 15 ms and 48 ± 12 ms in PM and no PM groups, respectively (P < 0.001). In multivariate analysis, MeDi predicted the need for PM after TAVI independently of GLS, QRS duration, RBBB, and first-degree AV block [odds ratio (OR): 1.73, 95% confidence interval (CI): 1.22–2.45] with an area under the curve (AUC) of 0.68 in receiver operating characteristic (ROC) curves. Moreover, RBBB was an independent predictor of PM need after TAVI (OR: 8.98, 95% CI: 1.78–45.03). When added to RBBB, MeDi had an incremental predictive value with an AUC of 0.73 in ROC curves (P = 0.01). Conclusion MeDi may be used as an echocardiographic functional predictor of the need for PM after TAVI. [ABSTRACT FROM AUTHOR]

Background: Heart failure with preserved ejection fraction (HFpEF) represents a significant proportion of heart failure cases. Accurate diagnosis is challenging due to the heterogeneous nature of the disease and limitations in traditional echocardiographic parameters. Main body: This review appraises the application of Global Longitudinal Strain (GLS) and Left Atrial Strain (LAS) as echocardiographic biomarkers in the diagnosis and phenotyping of HFpEF. Strain imaging, particularly Speckle Tracking Echocardiography, offers a superior assessment of myocardial deformation, providing a more detailed insight into left heart function than traditional metrics. Normal ranges for GLS and LAS are considered, acknowledging the impact of demographic and technical factors on these values. Clinical studies have demonstrated the prognostic value of GLS and LAS in HFpEF, especially in predicting cardiovascular outcomes and distinguishing HFpEF from other causes of dyspnea. Nevertheless, the variability of strain measurements and the potential for false-negative results underline the need for careful clinical interpretation. The HFA-PEFF scoring system's integration of these biomarkers, although systematic, reveals gaps in addressing the full spectrum of HFpEF pathology. The combined use of GLS and LAS has been suggested to define HFpEF phenogroups, which could lead to more personalized treatment plans. Conclusion: GLS and LAS have emerged as pivotal tools in the non-invasive diagnosis and stratification of HFpEF, offering a promise for tailored therapeutic strategies. Despite their potential, a structured approach to incorporating these biomarkers into standard diagnostic workflows is essential. Future clinical guidelines should include clear directives for the combined utilization of GLS and LAS, accentuating their role in the multidimensional assessment of HFpEF. [ABSTRACT FROM AUTHOR]

Introduction: Cardiac sarcoidosis (CS) is commonly diagnosed based on clinical criteria and abnormalities in noninvasive imaging reported in patients with biopsy‐proven extracardiac sarcoidosis. Electrocardiogram and two‐dimensional echocardiography have a low sensitivity for CS detection. Cardiovascular magnetic resonance imaging (CMR) and positron emission tomography (PET) have limitations in terms of cost and availability. Objectives: This study aimed to assess the usefulness of left ventricular longitudinal strain, measured using two‐dimensional speckle tracking echocardiography (STE), for the prediction of late gadolinium enhancement (LGE) presence in CMR in patients with biopsy‐proven sarcoidosis. Patients and Methods: A total of 119 patients with biopsy‐proven extracardiac sarcoidosis were divided, according to the clinical criteria proposed by the 2014 Heart Rhythm Society expert consensus statement (HRS 2014), into two groups: 43 individuals with "probable cardiac sarcoidosis", CS(+) and 76 individuals without cardiac sarcoidosis, CS (−). Data from echocardiography, CMR, 12‐lead ECG and 24 h Holter monitoring were analyzed. Results: Left ventricular global longitudinal strain (LV‐GLS) was slightly reduced in the entire sarcoidosis group (−18.61± 2.96), no difference between the CS (+) and CS (−) subgroups was found (−18.0% ± 3.2% and −18.9% ± 2.8%, respectively; p =.223). No cut‐off value for LV‐GLS was identified that could predict the presence of LGE. Segmental longitudinal strain impairment partially correlated with the presence of LGE on CMR. Conclusions: In our cohort of sarcoidosis patients, segmental longitudinal strain proved more helpful in the diagnostic process than LV‐GLS. The ultimate role of STE in the diagnosis of CS remains to be established. [ABSTRACT FROM AUTHOR]

BACKGROUND: Heart failure (HF) is considered the leading cause of cardiac-related morbidity and mortality during pregnancy. Peripartum cardiomyopathy (PPCM) presents diagnostic challenges, often mirroring dilated cardiomyopathy (DCM). The aim of the study is to evaluate echocardiographic features, including global and segmental longitudinal strain values, in pregnant women with a history of newly diagnosed left ventricular systolic dysfunction (LVSD) in the third trimester of pregnancy. METHODS: This cross-sectional study, conducted in two referral cardio-obstetric clinics in Isfahan, Iran, enrolled pregnant women with newly diagnosed LV systolic dysfunction in the third trimester of pregnancy. A multidisciplinary pregnancy heart team assessed the patients. Reevaluation of patients and advanced echocardiographic investigation, including speckle tracking echocardiography (STE), were performed at least six months after delivery. RESULTS: The study included 26 pregnant women. Baseline characteristics revealed varying NYHA functional classes and etiologies, including DCM or non-dilated LV cardiomyopathy and PPCM. Undiagnosed DCM with exacerbation during pregnancy or non-dilated LV cardiomyopathy were the most probable causes for LV systolic dysfunction (65.4%). In five cases, peripartum cardiomyopathy was more relevant. The mean global longitudinal strain (GLS) was -16.94% and -13.95% in PPCM and DCM, respectively. Significantly different regional longitudinal strain numbers among different LV segments in PPCM were observed (P=.042), whereas the segmental strain in DCM patients did not differ. CONCLUSION: When LVSD is discovered late in pregnancy, it is not easy for the authors to differentiate between peripartum cardiomyopathy and other cardiomyopathies. Advanced echocardiographic techniques, particularly GLS analysis, may be valuable in differentiating between these conditions. [ABSTRACT FROM AUTHOR]

Background and Objectives: Glucagon-like peptide-1 receptor agonists (GLP-1RA) and sodium-glucose cotransporter-2 inhibitors (SGLT-2i) are cardioprotective drugs. We investigated their effects on left atrial function, a major determinant of cardiac diastolic dysfunction in type 2 diabetes mellitus. We also explored the association of changes in arterial stiffness with those of the LA strain after treatment. Materials and Methods: A total of 200 patients (59.5 ± 9.1 year old, 151 male) with type 2 diabetes mellitus treated with metformin were randomized to insulin (n = 50 served as controls), liraglutide (n = 50), empagliflozin (n = 50) or their combination (liraglutide + empagliflozin) (n = 50). We measured at baseline and 6 months post-treatment: (a) left atrial and global left ventricular longitudinal strain by speckle tracking echocardiography; (b) pulse wave velocity (PWV) and central systolic blood pressure. Results: At baseline, there was a correlation of the LA reservoir strain with PWV (r = −0.209, p = 0.008), central SBP (r = −0.151, p = 0.030), EF (r = 0.214, p = 0.004) and GLS (r = −0.279, p = 0.009). The LA reservoir change 6 months post-treatment was correlated with the PWV change in all groups (r = −0.242, p = 0.028). The LA reservoir change 6 months post-treatment was correlated with the GLS change in all groups (r = −0.322, p = 0.004). Six months after intervention, patients treated with liraglutide, empagliflozin and their combination improved the left atrial reservoir strain (GLP1RA 30.7 ± 9.3 vs. 33.9 ± 9.7%, p = 0.011, SGLT2i 30 ± 8.3 vs. 32.3 ± 7.3%, p = 0.04, GLP1&SGLT2i 29.1 ± 8.7 vs. 31.3 ± 8.2, p = 0.007) compared to those treated with insulin (33 ± 8.3% vs. 32.8 ± 7.4, p = 0.829). Also, patients treated with liraglutide and the combination liraglutide and empagliflozin had improved left atrial conduction strain (p < 0.05). Empagliflozin or the combination liraglutide and empagliflozin showed a greater decrease of PWV and central and brachial systolic blood pressure than insulin or GLP-1RA. (p < 0.05). Conclusions: Impaired aortic elastic properties are associated with a decreased LA strain in type 2 diabetics. Treatment with liraglutide, empagliflozin and their combination for 6 months showed a greater improvement of left atrial function compared to insulin treatment in parallel with the improvement of arterial and myocardial functions. [ABSTRACT FROM AUTHOR]

Introduction: Cardiac fibres are affected invariably in myocardial infarction, with longitudinal strain being the earliest to be detected in the ischaemic cascade. The present study aims to assess strain imaging in acute myocardial infarction (AMI) patients admitted to the cardiology department at our institute and correlate GLS and DESL findings with other markers for myocardial function. Methods and material: This augmented cross-sectional study was conducted amongst the patients admitted with diagnosis of AMI. During the study period, 157 subjects were sampled through convenience sampling, and examined as well as tested with routine investigations at baseline. The subjects were then followed through at first, third and six months, and findings noted. Chi-square was used to assess the crude association between sample characteristics. Pearson correlation and student t-test were used to find association between continuous variables. Results: After screening 564 patients, 157 patients were included in the study after fulfilment of inclusion and exclusion criteria. A significant difference was found in baseline GLS scores and NTproBNP levels at 6 months in alive patients with STEMI, t (21.728) = −5.717, p