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The left atrial volume index ( LAVI) is a biomarker of diastolic dysfunction and a predictor of cardiovascular events. Three-dimensional echocardiography (3 DE) is highly accurate for LAVI measurements but is not widely available. Furthermore, biplane two-dimensional echocardiography (B2 DE) may occasionally not be feasible due to a suboptimal two-chamber apical view. Simplified single plane two-dimensional echocardiography (S2 DE) could overcome these limitations. We aimed to compare the reliability of S2 DE with other validated echocardiographic methods in the measurement of the LAVI. We examined 143 individuals (54 ± 13 years old; 112 with heart disease and 31 healthy volunteers; all with sinus rhythm, with a wide range of LAVI). The results for all the individuals were compared with B2 DE-derived LAVIs and validated using 3 DE. The LAVIs, as determined using S2 DE (32.7 ± 13.1 mL/m2), B2 DE (31.9 ± 12.7 mL/m2), and 3 DE (33.1 ± 13.4 mL/m2), were not significantly different from each other (P = 0.85). The S2 DE-derived LAVIs correlated significantly with those obtained using both B2 DE (r = 0.98; P < 0.001) and 3 DE (r = 0.93; P < 0.001). The mean difference between the S2 DE and B2 DE measurements was <1.0 mL/m2. Using the American Society of Echocardiography criteria for grading LAVI enlargement (normal, mild, moderate, severe), we observed an excellent agreement between the S2 DE- and B2 DE-derived classifications (κ = 0.89; P < 0.001). S2 DE is a simple, rapid, and reliable method for LAVI measurement that may expand the use of this important biomarker in routine echocardiographic practice. [ABSTRACT FROM AUTHOR]

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Abstract: Background: Obstructive sleep apnoea (OSA) is a predictor of right ventricle (RV) impairment. However, there is scant information on the effect of OSA treatment on RV performance. We sought to evaluate the impact of OSA treatment with a continuous positive airway pressure (CPAP) device on RV volume and function, as well as on variables related to pulmonary vascular haemodynamics. Methods: Fifty-six OSA patients and 50 controls were studied. All individuals underwent three-dimensional echocardiogram (3DE) to estimate RV volumes, function, pulmonary vascular resistance, and tricuspid regurgitation velocity. A total of 30 patients with apnoea-hypopnoea index greater than 20 were randomly selected to receive placebo (n =15) or effective CPAP (n =15) for 24weeks. They underwent 3DE examination on three different occasions: at baseline, after 12weeks, and after 24weeks of CPAP or placebo. Results: Higher pulmonary vascular resistance (2.1 Wood’s±0.5 vs. 1.8 Wood’s±0.4), larger end-diastolic RV volume index (52.2mL/m2 ±7.3 vs. 49.9mL/m2 ±6.0), larger end-systolic RV volume index (18.7mL/m2 ±4.3 vs. 15.4mL/m2 ±3.6), and lower RV ejection fraction (64.3%±6.8 vs. 68.4%±5.9) were observed in the OSA group compared to non-OSA controls (P <0.05, all). In the effective CPAP group we observed the following changes from the baseline to the 24-week echo evaluation: (A) reduction in pulmonary vascular resistance (2.2 Wood’s±0.3 to 1.8 Wood’s±0.3); (B) reduction in the RV end-systolic volume index (20.3mL/m2 ±4.5 to 16mL/m2 ±2.1); and (C) increase in RV ejection fraction (63.0%±7.2 to 70.8%±0.9) (P <0.05 for all). Conclusion: Twenty-four-week treatment with CPAP improved RV performance but did not change RV structural variables. [Copyright &y& Elsevier]

Background: There is a paucity of information concerning left ventricular (LV) dyssynchrony assessment by real time three-dimensional (3D) echocardiography (RT3DE) versus tissue Doppler imaging (TDI). Aims: To compare RT3DE and TDI LV dyssynchrony assessment. Methods: A prospective study of 92 individuals (56 men, age 47 ± 10 years), 32 with dilated cardiomyopathy (CMP), and 60 healthy individuals. By RT3DE, we measured the LV% dyssynchrony index (DI) of 6, 12, and 16 segments (SDI). By pulsed-wave TDI, we measured the QS electromechanical interval in the basal segments of the mitral valve annulus of the septum, the lateral, anterior and inferior walls, and the TDI% DI. Results: In the normal group, the 3D DI was 1.1 ± 0.8%, 1.4 ± 1.3%, 1.8 ± 1.7%, for 6 segments, 12 segments, and SDI, respectively. The correlation coefficient (Pearson's r) for the TDI DI and SDI was r = 0.2381 (P = 0.0470). In CMP group, the 3D DI was 4.6 ± 5.4%, 7.9 ± 7.1%, 11.1 ± 7.1%, for 6 segments, 12 segments, and SDI, respectively. The correlation coefficient for TDI DI and SDI was r = 0.7838 (P < 0.0001). Conclusions: We observed a good correlation between RT3DE and tissue Doppler LV dyssynchrony assessment in patients with advanced heart failure. [ABSTRACT FROM AUTHOR]