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Background Atrial myopathy (AM) is an entity reflecting left atrial (LA) structural and electrical remodeling, connected to atrial fibrillation (AF) development and heart failure progression in various substrates. In hypertrophic cardiomyopathy (HCM), prevalence of AM beyond AF and its correlations are not fully investigated. Purpose Aim of this study was to estimate the prevalence of AM in a cohort of HCM patients without AF history through assessment of LA volume index (LAVI), LA reservoir strain (LARS) and total atrial conduction time (TACT) (estimated by tissue Doppler imaging). Additionally, to investigate AM indices' correlation with other phenotypic and functional characteristics of HCM. Methods We included 50 HCM patients (60±16 years, 80% male, maximum wall thickness 18.6±4.1mm) without history of AF who have consecutively undergone 2D-speckle tracking echocardiography and cardiovascular magnetic resonance (CMR) with late gadolinium enhancement (LGE). TACT and LARS measurement is shown on left panel. Burden of fibrosis (percentage of LV mass) was defined by LGE extent (>5 standard deviations compared to nulled myocardium) in CMR slices. Cut-off points for TACT, LAVI and LARS were adopted by literature (≥115 msec, ≥34 mL/m2 and Results All HCM patients had preserved EF (61.8±8%), while 13 (26%) presented outflow tract obstruction and 4 (8%) diastolic dysfunction stage≥2. LGE was observed in 32 patients (64%) occupying 7.2±5% of left ventricular (LV) mass. Mean TACT was 139.9±22 msec, with LAVI being 30.8±16.1 mL/m2 and LARS 27.6±13.9%. After assessing prevalence of AM parameters, 41 patients (82%) presented a prolonged (≥115 msec) TACT with only 13 of them having also a significantly dilated LA (≥34 mL/m2) and 16 an impaired LARS. Among HCM demographic, phenotypic and functional characteristics tested, age and LV mass index were found to be the only independent regressors of TACT (r=0.54, p Conclusions Atrial electro-mechanical delay assessed through TDI based TACT, is the most frequent AM parameter among HCM patients irrespective of AF and even before LA dilatation and LA strain impairment. AM parameters seem to correlate with various morphological and functional characteristics of HCM, their significance, however, in predicting progression towards AF development or HF presentation remains to be elucidated. Funding Acknowledgement Type of funding sources: None.

Background/Introduction In a significant proportion of patients with neurally-mediated syncope (NMS), the mechanism of syncope remains largely undetermined. Adenosine has been proposed as a central humoral factor in various forms of NMS: high Adenosine Plasma Levels (ADP) are encountered in patients with vasovagal syncope (VVS), low ADP in non-prodromes syncope (NPS), while ADP in patients with situational syncope SS are less well determined. Purpose We sought to assess ADP in patients with different clinical forms of syncope, with an emphasis on the presence or absence of prodromal symptoms, as well as the relation between ADP and the outcomes of Head-Up Tilt Table Test (HUTT) and Adenosine test (ADT). Methods Patients with different clinical types of NMS (n=124), i.e., VVS, NPS, or SS, were investigated using a standard protocol including HUTT and ADT. During HUTT, ADP was measured in the supine position, at table tilting, and in syncope. Results Baseline ADP did not differ among groups. ADP at syncope were higher in NPS compared to VVS (1.55±1.29 vs 0.16±0.05 μM, p=0.03) and SS (0.15±0.05 μM, p=0.02). In NPS, ADP increased from the supine position to the time of syncope (0.47±0.25 to 1.55±1.29 μM, p=0.04). In VVS, ADP increased only from the supine to the tilt position (0.23±0.04 to 0.35±0.10 μMu, p=0.02), while in SS ADP did not change in any stage of HUTT. SS was associated with cardioinhibitory HUTT (OR 3.40, 95% CI 1.05 to 9.56, p=0.04) and positive ADT (OR 4.22, 95% CI 1.47 to 11.46, p=0.012). Conclusion(s) A distinct pattern of ADP increase is noted during HUTT in NPS, suggesting that an excessive increase of ADP may play the key role in triggering this type of clinical presentation of syncope independently of the baseline ADP. Cardioinhibition prevails in patients with SS without clear adenosine involvement. Such observations contribute to an enhanced understanding of the pathophysiology of different clinical forms of syncope which may offer the possibility to tailor the management approach appropriately. Funding Acknowledgement Type of funding sources: None.

Dans La vie des hommes infâmes, Michel Foucault entend travailler un corpus d’archives d’enfermement, de la police, de placets au roi et de lettres de cachet afin de les faire parler de manière à ce qu’ils rendent compte de l’infimité des existences ayant traversé l’histoire. Or, il est y est bien plus volontiers question des présumés vauriens et des canailles que de leurs proies, souffre-douleurs ou victimes. Dit autrement, Foucault s’intéresse bien plus aux personnages des « nouvelles » qu’il collecte – à ces « ces vies infimes devenues cendres dans les quelques phrases qui les ont abattues » – qu’à leurs auteurs à proprement parler. Il semble donc qu’on puisse voir se profiler deux types d’infamies chez Foucault : celle, infime, des existences indignes de la mémoire des hommes – et de ce point de vue, les scripteurs sont sans aucun doute plus infâmes encore que ceux qu’ils accusent – et celle, immonde, des criminels, avérés ou présumés, qui furent internés à la demande des premiers – et de ce point de vue, bien qu’il entende rester du côté des vies ordinaires (des hommes et des femmes sans fama), Foucault a bien raison de noter que des Gilles de Rais et Sade sont maîtres en la matière. L’infamie de Foucault navigue ainsi dans l’épaisseur poétique qui va de l’une à l’autre.A partir du cas des rats de Paris, cette proposition de communication entend étudier la façon ces animaux de la ville ont, au 19ème siècle et jusqu’à une date récente, été considérés comme un infâme-infime de la ville pour en devenir aujourd’hui des infâmes-immondes.

Background The contribution of atrial and ventricular function in neurocardiogenic syncope (NCS) pathophysiology is elusive. Hypothesis We assessed the influence of echocardiographic properties to the age of presentation and NCS recurrences. Methods We assigned 124 patients with symptoms suggesting NCS, to those with syncope initiation at age 35 years (group B, n = 68). Echocardiographic indices were measured before head‐up tilt test (HUTT). Results A total of 55 had positive HUTT (44%) with a trend favoring group A (p = .08). Group A exhibited lower left atrial (LA) volume index (17 ± 6 vs. 22 ± 11 ml/m2, p = .015), higher LA ejection fraction (69 ± 10 vs. 63 ± 11%, p = .008), LA peak strain (reservoir phase 41 ± 13 vs. 31 ± 14%, p = .001, contraction phase 27 ± 11 vs. 15 ± 10%, p 3 recurrences (82.0% vs. 50.1%, p

The regular open subsets of a topological space form a Boolean algebra, where the `join' of two regular open sets is the interior of the closure of their union. A `credence' is a finitely additive probability measure on this Boolean algebra, or on one of its subalgebras. We develop a theory of integration for such credences. We then explain the relationship between credences, residual charges, and Borel probability measures. We show that a credence can be represented by a normal Borel measure, augmented with a `liminal structure', which specifies how two or more regular open sets share the probability mass of their common boundary. In particular, a credence on a locally compact Hausdorff space can be represented by a normal Borel measure and a liminal structure on the Stone-\v{C}ech compactification of that space. We also show how credences can be represented by Borel measures on the Stone space of the underlying Boolean algebra of regular open sets. Finally, we show that these constructions are functorial., Comment: To appear in Real Analysis Exchange (https://msupress.org/journals/real-analysis-exchange/). 62 pages, two figures. Changes from previous version: Slight improvements to Section 8