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Epicardial adipose tissue (EAT) is a metabolically active visceral fat depot. Although EAT volume is associated with the incidence and burden of atrial fibrillation (AF), its role in subclinical left atrial (LA) dysfunction is unclear. This study aims to evaluate the relationships between EAT volumes, LA function, and LA global longitudinal strain.One hundred and thirty people without obstructive coronary artery disease or AF were prospectively recruited into the study in Australia and underwent cardiac computed tomography and echocardiography. EAT volume was quantified from cardiac computed tomography. Echocardiographic 3-dimensional (3D) volumetric measurements and 2D speckle-tracking analysis were performed.Using the overall median body surface area-indexed total EAT volume (EATi), the study cohort was divided into 2 groups of larger and smaller EATi volume. Subjects with larger EATi volume had significantly impaired LA reservoir function (3D LA ejection fraction, 46.1% ± 8.9% vs 49.0% ± 7.0%, P = 0.044) and reduced LA global longitudinal strain (37.6% ± 10.2% vs 44.1% ± 10.7%, P0.001). Total EATi volume was a predictor of impaired 2D LA global longitudinal strain (standardized β = -0.204, P = 0.034), reduced 3D LA ejection fraction (standardized β = -0.208, P = 0.036), and reduced 3D active LA ejection fraction (standardized β = -0.211, P = 0.017). Total EATi volume, rather than LA EATi volume, was the more important predictor of LA dysfunction.Indexed EAT volume is independently associated with subclinical LA dysfunction and impaired global longitudinal strain in people without obstructive coronary artery disease or a history of AF.

Background: Chronic right ventricular pacing may contribute to deterioration in left ventricular ejection fraction (LVEF). The aim of the study was to identify the prevalence of pacing-induced cardiomyopathy (PICM) in patients with chronic right ventricular pacing. Methods: Patients attending a pacemaker clinic were retrospectively identified as having had transthoracic echocardiographic LVEF measurement during the 12 months prior to device implantation. Those with cardioverter-defibrillators or biventricular devices were excluded. The remaining patients were invited back for a repeat echocardiogram. Three different definitions of PICM were employed: 1) follow-up LVEF of ≤40% if baseline LVEF was ≥50%, or an absolute reduction in LVEF ≥5% if baseline LVEF was

Background: The CHA2DS2-VASc score is the standard of care in thromboembolic risk assessment for patients with non-valvular atrial fibrillation (AF). Most patients will undergo transthoracic echocardiography (TTE) for further evaluation, and many also having transesophageal echocardiography (TEE) performed prior to cardioversion or ablation. We sought to evaluate the relationship between left atrial (LA) abnormalities detected on TEE and TTE parameters, to determine if imaging may be additive in risk assessment.Methods: Clinical, TEE and TTE data for patients in AF at the time of their study were included in this retrospective analysis. LA/LA appendage (LAA) abnormalities on TEE included the presence of spontaneous echo contrast, sludge, thrombus and LAA emptying velocity 90% in both groups. Median LAVI, septal e’ and E wave velocity in the ≤ 1 vs ≥2 groups were 46ml/m2vs 48ml/m2, 8cm/s vs 6cm/s and 0.8m/s vs 0.8m/s, respectively. Overall, increased LAVI and reduced septal e’ on TTE was associated with TEE LA/LAA abnormalities (p=0.02, p=0.005 respectively). In subgroup analysis, it was found that LAVI and septal e’ was statistically significant in the low CHA2DS2-VASc group (p=0.03, p =0.01), but not in the higher CHA2DS2-VASc group (p=0.21, p=0.30).Conclusion: TEE LA/LAA abnormalities were not infrequently noted in those patients traditionally deemed low risk (CHA2DS2-VASc ≤ 1). LAVI and septal e’ on TTE appear to be associated with LA/LAA abnormalities detected on TEE, which was particularly relevant in lower CHA2DS2-VASc patients and may be additive to conventional clinical risk assessment. Further study is needed to evaluate the role of imaging in AF thromboembolic risk stratification, and whether this translates to prognostic and clinical endpoints.

D. Harrop1,∗, M. Fryer 1, V. Indrajith 1, S. Butterly 2, B. Lowe3, A. Ng1,4, W. Wang1,4 1 Department of Cardiology, Princess Alexandra Hospital, Brisbane, Australia 2 Department ofCardiovascularMedicine, Sir CharlesGairdner Hospital, Perth, Australia 3 Department of EmergencyMedicine, Princess Alexandra Hospital, Brisbane, Australia 4 University of Queensland, School of Medicine, Brisbane, Australia

The evidence base for echocardiography in blunt chest trauma remains an area of ongoing investigation. Based on first principles, contemporary real world practicemandates echocardiography testing in patients with cardiac specific biomarker (troponin (TnI)) elevation. Prediction of echocardiogram abnormalities based on TnI elevation has not been formally evaluated in this patient category. Methods: Retrospective analysis of all patients presenting with blunt chest trauma, without established underlying cardiac disease, over a calendar year, included in a trauma database in our tertiary hospital. All patient presentations with chest trauma were reviewed and TnI values and echocardiograms independently audited. Results: 337 patients presented to our tertiary trauma centre secondary to blunt force chest trauma during a full 631