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• The effect of pPE on CCA-IMT has been poorly investigated. • 13 studies on CCA-IMT in pPE women were sistematically analyzed. • Average CCA-IMT was slightly, but significantly, increased in pPE women vs controls. • The overall effect of pPE on CCA-IMT was small and not statistically significant. • Intensive therapy, late-onset PE and short follow-up may explain these findings. During the last two decades, a few studies have evaluated the common carotid artery (CCA) intima-media thickness (IMT) in women with previous history of pre-eclampsia (pPE) in comparison to women with uncomplicated pregnancies, providing not univocal results. This systematic review and meta -analysis has been designed to summarize the main findings of these studies and to examine the overall influence of pPE on CCA-IMT. All studies assessing CCA-IMT in pPE women in comparison to women who had uncomplicated pregnancies, selected from PubMed and EMBASE databases, were included. Studies evaluating women with previous history of early-onset (EO) or late-onset (LO) PE vs healthy controls were separately analyzed. Continuous data (CCA-IMT) were pooled as a standardized mean difference (SMD) comparing pPE group with healthy controls. The subtotal and overall SMDs of CCA-IMT were calculated using the random-effect model. The full-texts of 12 studies with 583 pPE women and 610 healthy controls were analyzed. The average time after delivery was 8.5 yrs (range 1.1–20 yrs). The average CCA-IMT was significantly increased in pPE women than healthy controls in five studies (41.7 % of total), whereas it was similar between the two study groups or surprisingly reduced in pPE women vs controls in more than half of studies (58.3 % of total). The effect of pPE on CCA-IMT was very small for the studies including women with previous LO-PE (subtotal SMD 0.067, 95 %CI −0.339,0.472, P = 0.75) and small for those analyzing women with previous EO-PE (subtotal SMD 0.250, 95 %CI-0.231,0.732, P = 0.31). Overall, the effect of pPE on CCA-IMT was small and not statistically significant (SMD 0.143, 95 %CI −0.167,0.453, P = 0.37). Substantial heterogeneity was detected for the included studies, with an overall I2 statistic value of 81 % (P < 0.001). Egger's test for a regression intercept yielded a P-value of 0.58, indicating no publication bias. On meta -regression analysis, none of the moderators and/or potential confounders was significantly associated with effect modification (all P > 0.05). Women with previous history of PE have an increased burden of cardiovascular risk factors, but do not appear to be affected by significant subclinical carotid atherosclerosis, up to 20 years postpartum. [ABSTRACT FROM AUTHOR]

Background: During the last decades, a small number of studies reported a wide range of variability in the estimated prevalence of mitral valve prolapse (MVP) among individuals with pectus excavatum (PE). The present systematic review and meta-analysis has been primarily designed to summarize the main findings of these studies and to estimate the overall prevalence of MVP among PE individuals. Methods: All imaging studies assessing the prevalence of MVP in PE individuals vs. healthy controls, selected from PubMed and EMBASE databases, were included. The risk of bias was assessed by using the National Institutes of Health (NIH) Quality Assessment of Case–Control Studies. Events (presence of MVP) and nonevents (absence of MVP) in PE individuals and control groups were recorded. The main outcome was the measure of odds ratio (OR) for MVP presence pooled with 95% confidence intervals, using a fixed-effects model. Results: The full texts of eight studies with 303 PE patients (mean age 25.7 yrs) and 498 healthy controls (mean age 31 yrs) were analyzed. Three studies assessed MVP prevalence in children and early adolescents, whereas the remaining five studies examined PE adults. The prevalence of MVP in PE individuals and healthy controls was 40.6% and 12.8%, respectively. In the pooled sample, the OR for MVP presence was significantly higher in PE individuals compared to controls (OR = 5.80, 95%CI = 3.83–8.78, Z = 8.30, p < 0.001). Subgroup analysis revealed that MVP prevalence was approximately three-fold higher among PE children and early adolescents compared with PE adults. Overall, high consistency was observed in the pooled effect sizes, due to the low statistical heterogeneity among the included studies (I2 = 22.7%, p = 0.25). Egger's test for a regression intercept gave a p-value of 0.07, indicating no publication bias. The sensitivity analysis supported the robustness of the results. Conclusions: PE individuals are nearly six times more likely to have MVP than controls. MVP prevalence is three-fold higher in PE individuals during childhood and early adolescence, compared to PE adults. Given the strong association between MVP and PE, MVP should be suspected in all individuals with anterior chest wall deformity. [ABSTRACT FROM AUTHOR]

Background: To date, only a few studies have evaluated left atrial (LA) mechanics in patients with atrial fibrillation (AF) scheduled for electrical cardioversion (ECV). The present systematic review has been primarily designed to summarize the main findings of these studies and to examine the overall effect of AF on left atrial reservoir strain (LASr) in patients undergoing ECV. Methods: All the echocardiographic studies evaluating the effect of AF on LA mechanics in patients scheduled for ECV, selected from the PubMed and EMBASE databases, were included. There was no limitation of time period. The risk of bias was assessed by using the National Institutes of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Results: The full texts of 12 studies with 880 AF patients were analyzed. The pooled ECV success rate was 91.5% (range 65.8–100%). Over a median follow-up of 5.4 months (range 0.3–12 months), 35.2% of the patients (range 5–68.8%) experienced AF recurrence. At baseline, the average LASr was 11.4% (range 6.2–17.7%). A reduced LASr before ECV was strongly correlated with reduced left atrial appendage (LAA) flow velocities and/or thrombosis. The main independent predictors of cardioversion failure were impaired LASr and previous AF history. A severe LASr deterioration was independently correlated with AF recurrence after ECV. The other independent predictors of AR relapses were LA asynchrony, reduced difference between post- and pre-ECV LASr, and reduced right atrial reservoir strain. Conclusions: LASr assessment before ECV may provide useful prognostic information about AF relapses and improve the refinement of the thromboembolic risk of AF patients scheduled for ECV. [ABSTRACT FROM AUTHOR]

Background: Over the last five decades, a fair number of echocardiographic studies have evaluated the prevalence of mitral valve prolapse (MVP) in various cohorts of individuals, including heterogeneous study populations. The present systematic review has been primarily designed to summarize the main findings of these studies and to estimate the overall MVP prevalence in the general community. Methods: All echocardiographic studies assessing the MVP prevalence in various cohorts of individuals, selected from PubMed and EMBASE databases, were included. There was no limitation of time period. The risk of bias was assessed by using the National Institutes of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Results: The full texts of 21 studies with 1354 MVP individuals out of 63,723 participants were analyzed. The overall pooled prevalence of MVP was 4.9% (range of 0.6–21%). When dividing the studies in two groups according to the echocardiographic criteria used for MVP diagnosis (less specific old criteria or more specific new criteria, respectively), the estimated pooled prevalence of MVP was 7.8% (range of 2–21%) for the older studies (performed between 1976 and 1998) and 2.2% (range of 0.6–4.2%) for the more recent ones (conducted between 1999 and 2021). Potential selection bias, hospital- or referral-based series, and the use of less specific echocardiographic criteria for MVP diagnosis have been indicated as the main reasons for the higher MVP prevalence detected by the older studies. MVP was commonly associated with a narrow antero-posterior thoracic diameter, isolated ventricular premature beats and nonspecific ST-T-wave abnormalities on a resting electrocardiogram, mild-to-moderate mitral regurgitation (MR), the reduced probability of obstructive coronary artery disease, and a low frequency of serious complications, such as severe MR, infective endocarditis, heart failure, stroke, and atrial fibrillation. Conclusions: MVP has a low prevalence in the general population, regardless of age, gender, and ethnicity, and is associated with a good outcome. [ABSTRACT FROM AUTHOR]

• The influence of HDPs on LASr has been poorly investigated. • 8 studies on left atrial mechanics in HDP women were sistematically analyzed. • HDPs are associated with cardiac remodeling and subtle diastolic dysfunction. • HDPs are independently associated with LASr impairment in pregnancy. • Hemodynamic, metabolic and anthropometric factors may contribute to LASr impairment. The influence of hypertensive disorders of pregnancy (HDP) on left atrial (LA) mechanics assessed by speckle tracking echocardiography (STE) has been poorly investigated. Accordingly, we performed a meta-analysis to summarize the main findings of STE studies who measured LA reservoir (LASr), conduit (LAScd) and contractile (LASct) strain in HDP women. All echocardiographic studies assessing LA strain parameters in HDP women vs. healthy controls, selected from PubMed and EMBASE databases, were included. The risk of bias was assessed by using the National Institutes of Health (NIH) Quality Assessment of Case-Control Studies. Continuous data (LASr, LAScd and LASct) were pooled as standardized mean difference (SMD) comparing HDP group with healthy controls. The overall SMDs of LASr, LAScd and LASct were calculated using the random-effect model. The full-texts of 8 studies with 566 HDP women and 420 healthy pregnant women were analyzed. Average LASr (34.3 ± 6.4 vs 42.7 ± 5.3 %, P = 0.01) and LAScd (23.4 ± 6.3 vs 32.5 ± 6.0 %, P < 0.001) were significantly lower in HDP women than controls, whereas LASct (−13.0 ± 5.4 vs −13.7 ± 4.5 %, P = 0.18) was similar in the two groups of women. Substantial heterogeneity was detected among the studies evaluating LASr (I2 = 94.3 %), LAScd (I2 = 64.9 %) and LASct (I2 = 86.4 %). SMDs were large and statistically significant for LASr (−1.70, 95 %CI −2.34,-1.06, P < 0.001) and LAScd (−1.35, 95 %CI −1.69,-1.00, P < 0.001), small and not statistically significant for LASct (−0.11, 95 %CI −0.60,0.39, P = 0.678) assessment. Egger's test gave P-values of 0.10, 0.34 and 0.75 for LASr, LAScd and LASct measurement respectively, indicating no publication bias. On meta-regression analysis, none of the moderators was significantly associated with effect modification for LASr and its components (all P < 0.05). HDPs are independently associated with LASr impairment in pregnancy. STE allows to identify, among HDP women, those who might benefit from a more aggressive antihypertensive treatment and/or a closer clinical follow-up, aimed at reducing the risk of adverse maternal outcome and cardiovascular complications later in life. [ABSTRACT FROM AUTHOR]

Aims: The association between gestational diabetes mellitus (GDM) and common carotid artery (CCA) intima-media thickness (IMT) is still controversial. This systematic review and meta-analysis was performed to assess the correlation between GDM and CCA-IMT in and after pregnancy. Methods: PubMed and EMBASE databases were systematically reviewed on April 2023. Studies measuring CCA-IMT in both pregnant women with GDM and women with previous history of GDM (pGDM) vs. healthy controls were included. The subtotal and overall standardized mean differences (SMDs) of CCA-IMT were calculated using the random-effect model. Results: Nineteen studies with a total of 302 GDM and 861 pGDM women were analyzed. The average value of CCA-IMT measured in GDM/pGDM (0.59 ± 0.12 mm) was slightly increased in comparison to the accepted reference limits of IMT according to age classes. Substantial heterogeneity was detected for the studies involving both GDM and pGDM women, with an overall statistic I2 of 86.0% (p < 0.001). Large SMDs were obtained for the studies conducted on both GDM and pGDM women, with an overall SMD of 0.89 (95%CI 0.63–1.15, p < 0.001). Egger's test for a regression intercept gave a p-value of 0.37, indicating no publication bias. On meta-regression analysis, all potential confounders (number of patients, age at pregnancy, body mass index, measuring time, follow-up duration and GDM criteria) were not significantly associated with effect modification. Conclusions: GDM in and after pregnancy is independently associated with subclinical atherosclerosis. The association between GDM and carotid remodeling is potentially mediated by the longstanding underlying risk. [ABSTRACT FROM AUTHOR]

• The relationship between GDM and LV-GLS has been poorly investigated. • 10 studies assessing LV-GLS in GDM women were analyzed. • Average LV-GLS magnitude was significantly lower in GDM women than controls. • GDM was independently associated with LV-GLS impairment in pregnancy. • Pathophysiological mechanisms of GDM cardiac remodeling are discussed. The correlation between gestational diabetes mellitus (GDM) and subclinical myocardial dysfunction has been poorly investigated. Accordingly, we performed a meta-analysis to examine the influence of GDM on left ventricular (LV) global longitudinal strain (GLS), assessed by speckle tracking echocardiography (STE), during pregnancy. All echocardiographic studies assessing conventional echoDoppler parameters and LV-GLS in GDM women vs. healthy controls, selected from PubMed and EMBASE databases, were included. The risk of bias was assessed by using the National Institutes of Health (NIH) Quality Assessment of Case-Control Studies. The subtotal and overall standardized mean differences (SMDs) of LV-GLS were calculated using the random-effect model. The full-texts of 10 studies with 1147 women with GDM and 7706 pregnant women without diabetes were analyzed. GDM women enrolled in the included studies were diagnosed with a small reduction in LV-GLS in comparison to controls (average value −19.4 ± 2.5 vs −21.8 ± 2.5 %, P < 0.001) and to the accepted reference values (more negative than −20 %). Substantial heterogeneity was detected for the included studies, with an overall statistic value I2 of 94.4 % (P < 0.001). Large SMDs were obtained for the included studies, with an overall SMD of −0.97 (95 %CI −1.32, −0.63, P < 0.001). Egger's test for a regression intercept gave a P-value of 0.99, indicating no publication bias. On meta-regression analysis, all moderators and/or potential confounders (age at pregnancy, BMI, systolic blood pressure and ethnicity) were not significantly associated with effect modification (all P < 0.05). GDM is independently associated with subclinical myocardial dysfunction in pregnancy. STE analysis allows to identify, among GDM women, those who might benefit of targeted non-pharmacological and/or pharmacological interventions, aimed at reducing the risk of developing type 2 diabetes and cardiovascular complications later in life. [ABSTRACT FROM AUTHOR]

A number of anterior chest wall deformities, most notably pectus excavatum (PE), may have a detrimental effect on cardiac motion and function. Interpretation of transthoracic echocardiography (TTE) and speckle-tracking echocardiography (STE) results may be hampered by the possible influence of PE on cardiac kinetics. A comprehensive search of all articles assessing cardiac function in PE individuals was carried out. Inclusion criteria were: 1) individuals aged >10 years; 2) studies providing objective assessment of chest deformity (Haller index). Studies that measured myocardial strain parameters in PE patients were also included. The search (EMBASE and Medline) yielded a total of 392 studies, 36 (9.2%) of which removed as duplicates; a further 339 did not meet inclusion criteria. The full-texts of 17 studies were then analyzed. All studies concordantly reported impaired right ventricular volumes and function. With respect to left ventricle (LV), TTE studies uniformly demonstrated a significant impairment in conventional echoDoppler indices in PE individuals, whereas STE studies provided conflicting results. Importantly, LV functional alterations promptly reverted upon surgical correction of chest defect. In subjects with PE of mild-to-moderate severity, we observed that degree of anterior chest wall deformity, as noninvasively assessed by modified Haller index (MHI), was strongly associated with myocardial strain magnitude, in heterogenous cohorts of otherwise healthy PE individuals. Clinicians should be aware that in PE individuals, TTE and STE results may not always be indicative of intrinsic myocardial dysfunction, but may be, at least in part, influenced by artifactual and/or external chest shape determinants. Multimodality imaging assessment of chest wall conformation. Panel A: Conventional radiological Haller index assessment by CT scan. The Haller index is measured as the ratio of the maximum internal transverse diameter of the chest divided by the minimum antero-posterior diameter, at the deepest point of the deformity, at end inspiration. CT, computed tomography. Panels B1 and B2: Conventional radiological Haller index assessment by CXR. Panel B1: The internal L-L major thoracic diameter is measured, on a P-A view, at the level of the distal third of the sternum and/or of the eighth thoracic vertebra, without including the soft tissues (red line). Panel B2: The internal A-P minor thoracic diameter measured, on a L-L view, at the level of the maximum sternal depression, from the internal anterior chest wall to the anterior surface of the eighth thoracic vertebral (red line). CXR, chest X-ray; A-P, antero-posterior; L-L, latero-lateral; P-A, postero-anterior. Panels C1 and C2: MHI assessment. Panel C1: The L-L thoracic diameter is measured with the subject in the standing position and with open arms, by using a rigid ruler in centimeters coupled to a level (the measuring device), placed at the distal third of the sternum, at level of the point of maximum depression of the sternum. Panel C2: The A-P thoracic diameter is obtained during conventional transthoracic echocardiography, from the parasternal long-axis view, by measuring the distance between the true apex of the sector and the posterior wall of the descending thoracic aorta, visualized behind the left atrium. A-P, antero-posterior; Asc ao, ascending aorta; Desc ao, descending aorta; LA, left atrium; L-L, latero-lateral; LV, left ventricle; MHI, modified Haller index; RV, right ventricle. [Display omitted] • Chest wall abnormalities may impair cardiac motion and function. • Modified Haller index (MHI) is a radiation-free technique for assessing chest shape. • The MHI method may identify subjects with concave-shaped chest wall (MHI >2.5). • Subjects with MHI >2.5 have small cardiac chambers and impaired strain indices. • Impairment in myocardial deformation indices is strongly correlated with MHI. [ABSTRACT FROM AUTHOR]

The pathological remodeling of myocardial tissue is the main cause of heart diseases. Several processes are involved in the onset of heart failure, and the comprehension of the mechanisms underlying the pathological phenotype deserves special attention to find novel procedures to identify the site of injury and develop novel strategies, as well as molecular druggable pathways, to counteract the high degree of morbidity associated with it. Myocardial fibrosis (MF) is recognized as a critical trigger for disruption of heart functionality due to the excessive accumulation of extracellular matrix proteins, in response to an injury. Its diagnosis remains focalized on invasive techniques, such as endomyocardial biopsy (EMB), or may be noninvasively detected by cardiac magnetic resonance imaging (CMRI). The detection of MF by non-canonical markers remains a challenge in clinical practice. During the last two decades, two-dimensional (2D) speckle tracking echocardiography (STE) has emerged as a new non-invasive imaging modality, able to detect myocardial tissue abnormalities without specifying the causes of the underlying histopathological changes. In this review, we highlighted the clinical utility of 2D-STE deformation imaging for tissue characterization, and its main technical limitations and criticisms. Moreover, we focalized on the importance of coupling 2D-STE examination with the molecular approaches in the clinical decision-making processes, in particular when the 2D-STE does not reflect myocardial dysfunction directly. We also attempted to examine the roles of epigenetic markers of MF and hypothesized microRNA-based mechanisms aiming to understand how they match with the clinical utility of echocardiographic deformation imaging for tissue characterization and MF assessment. [ABSTRACT FROM AUTHOR]

Aims: No previous research provided a complete biventricular and multidirectional left ventricular (LV) functional assessment by two-dimensional (2D) speckle tracking echocardiography (STE) in infants of gestational diabetic mothers (IGDM) Methods: A total of 30 consecutive IGDM and 30 infants of healthy mothers were examined between March 2021 and July 2021. Both groups of infants underwent evaluation by neonatologist and 2D transthoracic echocardiography (TTE) implemented with 2D-STE quantification of LV-global longitudinal strain (GLS), LV-global circumferential strain (GCS), LV-global radial strain (GRS) and right ventricular (RV)-GLS, within 3 days of life and at 40 days after birth. Predictors of persistent subclinical myocardial dysfunction, defined as a LVGLS less negative than -20% at 40-day follow-up, in IGDM population, were determined. Results: At 2.2 ± 1.3 days after birth, LV-GLS (− 17.2 ± 1.9 vs. − 23.9 ± 3.8%), LV-GCS (− 17.9 ± 2.7 vs. − 27.3 ± 3.4%), LV-GRS (25.6 ± 3.4 vs. 35.8 ± 3.6%) and RV-GLS (− 17.6 ± 3.6 vs. − 22.6 ± 3.8%) were significantly impaired in IGDM than controls (all p < 0.001). At 36.8 ± 5.2 days of life, LV-GLS was still impaired (less negative than -20%) in 26.6% of IGDM. Maternal third trimester body mass index (BMI) (OR 1.89, 95%CI 1.05–3.39) and third trimester glycosylated hemoglobin (HbA1C) (OR 1.59, 95%CI 1.08–2.19) were independently associated with persistent LV-GLS impairment in IGDM. Maternal BMI ≥ 30 Kg/m2 and HbA1C ≥ 38 mmol/mol showed the maximum of sensitivity and specificity for predicting persistent subclinical myocardial dysfunction in IGDM at 40 days of life. Conclusions: IGDM have diffuse pattern of myocardial dysfunction during perinatal period. This dysfunction may be persistent up to 40 days of life in infants of GDM women with obesity and uncontrolled diabetes. [ABSTRACT FROM AUTHOR]

Objective: The association between gestational diabetes mellitus (GDM) and common carotid artery (CCA)-intima media thickness (IMT) is still controversial. In the present study, we aimed to compare the CCA-IMT measured in GDM women to that obtained in healthy pregnant women in the third trimester of pregnancy. Secondly, we investigated the main independent predictors of persistent CCA-IMT increase (defined as CCA-IMT ≥ 0.6 mm) in postpartum period in GDM women.Study Design: 30 consecutive GDM women and 30 healthy pregnant women matched for anagraphic age (34.1 ± 4.5 vs 32.8 ± 4.2 yrs, p = 0.25), ethnicity (caucasian 56.7 vs 63.3%, p = 0.59), gestational age (36.2 ± 1.7 vs 36.5 ± 1.6 weeks, p = 0.48) and cardiovascular risk factors were examined in this prospective case-control study. All women underwent obstetric visit, blood tests, conventional transthoracic echocardiography implemented with two-dimensional speckle tracking echocardiography analysis of left ventricular and left atrial myocardial strain parameters and carotid ultrasound examination at two time points: 36-38 weeks' gestation and 6-10 weeks after delivery.Results: At 36.2 ± 1.7 weeks of gestation, CCA-IMT was significantly increased in GDM women than controls (0.81 ± 0.11 vs 0.55 ± 0.12, p < 0.001). Twelve GDM women (40% of the total) were found with persistent CCA-IMT increase (0.76 ± 0.14 mm) in postpartum period (8.2 ± 2.2 weeks), whereas the remaining 18 (60% of the total) showed a normalization in CCA-IMT (0.56 ± 0.1 mm). At multivariate logistic regression analysis, third trimester body mass index (BMI) (OR 1.78, 95%CI 1.24-2.54, p = 0.01), glycosylated hemoglobin (HbA1C) (OR 1.51, 95%CI 1.13-1.89, p = 0.03) and neutrophil-to-lymphocyte ratio (NLR) (OR 1.68, 95%CI 1.25-4.65, p = 0.02) resulted to be independently associated with persistent CCA-IMT increase in postpartum period in GDM women. A BMI ≥ 29.2 Kg/m2, an HbA1C ≥ 37.5 mmol/mol and a NLR ≥ 5.5 were the best cut-off values for identifying GDM women with persistent CCA-IMT increase in postpartum period.Conclusions: GDM is associated with increased CCA-IMT during pregnancy. This increase may be persistent in postpartum period in GDM women with obesity, uncontrolled diabetes and increased inflammatory markers. [ABSTRACT FROM AUTHOR]

Bifonazole, an imidazole-based antifungal drug, can be easily amorphized and crystallizes upon reheating at moderate scanning rate. Driven by recent results in literature reporting for this compound the appearance of polymorphism under different thermal histories, the present study presents an extensive calorimetric characterization of bifonazole in its crystalline and amorphous state. A rich scenario in crystallization behaviour has been found, implying that the behaviour observed on reheating scans can strongly depend on the previous thermal history and on the distribution in number and size of crystalline regions. In particular, the decrease in melting enthalpy during reheating, related to the increase of the heating rate, can be stated to be the result of a partial crystallization of the sample. Additionally, the temperature intervals more favourable to crystal nucleation and growth, respectively, have been determined, thanks to the choice of ad hoc time–temperature profiles. Finally, also the nucleation occurrence in time at high temperature has been investigated using a suitable DSC protocol. The overall results show how complex can be the cold-crystallization behaviour of a molecular liquid. [ABSTRACT FROM AUTHOR]

Background: There is still controversy about whether transthoracic echocardiography (TTE) can provide reliable estimations of pulmonary artery pressures (PAP). The primary endpoint of this study was to evaluate the correlation between TTE and right heart catheterisation (RHC) in estimating systolic (SPAP) and mean (MPAP) pulmonary artery pressures.Methods: Between January 2011 and December 2018, 141 consecutive patients (average age 63.6±11.5 years; 84 women) with suspected or confirmed pulmonary hypertension (PH) were enrolled into this retrospective observational monocentric study. All patients underwent TTE and, within 3 hours, RHC. The correlation between TTE and RHC in estimating both SPAP and MPAP was retrospectively determined.Results: Seventeen (17) of the patients were excluded due to insufficient TTE signal quality. Of the remaining 124 patients, 18 had no PH. There was moderate correlation between both SPAP and MPAP estimated by TTE and those assessed by RHC (r=0.65 and r=0.60, respectively). Bland-Altman analysis revealed a bias of -11.9 mmHg (with the 95% limits of agreement ranging -45.4 to +21.5 mmHg) for SPAP estimation and -4.6 mmHg (with the 95% limits of agreement ranging -27.9 to +18.8 mmHg) for MPAP estimation, suggesting a general overestimation of PAP by TTE. The main factors responsible for discrepancies between TTE and RHC were: female gender, arrhythmic cardiac electrical activity, systemic arterial hypertension, and diuretic treatment.Conclusions: Transthoracic echocardiography frequently overestimated PAP in comparison with RHC, especially in hypertensive women with arrhythmias and under diuretic treatment. [ABSTRACT FROM AUTHOR]

Pulsed wave tissue Doppler imaging (PW-TDI) easily detects motion of cardiac structures. Hence, PW-TDI could be of value for assessing potentially cardioembolic masses. We sought to evaluate the prognostic value of left ventricular (LV) thrombus mobility assessed by PW-TDI. In 83 consecutive patients with echocardiographically detected LV thrombi, PW-TDI echocardiographic study was performed. At 1-year follow-up, the composite of major adverse cardiovascular events (MACE) defined as all-cause mortality plus hospitalizations for stroke/systemic embolism was evaluated. Seventy-two patients (77.1 ± 13.1 year/old, 32 males) were studied. All thrombi were located at the LV apex. At 1-year follow-up, 17 cardioembolic events occurred. By univariable Cox analysis, variables associated with MACE were heart rate (hazard ratio: 1.02, 95% CI: 1.00-1.05; P =.03), thrombi with mobile free edge (hazard ratio: 3.25, 95% CI: 1.25-8.44; P =.01), hypoechoic thrombi (hazard ratio: 2.86, 95% CI: 1.10-7.42; P =.03), and mass peak antegrade velocity (Va) ≥10 cm/s (hazard ratio: 8.79, 95% CI: 2.00-38.5; P =.004). By multivariable analysis, thrombi with mobile free edge (hazard ratio: 3.54, 95% CI: 1.23-10.2; P =.02), and mass peak Va ≥10 cm/s (hazard ratio: 7.97, 95% CI: 1.60-39.6; P =.01) retained statistical significance. Mass peak Va ≥10 cm/s predicted the composite end point with 94% sensitivity and 85% specificity (area under the curve = 0.86). In conclusion, PW-TDI allows objective prognostication of LV thrombi embolic risk. [ABSTRACT FROM AUTHOR]

Objective: Pregnancy may elicit a state of mild inflammation that might affect, either directly or indirectly, haematological parameters associated with systemic inflammation. In particular, both Neutrophil-to-lymphocyte ratio (NLR) and Red blood cells Distribution Width (RDW) have been found to be elevated in complicated pregnancy. However, data regarding the association of these haematological parameters with common carotid artery (CCA) intima-media thickness (IMT) in healthy pregnancy are scanty. Aim of this study was to evaluate possible changes in CCA-IMT during normal pregnancy and in the postpartum period, and to correlate these changes with NLR and RDW.Study Design: Between October 2019 and February 2020, a prospective study was carried out on 73 consecutive healthy pregnant women (32.8 ± 4.9 yrs/old). Women underwent obstetric assessment, complete blood cell counts with calculation of NLR and RDW, two-dimensional transthoracic echocardiography and carotid Doppler ultrasonography.Results: During normal pregnancy, both NLR and RDW progressively increased (p < 0.0001); likewise, parameters of carotid dimensions also significantly increased (p < 0.0001). Hematological and morphological changes all decreased in postpartum period. By univariable logistic regression, the variables which showed the greatest independent association with CCA-IMT (defined as CCA-IMT ≥0.55 mm) were: age (HR 1.33, 95% CI 1.15-1.53, p < 0.0001), pre-pregnant BMI (HR 2.75, 95% CI 1.72-4.41, p < 0.0001), third trimester E/e' ratio (HR 1.64, 95% CI 1.34-2.02, p < 0.0001), and third trimester NLR (HR 3.00, 95% CI 1.64-5.50, p < 0.0001). Multivariable logistic regression analysis demonstrated that third trimester NLR was the only variable that retained statistical significance (HR 2.49, 95% CI 1.35-4.59, p = 0.003). An NLR ≥ 2 reached 83% of sensitivity and 99% of specificity in identifying a CCA-IMT ≥0.55 mm (AUC = 0.95). A strong linear correlation of both third trimester NLR and RDW with CCA-IMT was observed (r = 0.89 and 0.83, respectively).Conclusions: Pregnancy is a state of chronic mild inflammation and the progressive increase in NLR and RDW during normal pregnancy is significantly associated with CCA intimal-medial thickening. [ABSTRACT FROM AUTHOR]

• Novel way to determine dynamical thermal lag. • Novel method to obtain specific heat capacity data from fast calorimetry data. • Original use of glass transition to detect and correct static thermal gradients. • Validation of the methods on prototypical organic molecular glass-formers. [Display omitted] Fast scanning calorimetry is an experimental technique very appreciated for its capability of suppressing reorganization processes, thanks to its wide interval of scanning rates, several orders higher than that of conventional calorimeters; nevertheless, drawbacks still exist. In this paper we propose a novel way to estimate the dynamical thermal lag by using the temperatures of maximum slope of the heat flow through the glass transition when we are not in the optimal conditions to apply the existing methods based on a reference material added on both cells of the chip or on the fictive temperature. Moreover, a novel interpretation of the heat flow losses due to the sample depending on the scanning rate sign is provided, in order to rescale the measured specific heat capacity to that from conventional calorimetry. Finally, the use of the glass to liquid transition measured on heating is shown as a new manner to reveal static thermal gradients. [ABSTRACT FROM AUTHOR]

Aims: To investigate whether liraglutide improves diastolic function in type 2 diabetes. Methods: Thirty-seven patients with type 2 diabetes who began liraglutide therapy between June 2013 and May 2014 were enrolled in this observational, prospective study. 26 patients received liraglutide therapy for at least 6months. The remaining 11 patients withdrew from liraglutide therapy during the first month, were started on other hypoglycaemic therapies and formed the control group. Anthropometric, metabolic and echocardiographic parameters including pulsed wave tissue Doppler imaging were evaluated at baseline and at 6months. Results: In the liraglutide group the early diastolic mitral annulus velocity on the lateral (e-lat) and medial (e-med) sides of the mitral annulus increased from 9.2±3.4 to 11.6±4.7cm/s (p<0.001) and from 6.9±1.7 to 8.4±2.6cm/s (p<0.003), respectively. The ratio of early-to-late velocities on the lateral and medial sides of the mitral annulus increased from 0.7±0.3 to 0.9±0.4 (p<0.001) and from 0.5±0.1 to 0.6±0.1 (p<0.02), respectively. The ratio of early diastolic mitral inflow velocity to early diastolic myocardial relaxation velocity decreased from 10.7±4.3 to 8.5±2.5 (p<0.005). No improvements in diastolic function was detected in the control group. Glucose control improved similarly in both groups: HA1bc -1.5% (-17mmol/mol) vs -1.3% (-14mmol/mol), p=0.67. Conclusions: In patients with type 2 diabetes, 6months liraglutide treatment was associated with a significant improvement in diastolic function. [ABSTRACT FROM AUTHOR]

• A new method for thermodynamic study of glass formation isothermally. • Effects on volume and bulk modulus on pressure scanning. • Direct determination of fictive pressure. • Would provide new insights of relaxational volume and relaxational enthalpy. • Has effect on thermodynamics in a potential energy landscape. In the commonly used technique of scanning calorimetry, one measures the heat capacity, C p , as a function of temperature T on heating or cooling a material at a fixed rate. In the study of liquid-glass-liquid transition, a calorimetry scan is modelled in terms of a non-exponential parameter, β , and non-linearity parameter, x , which describe the shape of the C p -scan as well as the time- and temperature-dependence of structural dynamics. A liquid also becomes glass on isothermal pressurizing and the glass is expected to become liquid on depressurizing. Here we describe the formalism of a technique in which the volume, V , may be measured as a liquid is isothermally pressurized at a fixed rate, r = (d p / d t) T , to form glass, and also as the glass is isothermally depressurized at a fixed rate until it becomes liquid. We name it pressure scanning volumetry (PSV) and simulate the pressurizing and depressurizing scans of (d V / d p) T within the framework of non-exponential, non-linear structural relaxation. Hence we show how the features of simulated PSV scans change with change of, (i) the pressurizing and depressurizing rates, (ii) the parameters β and x , and (iii) the volume of activation for characteristic relaxation time, Δ V *. We also describe how the limiting fictive pressure, p f ′ , can be determined from a PSV scan, and fit the PSV formalism to the available bulk modulus against p plot of atactic poly(propylene) at 297 K [S.P. Andersson, O. Andersson, Int. J. Thermophys. 18 (1997) 845-864] to obtain β , x and Δ V *. In addition to being of academic interest, the formalism would be useful for modelling polymer extrusion processes. The study may also stimulate commercial development of equipment with computer-controlled pressure-change for use in studies of academic and technological significance. [ABSTRACT FROM AUTHOR]

The objectives of this work were to identify the pollen types most representative of the airborne pollen content in the city of Bahía Blanca, Argentina (38° 44'S; 62° 16'W), and to estimate their quantity by means of daily sampling over long periods of time; to compare the airborne pollen contents corresponding to woody vegetation (trees and shrubs) to that of herbaceous vegetation, and to evaluate the month-to-month airborne pollen diversity throughout the calendar year. The study was carried out during three periods: August '96-July '97, August '97-July '98 and August '99-December '99, using a volumetric impact Rotorod 40 sampler. A total of 43 pollen types were recognized, of which 31 (72%) corresponded to arboreal pollen (AP, trees/shrubs) and 12 (28%) to non-arboreal pollen (NAP, herbs). According to their abundance the main types were Cupressus, Eucalyptus, Poaceae, Fraxinus, Amaranthus/Chenopodiaceae, Olea europaea and Pinus. Regarding the length of time present in the air the main types were Cupressus, Poaceae, Amaranthus/Chenopodiaceae, Eucalyptus, Brassicaceae and Asteraceae. [ABSTRACT FROM AUTHOR]