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International audience; The number of recreational scuba divers is steadily increasing. In its latest recommendations, the French Federation of Undersea Studies and Sports listed congenital heart disease as a formal and final contraindication to scuba diving. On the other hand, with the progress made in their management, the prognosis and quality of life of patients with congenital heart diseases have improved considerably, enabling them to engage in physical and sports endeavours, which are known to confer general health and psychological benefits. As a consequence, the ability of these patients to dive has become a regular and recurrent issue. We review the various types of scuba diving, the physical performance required for its practice, its effects on cardiovascular function and the elements that need to be considered before recommending whether it can be practiced safely at various levels of difficulty. Because of the diversity and broad heterogeneity of congenital heart diseases, a detailed evaluation of each-patient's performance based on clinical criteria common to all congenital heart diseases is recommended. (C) 2016 Elsevier Masson SAS. All rights reserved.

International audience; Purpose: Left ventricular mechanical dyssynchrony is based classically on the analysis of velocity or strain peak instants, which are detected manually. This method may not reflect the complexity of both contractility and timing of a dilated heart, particularly at exercise. We hypothesized that integral-based indicators of regional longitudinal strain signals, and their variation between rest and exercise, would provide additional information for the characterization of the evolution of heart failure patients. Methods: Forty-nine patients with NYHA II to III, ischemic (28%) or idiopathic DCM (72%), ejection fraction 29,6±7,1%, QRS width 138±35ms, were studied. All patients underwent submaximal supine bicycle exercise stress echocardiography. Thirty of 49 patients had a CRT device implantation following baseline evaluation. Patients were classified as responders (n=18) if they showed a decrease in LV end-systolic volume ≥15% at 6-months follow-up, non-responders (n=12) if not. Apical-4 chamber longitudinal strain was recorded manually on a dedicated software (EchoPAC PC, GE Healthcare) and then strain data was exported for a detailed analysis, based on custom-made methods and algorithms. Integrals of strain signals were calculated for each segment, from the beginning of the cardiac cycle (QRS onset), to the instant of the peak of longitudinal strain. Results: Concerning the global population (n=49), no significant change between rest and exercise was observed for septal and lateral peak of longitudinal strain, or intraventricular mechanical dyssynchrony, when recorded manually on the Echopac interface. Integrals to minimum of longitudinal strain decreased significantly between rest and exercise for mid septal segments (1,96±1,30 vs. 1,54±0,91, p