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Background: This study aims to evaluate the role of speckle-tracking echocardiography to identify myocardial deformation in acute rheumatic fever. Methods: Twenty-seven patients and 27 healthy children were prospectively evaluated. The patient group was divided into 2 subgroups based on echocardiographic findings, with or without carditis. The left ventricular global longitudinal strain and strain rate, left ventricular global circumferential strain and strain rate, and right ventricular global longitudinal strain and strain rate were assessed by speckle-tracking echocardiography. Results: In the acute phase of the disease, all values except the right ventricular global longitudinal strain were found to be significantly below the control group in the patient cohort. No significant difference was found between the patients grouped as carditis and non-carditis in the acute period. Comparison of the acute period with the post-treatment period revealed a significant increase in all strain values of the patients with carditis and significant increases observed in all values except left ventricular global longitudinal strain rate, left ventricular global circumferential strain rate, and right ventricular global longitudinal strain rate values in patients without carditis. Apart from the right ventricular global longitudinal strain rate, which was significantly lower in the non-carditis group compared to the control group, there was no significant difference in strain values between the patient and control groups following treatment. Conclusion: In the present study, we found that all patients, including patients in whom no valvular involvement was detected by echocardiography in the acute phase of acute rheumatic fever, had a lower right and left ventricular strain and strain rate measurements and that these findings improved after treatment, suggesting that strain echocardiography may be a helpful diagnostic method, especially in patients without valvular involvement. [ABSTRACT FROM AUTHOR]

Background: A higher frequency of premature ventricular complexes is associated with a higher risk of premature ventricular complex-induced cardiomyopathy. Although there are several studies on the systolic functions of the left ventricle in this patient group, it is clearly not known how the diastolic functions of the left ventricle are affected. This study examined the effect of premature ventricular complex on left ventricle diastolic functions using diastolic strain rate. Methods: The trial included 57 patients with frequent premature ventricular complexes and 54 healthy volunteers. The patient was evaluated using echocardiography in its entirety. The vendor-independent software system determined systolic and diastolic strain parameters via 2-dimensional speckle tracking analysis. Using the auto strain 3P semi-automated endocardial boundary tracking instrument, the global longitudinal strain was measured from the apical 4-chamber, 2-chamber, and long axis. The diastolic strain rate was determined by averaging the strain rates of 17 cardiac segments at 2 distinct periods of diastole. Results: In the patient group, early diastolic strain rate was significantly lower than that in the control group (1.62 ± 0.58 vs. 1.25 ± 0.38, P < .001). There were found to be significant negative connections between PVC's electrocardiographic QRS wave length and early diastolic strain rate and coupling interval and early diastolic strain rate. Significant positive associations between coupling interval and early diastolic strain rate were discovered (P < .001 and P < .001, respectively). Conclusions: Patients with premature ventricular complex exhibited a lower early diastolic strain rate than healthy individuals. The early diastolic strain rate can be used to predict left ventricle diastolic dysfunction, and persons with premature ventricular complex may have a higher risk of left ventricle diastolic dysfunction than the general population. [ABSTRACT FROM AUTHOR]

Background: In rheumatic severe mitral stenosis, right ventricular mechanics deteriorate with the increasing severity of mitral stenosis. Therefore, we aimed to investigate right ventricular mechanics in patients with mild mitral stenosis using 3-dimensional speckle tracking echocardiography. Methods: In total, 40 patients with mild mitral stenosis and 36 age- and gender-matched healthy controls were included. Conventional echocardiographic examination was performed and 3-dimensional data sets were acquired for strain analysis. Besides conventional echocardiographic parameters, right ventricular volume and function and 3-dimensional speckle tracking echoc ardio graph y-der ived right ventricular free wall longitudinal strain were compared between patients with mild mitral stenosis and healthy controls. Results: Although 3-dimensional right ventricular volumes and ejection fraction were similar between the groups, 3-dimensional speckle tracking echoc ardio graph y-der ived right ventricular free wall longitudinal strain was significantly lower in patients with mild mitral stenosis than in controls (25.57 ± 4.39% vs. 27.90 ± 4.71%, P = .028). Significant correlations were observed between right ventricular free wall longitudinal strain and mitral valve area and estimated systolic pulmonary artery pressure (r = 0.597, P < .001; r = -0.508, P = .003, respectively). Another significant positive correlation was observed between planimetric mitral valve area and 3-dimensional speckle tracking echoc ardio graph yder ived right ventricular free wall longitudinal strain (r = 0.597, P < .001). Conclusion: The degree of severity of mild mitral stenosis in terms of mitral valve area can help in the early detection of subclinical right ventricular systolic function impairment which can be easily detected by 3-dimensional speckle tracking echocardiography. Right ventricular contractile performance could decrease even in mild mitral stenosis. [ABSTRACT FROM AUTHOR]

The article presents research on Cardiology related with Arrhythmia, Electrophysiology, Pacemaker and an implantable Cardiac resynchronization therapy. Topics include Clinical outcome of pacemaker implantation in nonagenarians; effective treatment for Left atrial appendage occlusion; and comparative studies of ventricular arrhythmia in diabetics and nondiabetic metabolic syndrome patients.

Background: COVID-19 is a multi-systemic infectious disease. Nearly 20%-30% of hospitalized patients have evidence of acute myocardial involvement, portending a poorer prognosis. However, information about the long-term effects of the disease on cardiac functions is sparse. As a result, there is a growing concern about the cardiac sequelae of COVID-19 among survivors. This study aimed to investigate the effects of prior mild-moderate COVID-19 infection on cardiac functions, using speckle tracking echocardiography. Methods: Patients who have been diagnosed with COVID-19 within the previous 6 months and age-, sex-, and risk factor-matched healthy adults were included. All patients underwent a comprehensive echocardiographic examination. Both conventional and 2-dimensional speckle tracking echocardiographic measurements were performed. Serum cardiac biomarkers were also obtained on the day of the echocardiographic study. Results: Compared with healthy controls, COVID-19 survivors had similar left and right ventricular longitudinal strain values at 6 months. Also, left and right atrial peak systolic strain values did not differ between the groups. Conclusion: Our study is valuable in putting forth the unaffected ventricular and atrial functions on long term in uncomplicated COVID-19 cases and may decrease the survivors' anxiety and the number of unnecessary applications to cardiology clinics. [ABSTRACT FROM AUTHOR]

Background: In this study, we investigated whether left atrial functions evaluated by speckle tracking echocardiography, classic echocardiographic and clinic parameters predict appropriate Implantable Cardioverter Defibrillator (ICD) shock in patients who underwent ICD implantation for hypertrophic cardiomyopathy. Methods: Totally 87 patients who received ICD implantation for primary or secondary prevention were included in the study. Patients' clinical, elect rocar diogr aphic, 2 dimension classic, and speckle tracking echocardiographic data were collected. Left atrial functions were assessed by speckle tracking echocardiography. Left atrial strain just before mitral valve opening was taken as peak atrial longitudinal strain. Appropriate ICD therapy was defined as cardioversion or defibrillation due to ventricular tachycardia or fibrillation. Patients were divided into 2 groups as occurrence or absence of appropriate ICD therapy during follow-up (mean, 50.2 ± 9.3 months). Patients with an European Society of Cardiology (ESC) risk score >6% were considered high-risk patients. Results: A total of 24 (27.5 %) patients were observed to have an appropriate ICD therapy. In patients on whom appropriate ICD therapy was performed, a higher Sudden Cardiac Death risk Score and decreased peak atrial longitudinal strain and global longitudinal peak strain were observed. In patients with high ESC risk score (> 6%), in Cox regression analysis, peak atrial longitudinal strain (odds ratio: 0.806, P = .008), Sudden Cardiac Death risk score (odds ratio: 1.114, P = .03) and global longitudinal peak strain (odds ratio: 1.263, P = .02) were found to be independent predictors of occurrence of appropriate ICD therapy. Conclusion: Easily measurable peak atrial longitudinal strain may provide additional information in predicting ventricular arrhythmias or deciding on prophylactic medical treatment to prevent ventricular arrhythmias or reduce the frequency of appropriate shock in high-risk patients with ICD implanted. [ABSTRACT FROM AUTHOR]

Background: To determine the accuracy of global longitudinal strain and territorial longitudinal strain in determining myocardial viability in comparison to single-photon emission computed tomography in out of window period anterior wall myocardial infarction patients. Methods: This was a single-center, prospective study carried out in a tertiary care center in northern India. All patients presenting with anterior wall myocardial infarction–out of window period without ongoing chest pain and akinetic left-anterior descending territory on echocardiography were recruited. All patients underwent strain echocardiography and the determination of both global longitudinal strain and territorial longitudinal strain within 12-48 hours of anterior wall myocardial infarction. In addition, all underwent single-photon emission computed tomography to determine the viability status of the anterior myocardium. Results: Fifty-one patients of anterior wall myocardial infarction–out of window period were enrolled and underwent strain imaging with speckle tracking and single-photon emission computed tomography for viability determination. Gobal longitudinal strain and territorial longitudinal strain were significantly reduced in patients with nonviable myocardium (P < .001). On receiver-operating curves, a gobal longitudinal strain of <10.45% had a sensitivity of 77.8% and specificity of 93.9% (AUC=0.889) in predicting nonviability on single-photon emission computed tomography. Similarly, a territorial longitudinal strain of <7.60% had a sensitivity of 77.8% and specificity of 84.8% (AUC=0.825) in predicting nonviability. Conclusions: Treatment strategies in patients presenting with anterior wall myocardial infarction, outside the window period is largely guided by the hemodynamic status and influenced by the viability status of the myocardium. Strain echocardiography using speckle tracking provides gobal longitudinal strain and territorial longitudinal strain, both of which have good sensitivity and specificity in predicting viability and can be performed safely and quickly in high-risk group of patients. [ABSTRACT FROM AUTHOR]

Background: Facioscapulohumeral muscular dystrophy is one of the most common congenital muscle disorders. Whether facioscapulohumeral muscular dystrophy causes cardiac involvement is still controversial. Although electrocardiography and conventional echocardiography studies have been performed, there is no data on strain echocardiography in facioscapulohumeral muscular dystrophy. Our study aims to compare the myocardial strain parameters by 2-dimensional speckle tracking echocardiography in patients with facioscapulohumeral muscular dystrophy and the normal group. Methods: This prospective single-center study included 35 patients with facioscapulohumeral muscular dystrophy and 54 control patients. Demographic, clinical, and laboratory parameters of both groups were compared. In addition to conventional echocardiography images, myocardial strain parameters were performed using 2-dimensional speckle tracking echocardiography. Results: The median age of the study population was 25 (19-35 IQR) and 51 (57.3%) of them were male. Left ventricle-global circumferential strain was significantly lower in the facioscapulohumeral muscular dystrophy group than in the normal group [-20.3 (-22.0; -19.0) vs. -21.6 (-22.5; -20.0), P = .020]. Two-dimensional speckle tracking echocardiography findings except left ventricle-global circumferential strain [for left ventricle-global longitudinal strain P = .259, for left ventricle-global radial strain P = .338, for right ventricle-global circumferential strain P = .250, and for right ventricle-free wall longitudinal strain P = .288] were similar in both groups. Conclusions: As a result of our study, there was no significant difference between 2-dimensional speckle tracking echocardiography parameters other than the left ventricle-global circumferential strain between facioscapulohumeral muscular dystrophy and normal groups. [ABSTRACT FROM AUTHOR]

Objective: Anthracyclines are widely used in the treatment of acute lymphoblastic leukemia (ALL). However, cardiotoxicity is the most critical side effect that requires dose limitation. It is thought to occur at first exposure, but the clinical presentation may occur years later. In this study, we aimed to determine the time of initial damage and cardiotoxicity that develops in children with ALL. Methods: In this prospective study, 13 patients with newly diagnosed intermediate-risk precursor B cell ALL treated with the ALL-IC BFM 2009 protocol were included. Conventional echocardiography, tissue Doppler imaging (TDI), and speckle-tracking echocardiography (STE) were performed in all the patients before chemotherapy, after completing the induction phase, and at the end of the reinduction phase. Results: The mean age of the patients was 7.8±4.6 (3.1–16.3) years. Myocardial velocity during systole (Sm) determined by TDI at the interventricular septum significantly decreased during the induction phase. Despite a decrease in STE parameters, a statistically significant reduction was determined in the global longitudinal strain rate at both left and right ventricles at the end of the induction. Nevertheless, a statistically significant increase was observed among the conventional echocardiographic findings in the left ventricular end-diastolic diameter at the end of the reinduction. Conclusion: During the treatment of ALL, subclinical anthracycline-associated cardiotoxicity develops in the early stages of treatment. The findings detected by TDI and STE could be missed by conventional echocardiography. We recommend evaluating patients with these newly developed techniques to detect subclinical cardiotoxicity at an early stage and starting appropriate therapy on time. [ABSTRACT FROM AUTHOR]

Objective: Post-systolic shortening (PSS) has been shown to be sensitive in detecting ischemia on stress echocardiography. In this study, we aimed to assess the diagnostic potential of resting PSS and post-systolic index (PSI) in patients with suspected unstable angina (UA). Methods: A total of 159 participants with suspected UA without any wall motion abnormalities were recruited. They all underwent speckle tracking echocardiography (STE) and coronary angiogram (CAG). Global longitudinal strain (GLS); presence or absence of pathological PSS; PSI17 and PSI12, and PSI in left anterior descending, left circumflex, and right coronary artery territories were assessed. On the basis of CAG, those who had more than 70% stenosis were labelled to have obstructive CAD. Results: Obstructive disease was noted in 54.7% patients. The prevalence of PSS (62.1% vs. 13.9%), mean PSI17 (5.4 vs. 3.3), and PSI12 (6.2 vs. 3.7) were significantly higher in those with CAD compared with patients without obstructive disease. Both PSS [odds ratio (OR) 10.145; 95% confidence interval (CI) 4.577-22.489; p=0.001] and PSI17 (OR: 1.217; 95% CI: 1.064-1.393; p=0.004) were predictors of CAD by multivariate regression analysis. PSS had a sensitivity of 62.1% and specificity of 86.1% with a positive predictive value of 84.4%. PSI17 [area under curve (AUC): 0.637; p=0.003] and PSI12 (AUC: 0.661; p=0.001) have moderate accuracy in identifying obstructive CAD. Conclusion: In patients presenting with suspected UA, STE derived PSS has reasonable sensitivity and good specificity in diagnosis of obstructive CAD. Patients identified to have PSS can be subjected to CAG without further stress testing because of its high positive predictive value. [ABSTRACT FROM AUTHOR]

An editorial is presented on the Preventive Cardiology and New Methods, featuring discussions on catheter-directed therapies in acute pulmonary embolism, predictors of atrial fibrillation recurrence following catheter cryoballoon ablation and creation of three-dimensional (3D) models for para valvular leaks using echocardiographic data. It mentions the workplace assessment in cardiology training and the tracking echocardiography in identifying myocardial deformation in acute rheumatic fever.

Objective: Parkinson's disease (PD) is a neurological disorder, and ergot dopamine agonists (DAs) are no longer usually preferred in the treatment due to the increased risk of valvular heart disease. Some recent studies have shown that commonly used non-ergot DA also increases the risk of heart failure. On the other hand, there are studies showing conflicting data about this relationship. The aim of the present study was to investigate the cardiac effects of non-ergot DAs in patients with PD using echocardiography. Methods: Conventional echocardiography and two-dimensional (2D) speckle tracking strain echocardiography were performed to determine the possible systolic dysfunction prior to the development of apparent systolic heart failure. Ninety-one (55 male, 64±10 years) patients with PD were included in the study. Furthermore, 25 subjects with newly diagnosed PD and using no drug were enrolled as the control group. All patients were divided into groups according to their medication. Patients using levodopa were classified as Group 1 (36), levodopa+pramipexole as Group 2 (27), and levodopa+ropinirole as Group 3 (28). Results: Left ventricle dysfunction with non-ergot DA use in patients with PD was not established with conventional echocardiographic evaluation. For 2D strain analysis, global longitudinal strain values were obtained as -18.5%, -18.5%, and -18.9% in the groups, respectively. Strain and strain rate values of the left ventricle were not different between the groups (p=0.816 and p=0.881, respectively). Conclusion: There was no significant relationship between left ventricular dysfunction and use of non-ergot DA in patients with PD. Similar results were obtained in strain analysis showing left ventricular subclinical dysfunction. Our study appears to confirm the safety of non-ergot DA in the point of heart failure risk. To our knowledge, this is the first study to evaluate the effect of this group of drugs on subclinical left ventricular systolic function. [ABSTRACT FROM AUTHOR]

Objective: Parkinson's disease (PD) is a neurological disorder, and ergot dopamine agonists (DAs) are no longer usually preferred in the treatment due to the increased risk of valvular heart disease. Some recent studies have shown that commonly used non-ergot DA also increases the risk of heart failure. On the other hand, there are studies showing conflicting data about this relationship. The aim of the present study was to investigate the cardiac effects of non-ergot DAs in patients with PD using echocardiography. Methods: Conventional echocardiography and two-dimensional (2D) speckle tracking strain echocardiography were performed to determine the possible systolic dysfunction prior to the development of apparent systolic heart failure. Ninety-one (55 male, 64±10 years) patients with PD were included in the study. Furthermore, 25 subjects with newly diagnosed PD and using no drug were enrolled as the control group. All patients were divided into groups according to their medication. Patients using levodopa were classified as Group 1 (36), levodopa+pramipexole as Group 2 (27), and levodopa+ropinirole as Group 3 (28). Results: Left ventricle dysfunction with non-ergot DA use in patients with PD was not established with conventional echocardiographic evaluation. For 2D strain analysis, global longitudinal strain values were obtained as -18.5%, -18.5%, and -18.9% in the groups, respectively. Strain and strain rate values of the left ventricle were not different between the groups (p=0.816 and p=0.881, respectively). Conclusion: There was no significant relationship between left ventricular dysfunction and use of non-ergot DA in patients with PD. Similar results were obtained in strain analysis showing left ventricular subclinical dysfunction. Our study appears to confirm the safety of non-ergot DA in the point of heart failure risk. To our knowledge, this is the first study to evaluate the effect of this group of drugs on subclinical left ventricular systolic function. [ABSTRACT FROM AUTHOR]

An introduction is presented in which author discusses articles on topics including focuses on Myocardial infarction associated with the autophagy and apoptosis of cardiomyocytes and the AKT/mTOR pathway plays a crucial role in this mechanism.

An editorial is presented on World for health and climate changes. Topics include TAVI being associated with lower all-cause mortality at 30-day follow-up and lower cardiovascular mortality at 1-year follow up; and investigating the relation of the development of abdominal aortic aneurysm (AA) and the duration of ciprofloxacin use in rats.

The article presents the discussion on Venepally et al from USA reviewing non-bacterial thrombotic endocarditis (NBTE). Topics include investigating the dose-dependent effects of leptin on human umbilical vein endothelial cells (HUVECs) wound healing model and eNOS production; and Liver-spleen (L/S) ratio which being one of the strong indicators of hepatosteatosis, and epicardial adipose tissue (EAT) volume.

An editorial is presented on evaluating the efficacy and safety of orthotropic Transcatheter Tricuspid Valve Replacement (TTVR) for moderate-severe native tricuspid regurgitation (TR). Topics include comparing myocardial strain measurements by 2-dimensional speckle tracking strain echocardiography (2D-STE); and causing conduction disturbance (CD) as a result of compression in the area after transcatheter aortic valve implantation (TAVI).

Objective: The aim of this study was to evaluate left ventricular (LV) systolic strain by speckle tracking echocardiography (STE) and real-time three-dimensional echocardiography (3-DE) for the early detection of myocardial dysfunction in patients with cardiac syndrome X (CSX). Methods: We compared 34 patients with CSX (18 females, mean age 47.9±10.0 years) with 41 healthy persons as a control group (23 females, mean age 50.6±9.9 years). Inclusion criteria for CSX were typical angina, a positive exercise ECG stress test, and angiographically documented normal coronary arteries. Exclusion criteria for both groups were hypertension, valvular heart disease, cardiomyopathies, inflammatory diseases, myocarditis, vasculitis, arthropathies, Tietze's syndrome, gastrointestinal diseases, aortic diseases, hormone replacement therapy, arrhythmias, liver diseases, and alcohol use. All subjects underwent two-dimensional STE and 3-DE to assess resting LV function. STE measures were taken from the basal septum, mid-septum, apical septum, apex, apicolateral, mid-lateral, basal lateral, anteroseptal, anterior, anterolateral, inferolateral, inferior, and inferoseptal walls. Student's t-test, Mann-Whitney U test, and chi-square test were used to statistically analyze data. Results: LV echo ejection fraction (EF) and systolic wave peak velocity were similar for both groups. Regional mean longitudinal strain (-17.7±2.5% vs. -19.8±1.8%; p<0.0001) was significantly lower in patients with CSX than in healthy control patients. However, regional mean circumferential strain values (-22.0±1.6% vs. -22.2±2.3%; p=0.78) did not differ significantly between the two groups. Conclusion: Significant impairment of LV longitudinal myocardial systolic function was detected with STE in patients with CSX, although normal 3-D EF and tissue Doppler imaging systolic parameters were observed. Arteriosclerosis of small coronary arteries and microvascular dysfunction may affect myocardial longitudinal strain. [ABSTRACT FROM AUTHOR]

Objective: Impairment in left ventricular (LV) function due to excessive ventricular extrasystoles (VESs) occurs during long-time follow-up. Speckle tracking echocardiography (STE) has been shown to be superior to conventional methods for evaluating cardiac functions. We aimed to use STE for early detection of LV dysfunction in patients with apparently normal hearts who have frequent VESs. Methods: Fifty-five patients with frequent VESs were identified according to the Lown classification (Grade 2; unifocal more than 30 times in 1 h). Subjects aged 22-60 years with frequent VESs that had been detected for at least 1 year were included in the study according to the inclusion criteria. Forty-five subjects with similar demographic characteristics, but without VESs, were included as the control group. All participants were evaluated by STE. Results: Fifty-five patients with frequent VESs (mean age 47 years, range 22-60 years; 42.2% male) and 45 control subjects (mean age 46 years, range 22-60 years; 37.8% male) were enrolled in the study. Global LV longitudinal strain (GLS) was decreased in patients with frequent VESs (-18.41±3.37 and -21.82±2.43; p<0.001). In addition, global LV circumferential strain was decreased in patients with frequent VESs (-16.83±6.06, -20.51±6.02; p<0.001). The frequency and exposure time of VESs were negatively correlated with GLS (r=-0.398, p<0.001; r=-0.191, p=0.001, respectively). Conclusion: STE revealed that LV functions were decreased in patients with VESs. This deterioration increased with the frequency and exposure time of VESs. Impairment of LV function due to excessive VESs occurs during long-time follow-up. STE may be used for early detection of LV dysfunction. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to explore right ventricular (RV) mechanical function in patients with hypertrophic cardiomyopathy (HCM) by 2-D speckle tracking echocardiography (2-D-STE). Methods: Forty-three patients with HCM (mean age 48, 17 females) and 40 healthy subjects were consecutively included in this cross-sectional study. The diagnosis of HCM was based on the presence of typical clinical, electrocardiographic (ECG), and echocardiographic features. Patients with LV systolic impairment, significant valvular disease, history of coronary artery disease, hypertension, malignancy, and chronic obstructive pulmonary disease were excluded. Right and left ventricular (LV) function was assessed by tissue Doppler imaging (TDI) and 2-D-STE. Hypertrophic cardiomyopathy patients were divided into two groups according to ACC/ESC guidelines (LVOT gradient below and above 30 mm Hg). Student t-test was used to compare differences between groups. Non-parametric tests (Mann-Whitney U) were used in cases of abnormal distribution. Results: Hypertrophic cardiomyopathy patients had a significantly larger right atrium and RV diameters compared to controls. Mean pulmonary artery pressures (mPAB) were significantly higher in HCM patients (19.01±13.09 mm Hg vs. 8.40±4.50 mm Hg; p<0.001). Although RV Sm measurements were similar, RV strain measurements (-28.51±5.36% vs. -32.06±7.65%; p=0.016) were significantly lower in HCM patients. Left ventricular global longitudinal, radial, and circumferential strain values were also significantly different between the two groups (-20.50±3.58% vs. -24.12±3.40%; p<0.001, 38.18±12.67% vs. 44.80±10.15%; p=0.012, -21.94±4.28% vs. -23.91±3.95%; p=0.036 consecutively). Rotational movement of LV in each apical, mid-, and basal left ventricular segment was determined, and only mid-ventricular rotation of the HCM patients was more clockwise (-1.71±2.16 ° vs. 0.04±1.72 °; p<0.001). Although mPAP measurements were higher in HCM patients with significant LVOT obstruction (21.52±13.26 mm Hg vs. 12.31±10.53 mm Hg; p=0.049), none of the other TDI or 2-D-STE parameters was significantly different between groups. Conclusion: Speckle tracking echocardiography-derived right ventricular systolic function is impaired in HCM patients when compared with healthy subjects. However, RV systolic function is not affected form LVOT obstruction and left ventricular rotation dynamics in HCM patients. [ABSTRACT FROM AUTHOR]

Objective: Nonalcoholic steatohepatitis (NASH) is a part of histological spectrum of nonalcoholic fatty liver disease (NAFLD). Higher incidence of cardiovascular mortality has been reported in studies including patients with NAFLD. Impaired myocardial function can be detected by a novel echocardiographic method called speckle tracking echocardiography (STE) when conventional methods were normal. Methods: Twenty-eight biopsy-proven NASH patients (mean age 41.6±9.8, 16 male) without hypertension and diabetes mellitus were included in study. All patients underwent transthoracic echocardiography. Offline analyses of images was performed and strain (S), strain rate (SR) parameters compared between NASH patients and controls. Statistical analysis were done by independent samples t test between groups and a multiple linear regression model was used to identify the statistical significance of relationships between selected variables. Results: RSR-S values were similar but RS, RSR-E, RSR-E/A values were significantly lower and RSR-A was higher in the NASH patients. There were no significant differences in CS, CSR-S, CSR-E, CSR-A and CSR-E/A values among the two groups. The most impressive results were obtained from longitudinal strain and strain rate parameters. LS, LSR-S, LSR-E, LSR-A, values were significantly lower in NASH group when compared with healty controls. Linear regression analysis showed that RS and LS was not associated with diastolic blood pressure, total cholesterol and LDL cholesterol. Conclusion: The LV longitudinal and radial systolic functions may be deteriorated in patients with NASH even in the absence of apparent decrease in the LV ejection fraction. STE may be useful in detecting preclinical LV impairment in patients with NASH. [ABSTRACT FROM AUTHOR]

Objective: We aimed to investigate left atrium (LA) function by speckle tracking echocardiography in patients with metabolic syndrome (MetSyn) and to show a possible relationship between the severity of MetSyn and LA function and to determine the predictors of low strain in MetSyn patients. Methods: Our study design was observational and cross-sectional design consisted of 80 MetSyn patients without overt diabetes and 50 controls. The patients were classified into three groups based on the number of MetSyn criteria. The peak LA strain at the end of the ventricular systole (LAs-strain) as well as the LA strain with LA contraction (LAa-strain) was obtained. Correlation analysis performed to assess the association of LA strain parameters with the severity of MetSyn and logistic regression analysis performed to assess the relationship of low LA strain with MetSyn. Results: Both LAs (37.5±8.7 vs. 26.0±10.2, p<0.001) and LAa (19.9±6.3 vs. 13.0±6.4, p<0.001) strain measurements were found to be significantly decreased in patients with MetSyn when compared to the control group. Moreover, both LAs and LAa were found to be significantly decreased with the increasing severity of the MetSyn. A multiple logistic regression analysis demonstrated that the presence of MetSyn [OR:0.26 (95% CI 0.06-0.89), p=0.032] and left ventricular ejection fraction [OR:1.14 (95% CI 1.03-1.27), p=0.021] were independent predictors of LAs strain. Conclusion: MetSyn is associated with reduced LAs strain and LAa strain representing LA reservoir and pump function, respectively. Furthermore, LA mechanical function decreases even more with the increasing severity of the MetSyn. [ABSTRACT FROM AUTHOR]

Objective: bWe aimed to evaluate the subclinical left ventricular (LV) systolic dysfunction with the automated function imaging method (AFI) based on speckle tracking echocardiography (STE) in obstructive sleep apnea patients (OSA) with normal left ventricular ejection fraction (LVEF) and without any confounding disease that can cause myocardial dysfunction. Methods: Twenty-one healthy individuals and 58 OSA patients were included in this observational cross-sectional study. According to the severity of disease, OSA patients were examined in three groups; mild, moderate and severe OSA. Apical 2-, 3- and 4- chamber images were obtained for AFI evaluation. The global systolic longitudinal strain (GLS) values were determined for each view, and averages of these were used in comparison of the patient groups. One-way ANOVA, Kruskal-Wallis, Pearson correlation tests and linear regression analysis were used for statistical analysis. Results: The GLS values of the OSA patients were lower than of the healthy individuals and these values were decreased along with the OSA severity (Healthy:-25.58±-2.16%, Mild:-23.93±-3.96%, Moderate:-21.27±-2.60%, Severe:-16.94±-2.66%, respectively). The difference was significant between moderate OSA patients and healthy individuals, and significant between severe OSA patients and all other groups (p<0.03). The apnea-hypopnea index was found to be correlated with the GLS (β=-0.659, 95% CI: 0.09-0.17, p<0.001). Conclusion: Longitudinal LV mechanics in OSA patients with normal LVEF are deteriorated in the subclinical stage being associated with the severity of disease. AFI can be used as an effective and safe method in the determination of subclinical myocardial dysfunction in OSA patients, because it is semi-automated and easy to use with a short analysis time. [ABSTRACT FROM AUTHOR]