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To examine left ventricular (LV) function in elite young athletes in relation to structural adaptation to prolonged intense training. Conventional echocardiography and tissue Doppler imaging (TDI) were performed in 15 elite rowers and 12 sedentary matched controls. Rowers had increased LV mass index, septal (12 vs 10 mm, P<0.005) and posterior wall thicknesses (12 vs 9 mm, P<0.001) and increased relative wall thickness. Septal and lateral systolic velocities were enhanced in rowers (septal Sm=8.5 vs 6.3 cm/s, P<0.001; lateral Sm=11.4 vs 8.0 cm/s, P<0.005), representing a 35% and 42% increase, respectively. Similarly, septal and lateral early diastolic velocities were enhanced (septal Em=12.1 vs 9.5 cm/s, P<0.01; lateral Em=16.6 vs 11.6 cm/s, P<0.001), representing a 27% and 43% increase, respectively. Systolic and early diastolic TDI velocities of the lateral wall showed a positive correlation ( r=0.65, P<0.01) in athletes indicating a parallel improvement of systolic and diastolic function, while LV stiffness was decreased [( E/ Em)/(LV end-diastolic diameter)=1.13 vs 1.57, P<0.005). Both systolic and diastolic LV function were improved in elite rowers, despite a pattern of concentric hypertrophy. [ABSTRACT FROM AUTHOR]

Aims Diabetes mellitus (DM) is associated with macrovascular disease and impaired aortic function. We hypothesized that the change in aortic elastic properties could be investigated with colour tissue Doppler imaging (CTDI) in Type 1 diabetic patients and that these findings could be related to the aortic stiffness index. Methods We examined by echocardiography 66 patients with Type 1 DM (mean age 35 ± 10 years, mean duration of disease 20 ± 9 years) without a history of arterial hypertension or coronary artery disease (negative thallium-201 stress test) and 66 age- and sex-matched normal subjects. Arterial pressure was measured before echocardiography was performed. Internal aortic systolic and diastolic diameters by M-mode echocardiography and aortic systolic upper wall tissue velocity (Sao, cm/s) by CTDI were measured 3 cm above the aortic valve. Aortic distensibility and aortic stiffness index were calculated using accepted formulae. Results Aortic stiffness, distensibility and Sao velocity differed significantly between the studied groups. In the diabetic group, duration of diabetes correlated with aortic stiffness ( r = 0.53, P < 0.001), distensibility ( r = −0.61, P < 0.001) and Sao velocity ( r = −0.48, P < 0.001). There was a negative correlation between aortic stiffness and Sao velocity ( r = −0.49, P < 0.001). Multiple stepwise linear regression analysis in the diabetic group revealed that aortic S velocity (β = 0.30, P = 0.005) and duration of diabetes (β = −0.49, P = 0.001) were the main predictors of aortic distensibility (overall R2 = 0.48). Conclusions Aortic elastic properties can be directly assessed by measuring the movements in the upper aortic wall. Reduced aortic S velocity is associated with increased aortic stiffness in Type 1 diabetic patients. [ABSTRACT FROM AUTHOR]

Background: Interatrial block (IAB: P wave > or = 110 ms) is highly prevalent in people > or =65 years old living in a community.Methods: We investigated 720 consecutive people age > or =65 years old, from the general population, with the intention of evaluating the prevalence of IAB in their electrocardiogram. After excluding 42 people with atrial fibrillation and atrial flutter (5%) or having a permanent pacemaker (0,83%), we evaluated the electrocardiograms of the remaining 678 people with sinus rhythm.Results: We identified 400 (59%) persons with IAB with a similar distribution between men (58.5%) and women (59.4%). IAB was also identified in 347 from a total of 570 hypertensive people (60,9%) and only in 53 out of 108 (49.1%) nonhypertensive people (P = 0.015).Conclusions: The surprisingly large prevalence of the IAB in the general older population emphasizes the importance of the early recognition of this abnormality from the surface 12-lead electrocardiogram. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented addressing the issue of cardiovascular screening for athletes prior to participating in sports competition or training.

An abstract of the article "Echocardiographic characteristics of functional mitral regurgitation in ischaemic versus idiopathic dilated cardiomyopathy," by K. Papadopoulou and colleagues is presented.

Background: Recent studies have shown that mitral regurgitation (MR) represents a major determinant of left atrial (LA) function in patients with heart failure with preserved ejection fraction. The role of MR in determining LA myopathy in hypertrophic cardiomyopathy (HCM) is unknown. The aim of this study was to examine the association of MR with LA myopathy, assessed by LA strain values in HCM patients., Methods: In total 250 consecutive patients (mean age 51 ± 16 years, 67.2% male) with an established diagnosis of HCM and with sinus rhythm at index echocardiography evaluation were included. LA reservoir, conduit and booster strain were analyzed, besides LA size, left ventricular (LV) systolic and diastolic function. The predictors of LA strain values were identified with linear regression analysis., Results: Significant (more than mild) MR was a significant univariate predictor of all the three LA strain values. In multivariate linear regression analysis, independent predictors of LA reservoir strain were more than mild MR (r = -.23), LV global longitudinal strain (r = -.49), LA volume index (r = -.27) and patient age (r = -.23). Significant MR was also an independent determinant of LA conduit (r = -.17) and booster strain (r = -.12). In patients with LA volume index < 34 ml/m 2 more than mild MR was an independent predictor of LA reservoir (r = -.32) and conduit strain (r = -.27), but not LA booster strain., Conclusion: Significant MR is associated with LA myopathy independently of the LV diastolic and systolic function and LA size., (© 2022 Wiley Periodicals LLC.)

Background: With this study, we sought to investigate the prognostic value of echocardiographic tissue imaging markers in predicting tamponade among patients with large malignant pericardial effusion compared to routinely used echocardiographic signs., Methods: A total of 96 consecutive patients with large malignant pericardial effusion, not in clinical cardiac tamponade, underwent an echocardiographic examination and were prospectively assessed for 1 month. Clinically evident cardiac tamponade was considered as the study endpoint. The prognostic performance of tricuspid valve annular plane systolic excursion (TAPSE) and peak systolic annular velocity at the lateral margin of the tricuspid valve annulus (S TV ) was assessed and compared to routinely used imaging signs., Results: During follow-up, 37 patients (39%) developed clinically evident cardiac tamponade. TAPSE (area under the curve [AUC] 0.958) and S TV (AUC 0.948) had excellent predictive accuracy for tamponade. Multivariate analysis showed that TAPSE (Hazard ratio [HR] 3.03; 95% CI 1.60-5.73, P=.001) and S TV (HR 1.17; 95% CI 1.05-1.29, P=.005) remained independent significant predictors of cardiac tamponade. Reclassification analysis and decision curve analysis showed additive prognostic value and adjunct clinical benefit of these markers when added to a recently published triage pericardiocentesis score., Conclusion: Echocardiographic tissue imaging markers such as TAPSE and S TV are characterized by an excellent prognostic ability for development of cardiac tamponade and better prognostic value compared to routine echocardiographic signs in patients with large malignant pericardial effusion. Incorporating these markers to a recent triage pericardiocentesis score resulted in additional prognostic value and increased clinical benefit., (© 2017, Wiley Periodicals, Inc.)