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Background: We aimed to evaluate whether right ventricle (RV) longitudinal strain indexed to pulmonary arterial systolic pressure (PASP) has prognostic significance in patients undergoing cardiac resynchronization therapy (CRT). Methods: Patients undergoing CRT were prospectively included. The primary endpoint was adverse cardiovascular events (death and HF-related hospitalizations). RV global longitudinal strain (RVGLS) and RV free wall strain (RVfwS) were measured by speckle tracking and indexed to echocardiographic estimated PASP. Results: A total of 54 patients (64.0 ± 13.8 years; 58% male) were included. After 33 ± 12.9 months, the primary endpoint occurred in 18 patients. Baseline RVGLS/PASP and RVfwS/PASP showed good discriminative ability for response to CRT (AUC = 0.88, 95% CI (0.74–1) and AUC = 0.87, 95% CI (0.77–1)). RVGLS/PASP and RVfwS/PASP were significantly associated with high risk of events at univariate analysis (HR 0.039, 95% CI (0.001–0.8) p < 0.05, respectively HR = 0.049, 95% CI (0.0033–0.72), p < 0.05). Upon multivariate Cox regression analysis, RVGLS/PASP and RVfwS/PASP remained associated with high risk of events (HR 0.018, 95% CI (0.0005–0.64), p = 0.02 and HR 0.015, 95% CI (0.0004–0.524), p = 0.01) after correction for gender, etiology, QRS duration and morphology. Conclusions: Indexing RV longitudinal strain (global and free wall) by PASP provides a parameter, which independently identifies patients with high risk of cardiovascular events and predicts non-response to CRT. [ABSTRACT FROM AUTHOR]

Objectives: We sought to investigate left atrial (LA) structural and functional abnormalities in a group of optimal treated hypertensives, in comparison to a control group. Methods: This study included 35 prospectively enrolled subjects with treated, uncomplicated, essential hypertension (HTN). Left atrial diameters (anteroposterior, transversal and longitudinal) and left atrial phasic volumes [maximal (LAV max), minimal (LAV min) and before atrial contraction (LAVpreA)] were assessed by echocardiography and LA emptying functions (LAEF) (global, active and passive) were calculated. Using the current recommendations of speckle tracking technique, peak longitudinal strain of LA walls (PALS)(mean value from apical four chambers and two chambers view) were analysed. The results were compared with a group of 37 age-matched healthy controls. Results: LA anteroposterior diameter as well as all three phasic LA volumes were significantly greater in HTN group (39.54±4.6 mm vs 35.43±4.5 mm for anteroposterior diameter, 60.51±14.9 ml vs 45.22±13.4 ml for LAV max, 25.48±10.3 ml vs 14.64±5.3 ml for LAVmin and 42.14±11.4 vs 24.86±8.5 for LAVpreA , for all p<0.0001), while the transversal and longitudinal diameters were similar. We found significantly lower total and passive EF in hypertensives than in control group (total LAEF 49.78±8.4% vs 66.05±7.44, p<0.001and passive LAEF 44.62±8.36% vs 58.79± 8.14%, p<0.001), but the active LAEF was preserved. The peak systolic strain values were also significantly lower in HTN group versus control (22.7% versus 35.1%, p<0.0001) Conclusion: Hypertension, even correctly treated, affects the mechanical function of left atrium. In our hypertensive group we observed the dilation of left atrium and an altered passive and total atrial function, with preservation of atrial pump function compared to control group. LA dysfunction was also demonstrated through low peak strain values. [ABSTRACT FROM AUTHOR]

Objectives: We sought to investigate left atrial (LA) structural and functional abnormalities in a group of optimal treated hypertensives, in comparison to a control group. Methods: This study included 35 prospectively enrolled subjects with treated, uncomplicated, essential hypertension (HTN). Left atrial diameters (anteroposterior, transversal and longitudinal) and left atrial phasic volumes [maximal (LAV max), minimal (LAV min) and before atrial contraction (LAVpreA)] were assessed by echocardiography and LA emptying functions (LAEF) (global, active and passive) were calculated. Using the current recommendations of speckle tracking technique, peak longitudinal strain of LA walls (PALS)(mean value from apical four chambers and two chambers view) were analysed. The results were compared with a group of 37 age-matched healthy controls. Results: LA anteroposterior diameter as well as all three phasic LA volumes were significantly greater in HTN group (39.54±4.6 mm vs 35.43±4.5 mm for anteroposterior diameter, 60.51±14.9 ml vs 45.22±13.4 ml for LAV max, 25.48±10.3 ml vs 14.64±5.3 ml for LAVmin and 42.14±11.4 vs 24.86±8.5 for LAVpreA , for all p<0.0001), while the transversal and longitudinal diameters were similar. We found significantly lower total and passive EF in hypertensives than in control group (total LAEF 49.78±8.4% vs 66.05±7.44, p<0.001and passive LAEF 44.62±8.36% vs 58.79± 8.14%, p<0.001), but the active LAEF was preserved. The peak systolic strain values were also significantly lower in HTN group versus control (22.7% versus 35.1%, p<0.0001) Conclusion: Hypertension, even correctly treated, affects the mechanical function of left atrium. In our hypertensive group we observed the dilation of left atrium and an altered passive and total atrial function, with preservation of atrial pump function compared to control group. LA dysfunction was also demonstrated through low peak strain values. [ABSTRACT FROM AUTHOR]