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Deformation analysis using 2-dimensional strain echocardiography can detect early systolic function abnormalities in patients with left ventricular hypertrophy. This study was designed to characterize global and regional myocardial deformation using 2-dimensional strain in professional soccer players (PSPs) compared with control subjects and patients with hypertrophic cardiomyopathy (HC). Twenty nine PSPs, 26 patients with HC, and 17 controls were investigated at rest using transthoracic echocardiography with 2-dimensional strain analysis. Radial and transverse strains were significantly higher in PSPs compared with controls, whereas longitudinal strain was lower. Compared with patients with HC, athletes had higher values for transverse, radial, and circumferential strains. In pathologic hypertrophic segments, longitudinal strain was lower in patients with HC than in PSPs. In conclusion, 2-dimensional strain can identify specific patterns of myocardial deformation in PSPs, controls, and patients with HC. It has the potential to become a routinely used method for the differentiation of athlete's heart and HC.

SummaryBackgroundSpeckle tracking is a new technique based on pure 2D grayscale ultrasound acquisition allowing calculation of segmental strains. To facilitate clinical application, speckle tracking has been integrated into the most recent echocardiographic systems for quick, automated evaluation of left ventricular function (Automated Function Imaging, AFI).ObjectiveTo evaluate the feasibility, calculation time, accuracy and reproducibility of global longitudinal strain (GLS) from AFI in determining LV function in comparison to reference echocardiographic and angiographic methods–whatever the operator's experience.MethodsEchocardiography was performed in 65 patients scheduled for cardiac catheterization using a Vivid 7 system. They were divided into 3 groups according to EF (>55%, 35≤EF≤55%

Background: Persistent/Permanent atrial fibrillation (Per AF) and electromechanical left ventricular (LV) dyssynchrony are frequently associated in patients with systolic heart failure. Their relationships have not been investigated yet. Objective: We hypothesized that Per AF could induce or worsen ventricular dyssynchrony. The aim of this prospective study was to evaluate the degree of LV dyssynchrony in patients with Per AF and depressed LV function; to describe the evolution of dyssynchrony after AF catheter ablation. Methods: 28 patients with isolated Per AF and depressed LV function were investigated with a VIVID7 (General Electric) before ablation (D-1), at 1 month (M+1) and at 6 month (M+6) after the procedure and compared to 28 controls. LV ejection fraction was evaluated by biplane Simpson rule. LV dyssynchrony was quantified by tissue Doppler imaging in apical views using a triplane 3D/4D acquisition. Maximal difference between times to peak (mdTP) was determined. TP was measured as the delays between the onset of the QRS and the peak velocity of systolic wave on the 6 basal LV segments. Values were averaged on 3 consecutive cardiac cycles. LV dyssynchrony was defined for a mdTP value >65ms. Parameters of dyssynchrony were normalized to RR interval. Results: Before ablation, mdTP was >65ms for 10 (36%) of the patients (group1) and >65ms for 18 patients (group 2). Ejection fraction was significantly lower in group 1 than in group 2. During the follow-up, the LV ejection fraction increase was similar in the 2 groups (+42%; +41%)(Table ). In the whole population, mdTP decreased from 57.5±35ms to 44.1±35ms (P Conclusions: In this study, LV dyssynchrony was present in 36% of the patients with permanent AF and impaired LV ejection fraction. Catheter ablation significantly improved both LV ejection fraction and LV dyssynchrony in this population. Table