bluuebunny/crossref_metadata_2025_split huggingface dataset:
P326 Changes in left atrial dimensions during stress echocardiography: linear vs planimetric methods
Authors: Torres M A R , Texeira T F , Camarozano A C , Bertoluci C , Heidemann Jr A I , Pianca E G , Branchi M N , Quevedo N M , Bellagamba C C A , Rodrigues J , Simbine R E B , Morrone D , Ciampi Q , Picano E 
Published: January 2020

Abstract

OnBehalf
On behalf of the Stress Echo 2020 study group of the Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI)
Background The measurement of left atrium (LA) can be obtained with simple linear or more complex biplane disk summation Simpson (S) method at rest and during stress echocardiography (SE). Although planimetric methods are mandatory to accurately assess resting LA volume, we sought to study if linear (L) methods can be equally valuable in assessing dynamic changes during SE.

Purpose
To assess accuracy of LA- SE with S compared to L method.

Methods
SE was performed in 34 patients (age 59 ± 16 years, 18 females) with known or suspected coronary artery disease. All had acceptable acoustic window at rest and were referred for clinically-driven SE (dobutamine in 21, dipyridamole in 13). LA was measured at rest and peak stress with both methods: 1- S biplane method from 4- and 2-chamber views; 2- L method with measurement of anteroposterior diameter from 2-D targeted M-mode in parasternal long-axis view. Two independent observers measured a set of 20 clips and repeated the measurements after 1 month on the same images. Stress-rest differences of L and S were compared with Spearman non-parametric correlation.

Results
LA measurement was obtained in all patients with L, 34/42 with S (feasibility 100%, and 80%, respectively). The off-line analysis time at each step (rest and stress) measured by stop-clock was 22.3 sec for L and 93 sec for S method (p &lt; 0.001). The intra-rater intra-class correlation coefficient for L was 0.965 for single measures and 0.982 for average measures. For S, it was 0.830 in single measures and 0.907 for average measures. The inter-rater correlation coefficient for L was 0.920 for single measures and 0.958 for average measures. For S, it was 0.901 for single measures and 0.948 for average measures. Absolute LA dimensions were moderately correlated between S and L at rest (r = 0.61, p &lt; 0.01), and during stress (r = 0.476, p &lt; 0.01). Rest-stress variations were not correlated (r = 0.004, p = NS).
Conclusion LA measurement is highly feasible during SE with L and S methods. Absolute values with both are only moderately correlated at rest, less at peak stress, and not correlated when only rest-to-stress variations are considered. Although L is more feasible, less time-consuming, and more reproducible, S should be the first choice for more accurate assessment of rest-stress LA dimensions in pharmacologic SE.
Abstract P326 Figure. Correlation of LA rest-stress
P332 is 3D analysis of longitudinal strain useful to predict cardiac events in patients undergoing mitral valve repair?
Authors: Volpato V , Mantegazza V , Manfredonia L , Gripari P , Fusini L , Tamborini G , Pepi M 
Published: January 2020

Abstract

Background
The presence of abnormal 3D left ventricular (LV) strain values in patients diagnosed with mitral valve prolapse (MVP) and significant mitral regurgitation (MR) has been described previously. Recently, some studies showed an addictive prognostic role of Global Longitudinal Strain (GLS) in patients with severe aortic regurgitation. Few data are available about the prognostic role of LV strain in patients diagnosed with severe MR secondary to Myxomatous or fibroelastic deficiency (FED) MVP, undergoing MV repair.

Purpose
The aim of the study was to determinate whether LV GLS, strain rate, twist rate and left atrial strain (LAS) may identify a subgroup of patients with MVP and severe MR at higher risk of clinical events after surgical repair in both Myxomatous and FED disease.

Methods
We retrospectively studied 100 patients diagnosed with MVP and severe MR due to Myxomatous or FED disease, eligible for MV surgery between 2012 and 2015. Only patients with normal LV function who underwent a 3D transthoracic echocardiographic examination were included. 3D LV GLS, strain rate, twist rate and LAS were measured using 3D analysis software. Clinical data were recorded during a median follow-up of 48 months. Clinical events included cardiac death, arrhythmia and cardiac hospitalization for heart failure or arrhythmic events.

Results
65 patients were diagnosed with Myxomatous and 35 with FED disease. A total of 13 events were recorded during the follow-up, including 1 death, 2 hospitalizations for heart failure and 10 minor arrhythmic events, mostly isolated premature ventricular complex. The number of events was not statistically different between the two groups. In both groups no significant correlation was found between clinical events and each of the echocardiographic parameters measured.

Conclusion
In patients with MVP and severe MR but normal LV function, undergoing MV repair, LV strain analysis was not able to predict long term cardiac events., regardless of the etiology.
P343 Evaluation of the age-related reference values of aortic pulse wave velocity in healthy subjects using Doppler echocardiography
Authors: Styczynski G , Cienszkowska K , Ludwiczak M , Szmigielski C 
Published: January 2020

Abstract

Introduction
Aortic pulse wave velocity (aPWV) is a measure of aortic stiffness, which is an indicator of vascular aging and has established independent prognostic role in predicting cardiovascular complications. aPWV can be measured with various non-invasive methods, but with different reference values depending on the technique used. The Doppler echocardiography method is potentially widely accessible and has been recently showed to have high correlation with invasive reference method of aPWV based on intraarterial pressure evaluation.

Purpose
The aim of the study was to establish reference values of aPWV, measured by Doppler method during a standard echocardiography in healthy subjects.

Methods
121 healthy adults, normotensive, non-smoking, without chronic diseases and not taking medication, were included. All the patients were divided into 5 groups due to age criterion (D1-age 21-30 yrs., n = 33; D2-age 31-40 yrs., n= 23; D3-age 41-50 yrs., n = 26; D4-age 51-60 yrs., n = 22; and D5-age 61-70 yrs., n = 17). During a routine echocardiographic examination with a cardiac probe, standard echocardiographic and anthropometric parameters were acquired. Additionally, 10 Doppler waveforms were recorded in the distal aortic arch and then in the left external iliac artery. The transit time was calculated as a difference between time delay of the two points of the Doppler recordings relative to ECG signal. The distance between proximal and distal points was measured over the body surface using a flexible measuring tape. aPWV values were calculated according to the formula: PWV = distance/transit time.

Results
The mean age of the studied group was 42 ± 13 yrs., BMI 24.5 ± 3.4, SBP 123 ± 10.39 mm Hg, DBP 76.98 ± 6.53 mm Hg, HR 64 ± 10 bpm. aPWV 5.28 ± 1.07; LVEDD 4.6 ± 0.4 cm; LA 3.65 ± 0.33 cm; aorta 3.26 ± 0.38 cm; LVMI 87.12 ± 15.00 g/m2. In the studied subjects, aPWV did not differ according to sex (females, n = 53, aPWV 5.38 ± 1.21 m/s vs. males, n = 68, aPWV 5.21 ± 0.94 m/s, p = 0.37). In the multivariate linear regression analysis only age and SBP were independently associated with aPWV, but none of the echocardiographic parameters studied. Mean aPWV values with 95% confidence interval (95%CI) for each decade of life were recorded as follows: D1-age 21-30, aPWV 4.56 m/s (95%CI 4.41 to 4.72), D2-age 31-40, aPWV 4.65 m/s (95%CI 4.37 to 4.94), D3-age 41-50, aPWV 5.15 m/s (95%CI 4.88 to 5.43), D4-age 51-60, aPWV 5.96 m/s (95%CI 5.54 to 6.38), D5-age 61-70, aPWV 6.88 m/s (95%CI 6.42 to 7.34).

Conclusions
We report age-related values of aPWV in a healthy population measured by Doppler echocardiography method. This may be helpful in future research exploring the associations between aortic stiffness, cardiac function and cardiovascular prognosis in a large population of patients referred for echocardiography.
P345 Temporal changes of left atrial function after orthotopic heart transplantation in a single-center prospective study
Authors: Dohy Z , Czimbalmos C , Assabiny A , Tarjanyi Z , Szakal-Toth Z , Parazs N , Toth A , Suhai F , Kiraly A , Edes I , Becker D , Sax B , Merkely B , Vago H 
Published: January 2020

Abstract

Funding Acknowledgements
Project no. NVKP_16-1-2016-0017 has been implemented with the support provided from the National Research, Development and Innovation Fund of Hungary
The geometry and function of the left atrium (LA) change after orthotopic heart transplantation (HTX) with bicaval technique, as the LA has a recipient part around the pulmonary veins and a donor part, and these often contract separately. Because of this altered LA function, the recognition of left ventricular diastolic dysfunction can be challenging. The standard echocardiographic diastolic parameters are often in abnormal range in HTX patients despite of normal left ventricular diastolic function.
The aim of our prospective study was to investigate the LA volumes and function and their temporal changes after HTX using cardiac magnetic resonance (CMR).
To better understand the cardiac characteristics of HTX patients, we started a prospective trial in January 2018. CMR was performed at one, three and six months after HTX. Left atrial contour detection was performed in 2- and 4-chamber views. Patients who had ≥Grade II allograft rejection before the CMR examination, were excluded (n = 2). In the remaining HTX patients (n = 21) and in a control group (n = 21) LA ejection fraction (EF), BSA-corrected maximum and minimum LA volume (Vi), stroke volume (SVi) were evaluated using bi-plane mode. LA global longitudinal strain (GLS) was defined with CMR based deformation imaging, called feature tracking.
HTX patients had significantly higher LA volumes (maxLAVi 71 ± 22 vs. 47 ± 6 ml/m2, minLAVi 53 ± 22 vs. 18 ± 5 ml/m2) lower LASVi (19 ± 7 vs. 29 ± 4 ml/m2), LAEF (27 ± 10 vs. 62 ± 8%) and LA-GLS (8 ± 3 vs. 39 ± 10%) compared to the control group (p &lt; 0.0001).
Analysing the temporal changes in HTX patients, we found an increase in the LAEF (26 ± 8 vs. 30 ± 5%) and LA-GLS (8 ± 3 vs. 11 ± 3%) at three months (p &lt; 0.05), there was no significant difference between the LA parameters at three and six months.
Better understanding of the changes of left atrial function after HTX could help us to recognise pathological conditions.
Abstract P345 Figure. Strain analysis of the left atrium
P347 Profile of coagulase negative staphylococci native valve infective endocarditis in a referral hospital
Authors: Ruiz Martinez B , Vallejo Camazon N , Seder Colomina E , Gonzalez Lopera M , Nunez Aragon R , Dolores Quesada M , Mateu L , Ferrer Sistach E , Pedro Botet L , Bayes Genis A 
Published: January 2020

Abstract

Coagulase-negative staphylococci (CNS) are the most frequently isolated microorganisms in early
prosthetic endocarditis. On the other hand, they rarely affect the native valve, so the profile of
native valve endocarditis by CNS is little known.

METHODS
Prospective observational study with retrospective analysis of 468 episodes of infectious
endocarditis (IE) admitted to our hospital from 2003-2018. Of these, 54 (11%) corresponded to IE by
CNS, and 22 were in native valve. We describe the characteristics of these 22 patients and compare
them with the group of IE by CNS in prosthesis and devices.

RESULTS
Average age was 67 years, with 77% male sex. There were no differences in predisposing
factors. Acquisition was predominant in-hospital (54%), but only previous manipulation was
detected in 31%. The presence of clinical and echocardiographic complications was similar, with
higher incidence of heart failure in the native group (81 vs. 34%, p = 0.001). Surgery was indicated in
86%, but only 50% underwent surgery. Mortality was very high (68% ) even greater than the
prosthetic/device group, although without significant differences.

CONCLUSION
IE due to CNS in native valve present clinical complications, frequently require surgery
and has a high mortality rate.
P353 Structural, functional, and electromechanical alterations in patients with paroxysmal atrial fibrillation compared to healthy controls
Authors: Trivedi S , Stefani L , Brown P , Kizana E , Kumar S , Thomas S , Thomas L 
Published: January 2020

Abstract

Background and Methods
We sought to evaluate the clinical and echocardiographic differences between healthy controls and paroxysmal atrial fibrillation (AF) patients. Clinical and echocardiographic parameters (performed in sinus rhythm) in 46 paroxysmal AF patients were compared with a departmental database of 83 health controls.

Results
AF patients were older and had increased body size (Table 1). 39/46 (84%) of AF patients had hypertension and 23/46 (50%) had diabetes mellitus.
AF patients had increased left ventricular (LV) mass, and reduced diastolic function (lower e’ and increased E/e’ ratio) when compared to healthy controls. Left atrial (LA) volumes were significantly increased in the AF group. All strain parameters – reservoir, conduit, and contractile strain – were impaired in AF patients compared to controls. LA mechanical dispersion (MD) was significantly increased in AF patients. A ratio of indexed LA volume/LA reservoir strain was significantly higher in AF patients over controls.
The duration of AF had an inverse correlation with LA reservoir strain (Fig 1) (r=–0.78; p &lt; 0.001).

Conclusions
Compared to healthy controls, patients with paroxysmal AF have significant structural, functional and electromechanical alterations. LA strain is significantly impaired in paroxysmal AF and correlates with AF duration.
Table 1. Echocardiographic parameters Parameter Controls (mean ± SD) AF patients (mean ± SD) P value Age (years) 48 ± 18 58 ± 14 0.001 Body surface area (m2) 1.9 ± 0.2 2 ± 0.2 0.014 LV mass (g) 178 ± 48 223 ± 68 &lt;0.001 Average e’ velocity (cms-1) 10.3 ±2.7 8.1 ± 2.2 &lt;0.001 E/e’ 7.4 ± 1.9 9.3 ± 3.4 0.001 Indexed LA end systolic volume (ml/m2) 27.2 ± 7.1 39.0 ± 11.6 &lt;0.001 LA ejection fraction 55.2 ± 10.4 48.5 ± 14.0 0.007 LA functional index 43.7 ± 14.6 29.8 ± 14.3 &lt;0.001 LA reservoir strain (%) 34.3 ± 6.8 27.9± 8.1 &lt;0.001 LA conduit strain (%) 18.4 ± 6.2 13.5 ± 4.7 &lt;0.001 LA contractile strain (%) 15.9 ± 3.9 14.4 ± 5.5 0.007 LA mechanical dispersion (ms) 25.8 ± 9.6 30.9 ± 11.6 0.018 Indexed LA volume / Reservoir strain ratio 0.8 ± 0.3 1.6 ± 0.9 &lt;0.001 LV = left ventricular; LA = left atrium; SD = standard deviation
Abstract P353 Figure. Fig 1. AF duration vs. Reservoir strain
P366 Role of mechanical dispersion in the prediction of heart failure admissions in dilated non ischemic cardiomyopathy
Authors: Travieso Gonzalez A , Ferrandez Escarabajal M , Islas F , Luaces M , Perez De Isla L , Olmos C 
Published: January 2020

Abstract

Introduction
Non ischemic dilated cardiomyopathy (DCM) is a disease with poor prognosis and limited therapeutic options. Several echocardiographic measures attempt to provide good estimators of the risk of heart failure (HF) admissions.

Purpose
To assess the potential additional value of mechanical dispersion (MD) compared to global longitudinal strain (GLS) in the prediction of outcomes in DCM.

Methods
74 patients with DCM and left ventricle ejection fraction (LVEF) of less than 50% were prospectively evaluated from 2015 to 2019. MD and GLS were blindly measured using 2D speckle tracking echocardiography. Hospital admissions due to worsening HF were examined.

Results
Mean LVEF was 29.4%, and median follow-up time was 14 months. Baseline characteristics are shown in Table 1.
Patients with high MD, defined as &gt;67 ms, showed a significantly higher risk of admissions due to HF (50.5% vs 22.0%, p = 0.026), even when adjusted with LVEF and end-diastolic volume in multivariable analysis, with a hazard ratio of 2.6 (95% confidence interval 1.1-6.1) (Figure). No differences in the use of cardiac resynchronization therapy and implantable cardioverter defibrillator were observed in both groups. This cut off value had a Sensitivity of 52.2% and Specificity of 76.5%.
Despite significant correlation between MD and GLS (R = 0.36, p = 0.002), a GLS of less than -10% was not significantly associated with higher incidence of HF admissions in this population (40.6% vs 23.8%, p = 0.229).

Conclusion
Mechanical dispersion, measured by 2D speckle tracking echocardiography, predicts HF admissions more accurately than global longitudinal strain in patients with non-ischemic DCM.
Table 1 Mech. Disp &lt;67 ms (n = 50) Mech. Disp ≥67 ms (n = 24) p Age 62.2 (±2.2) 64.6 (±3.0) 0.538 Female sex 13 (26.0%) 10 (41.7%) 0.173 NYHA class III-IV 4 (8.5%) 3 (13.6%) 0.882 CRT 23 (46.0%) 12 (50.0%) 0.747 ICD 27 (54.0%) 17 (70.0%) 0.167 QRS duration (ms) 144.2 (±8.6) 152.7 (±7.9) 0.496 NTproBNP (pg/ml) 4495 (±964) 4488 (±1529) 0.997 LVEF (%) 29.9 (±1.1) 28.6 (±1.7) 0.520 LVEDV (ml/m2) 93.0 (±5.6) 95.2 (±5.8) 0.802 Table 1: baseline characteristics in population with MD &lt;67 ms or ≥ MS. Data is shown as N(%) or Mean(±SD). CRT: cardiac resynchronization therapy. ICD: implantable cardioverter defibrillator. LVEDV: LV end-diastolic volume.
Abstract P366 Figure
P372 Aortic stiffness in Loeys-Dietz syndrome: a comparison with Marfan syndrome patients and healthy volunteers
Authors: Ruiz Munoz A , Guala A , Rodriguez-Palomares J F , Lopez-Sainz A , Granato C , Valente F , Gutierrez L , Galian L , La Mura L , Gonzalez-Alujas T , Servato L , Sao-Aviles A , Ferreira I , Evangelista A , Teixido-Tura G 
Published: January 2020

Abstract

Funding Acknowledgements
ISCIII PI14/0106 and PI17/00381, La Marató de TV3 (20151330), Eur FP7/People 267128 and CIBERCV

BACKGROUND
Genetic syndromic aortic diseases are rare, with Marfan syndrome (MFS) being the most common. However, less is known of Loeys-Dietz syndrome (LDS) which has much lower prevalence and presumed worse prognosis. Increased aortic stiffness in MFS has been previously described but no studies have evaluated aortic biomechanics in LDS. Pulse wave velocity (PWV) is the gold standard measure for arterial stiffness and can be quantified by 4D flow MRI. We aim to evaluate regional aortic PWV by 4D flow MRI in LDS compared to MFS and healthy volunteers.

METHODS
Sixteen LDS patients with a pathogenic mutation, 76 MFS and 49 healthy volunteers were prospectively and consecutively included. No patient had previous aortic dissection or surgery. All underwent a 4D flow MRI study in a 1.5 T clinical scanner. Ascending (AAo) and descending (DAo) aorta PWV were computed using wavelet analysis of the systolic upslope for transit time calculation (Figure). Statistical comparison was made with non-parametric analysis to account for the non-normality of data and multivariate analysis was evaluated separately for AAo and DAo PWV.

RESULTS
Ascending and descending aortic PWV revealed stiffer aortas in LDS patients than in healthy volunteers, even after adjustment for diameter of sinus of Valsalva (SoV) and sex. Conversely, no differences in aortic stiffness were found between LDS and MFS patients (Table).

CONCLUSIONS
Abnormally high regional aortic stiffness was observed in LDS patients when compared with controls. The severity of increased regional aortic stiffness was found similar to the one affecting MFS patients.
Table Controls (N = 49) LDS (N = 16) MFS (N = 76) LDS vs. HV LDS vs. MFN Parameter Unadjusted p-value Adjusted p-value Unadjusted p-value Adjusted p-value Age [years] 39 ± 12 39 ± 16 36 ± 12 0.903 0.599 Men 32 (65%) 6 (37%) 34 (45%) 0.079 0.782 Weight [kg] 72 ± 11 69 ± 13 74 ± 16 0.288 0.194 Height [cm] 172 ± 8 172 ±12 181 ± 11 0.834 0.008 Systolic BP [mmHg] 126 ± 18 125 ± 14 127 ± 17 0.957 0.523 Diastolic BP [mmHg] 70 ± 11 77 ± 6 75 ± 12 0.011 0.318 SoV diameter [mm] 30.6 ± 3.9 35.4 ± 4.6 38.1 ± 5.9 0.001 0.060 AAo diameter [mm] 27.7 ± 3.8 29,0 ± 5.0 29.7 ± 5.4 0.458 0.579 DAo diameter [mm] 20.0 ± 2.0 21.3 ± 3.6 22.9 ± 3.8 0.546 0.124 AAo PWV [m/s] 5.2 ± 1.9 7.6 ± 2.4 7.3 ± 2.8 0.001 0.050* 0.534 NS DAo PWV [m/s] 7.1 ± 2.2 9.4 ± 2.6 10.7 ± 4.6 0.003 0.025** 0.493 NS
Abstract P372 Figure
P373 Left atrial mechanics and aortic stiffness following high intensity interval training: a randomised controlled study
Authors: Jalaludeen N , Bull S , Taylor K , Wiles J , Coleman D , Mukhtar O , Cheriyan J , Wilkinson I , Sharma R , O"driscoll J 
Published: January 2020

Abstract

Background
Physical inactivity is associated with an increased risk of cardiovascular disease. High intensity interval training (HIIT) has been shown to improve important health parameters, including aerobic capacity, arterial blood pressure, cardiac autonomic modulation and left ventricular mechanics. However, adaptations in left atrial (LA) mechanics and aortic stiffness remain unclear. Therefore, the aim of the present study was to assess any left atrial and aortic adaptations to HIIT.

Methods
Forty-one physically inactive males and females (aged 23 ± 2.7 years) volunteered for the study. Participants were randomised to either a 4-week HIIT intervention (n = 21) or 4-week control period (n = 20). The HIIT protocol consisted of 3 x 30-second maximal cycle ergometer sprints with a resistance of 7.5% body weight, interspersed with 2-minutes of active unloaded recovery. Speckle tracking imaging of the left atrium and M-Mode tracing of the aorta was performed pre and post HIIT and control period using commercially available software (EchoPac; GE Medical Systems). Analysis of covariance, with baseline measures as the covariate, was used to explore any differences in left atrial mechanics and aortic stiffness between the intervention and control groups. Stepwise linear regression analysis using LA stiffness as the dependent variable was conducted.

Results
Following 4-weeks of HIIT, there was significant improvement in LA mechanics, including LA reservoir (13.9 ± 13.4%, p = 0.033) and LA stiffness (-0.05 ± 0.04%-1, p = 0.032) compared to the control condition. In addition, improvements were observed in aortic distensibility (2.1 ± 2.7 cm2 × dyn×-1 × 103, p = 0.031) and aortic stiffness index (-2.6 ± 4.6, p = 0.041) compared to the control condition. In stepwise linear regression analysis, aortic distensibility change was significantly associated with LA stiffness change (p = 0.002), with an R2 of 0.613.

Conclusion
A short-term programme of HIIT was associated with a significant improvement in LA mechanics and aortic stiffness. These adaptations may have important health implications and contribute to the improved left ventricular diastolic and systolic mechanics, aerobic capacity and reduced arterial blood pressure previously documented following HIIT.