bluuebunny/crossref_metadata_2025_split huggingface dataset:
Speckle tracking parameters in the two genders in chronic heart failure: a multicentric italian study
Authors: Mandoli G E , Martini L , Spaccaterra L , Pastore M C , Benfari G , Santoro C , De Giovanni A , Patti G , Giannoni A , Emdin M , Malagoli A , Lisi M , Cameli M 
Published: January 2025

Abstract

Introduction
the incidence of heart failure (HF) with reduced ejection fraction (EF, HFrEF) and with mildly reduced EF (HFmrEF) is globally lower worldwide and women are underrepresented in clinical trials. A deeper knowledge of possible gender differences in HF is needed to guarantee a better management.

Purpose
to evaluate left (LV) and right ventricular (RV) and left atrial (LA) longitudinal deformation by speckle tracking echocardiography (STE) in a population of patients with HF and ejection fraction (EF) &lt;50%, to describe possible gender differences.

Methods
we retrospectively enrolled patients from 7 different Italian centers, referred to a high experience echocardiographic laboratory for stable chronic HF follow up. We excluded patients with preserved LV ejection fraction, recent admission for acute HF, previous cardiac surgery, and absent informed consent. All patients underwent complete standard and advanced echocardiography, including STE-derived LV, RV and LA strain. Kolmogorov-Smirnov test was used to verify normal distribution of variables. Continuous variables were compared using the unpaired t test for normally distributed variables and the nonparametric Mann-Whitney U test for non-normally distributed variables.

Results
a multicentric population of 644 patients (mean age 66.8±11.4, 237 female, 37%) was finally included in the study. The population had a globally reduced systolic function (mean LVEF 33.4±9.7%, mean LV global longitudinal strain (GLS) -9.7±3.5%) with abnormal RV longitudinal deformation (mean free wall RVLS -17.6±6.1%), increased pulmonary pressures (sPAP 35.1±12 mmHg) and diastolic disfunction (LA strain (PALS) was 16.3±8%, mean E/e’ ratio 12.2±3.6). Analyzing the female population with HF (see Table 1), women had lower LV and RV mass and diameters. The LA was smaller, but they had similar diastolic indices compared to man. Interestingly, deformation analysis revealed comparable LV, LA, and RV longitudinal strain in the two genders.

Conclusion
female HF population seems to have similar cardiac longitudinal dysfunction compared to men. It could be then credible to expect similar therapeutic response to HF drugs in the two genders. Further studies are needed to evaluate different echocardiographic prognostic parameters across gender in HFrEF and HFmrEF.
Association of left atrial strain with hypertension in pregnancy: a prospective observational study.
Authors: Alegre M , Bundalian I , Katimbang-Lazaro K 
Published: January 2025

Abstract

Introduction
Maternal hypertension, be it gestational or pre-existing, has been a health concern throughout the modern world. Although advances in healthcare have drastically improved the outcome of pregnancies in the past decade or so, the increasing age of expectant mothers, as well as the prevalence of hypertension in the general population and its associated complications, have dealt a different dilemma for current medical practitioners. Hypertension was documented as the 3rd third leading cause of maternal mortality in the Philippines. Studies also showed that Filipinos, when compared to their other Asian counterparts, have a higher incidence of maternal hypertension and its complications. Left atrial strain, a non-invasive, early marker of diastolic dysfunction, has been studied as predictor of chronicity of cases of gestational hypertension. As of writing of this paper, no local study using left atrial strain has been conducted on Filipino people, less so for pregnant women. Hence, further investigation to determine the baseline values and the effect of hypertension in left atrial strain in this population is warranted.

Objectives
This study aims to determine the relationship between left atrial strain using 2D echocardiogram and the presence of hypertension in pregnant Filipino women.

Methods
This was a single center, prospective, cross-sectional observational study involving pregnant patients seen at a tertiary hospital. The primary endpoint was the difference in left atrial strain and compliance between hypertensive and non-hypertensive subjects. For comparison, demographics and other systolic and diastolic echocardiographic parameters were evaluated. A sub-analysis between gestational and chronic hypertensive patients was also done.

Results
Twenty-six pregnant patients between 20 to 38 weeks age of gestation were divided into hypertensive (n=7) and normotensive (n=19) groups. Age (p=0.938), gestational age (p=0.909), and other co-morbidities were comparable between both groups. The left atrial reservoir strain (LASr) was significantly lower in hypertensive patients (32.15 ± 6.17%) compared to normotensive patients (43.85 ± 4.50%), indicating impaired left atrial function in hypertensive individuals (p&lt;0.001). Left atrial compliance was also significantly lower in the hypertensive group (p=0.006), suggestive of elevated filling pressure. Comparison between gestational (n=2) and chronic hypertensive patients (n=5) yielded minimal difference in strain values.

Conclusion
Aside from the physiologic decrease in left atrial strain in pregnancy, the presence of hypertension further decreases left atrial function, specifically, the left atrial reservoir strain and compliance, despite normal standard echo parameters. Its implication on the future cardiac complication requires further investigation.
LA strain: Normotensive pregnant woman
LA strain: Hypertensive pregnant woman
Variation of left atrium strain after TAVI implantation
Authors: Santiago Setien I , Perez Barquin R , Ruisanchez Villar C , Veiga Fernandez G , Serrano Lozano D , Carreiro Da Cunha E , Coroas Pascual C , Cuesta Cosgaya J M , Lerena Saenz P , Llano Cardenal M F , Gil Ongay A , Zarauza Navarro M J , Garcia Camarero T , Sainz Laso F , De La Torre Hernandez J M 
Published: January 2025

Abstract

Introduction
Left atrium strain (LAS) is a marker of left atrium function, which has been shown to have diagnostic and prognostic value in various cardiovascular pathologies, serving as an indirect marker of left atrium fibrosis. On the other hand, the implantation of TAVI is currently a therapeutic alternative indicated in an increasingly broad cohort of patients with aortic stenosis (AS). Our objective was to analyze the variation in LAS values after TAVI implantation.

Methods
Patients with a diagnosis of severe symptomatic AS who received a TAVI (Edwards-Sapien) between October 2018 and February 2020 were included. Baseline echocardiographic studies conducted on the day of implantation, prior to the intervention, were analyzed and compared with examinations at a medium-term follow-up, established at six months. Variables of left atrium strain (LAS) in its three phases: reservoir, conduit, and contractile phases were detailed.

Results
A total of 129 patients (mean age 80.2 years, SD 9.02) were included, with 72 (55.8%) being women and the majority (76%) in functional class II. LAS could be analyzed in 99 cases. The baseline echocardiogram showed a global decrease in LAS values in its three phases compared to normal values (reservoir phase 20.4%, conduit phase -9.2%, contractile phase -10.9%). At follow-up, we observed a statistically significant improvement in LAS values in the reservoir phase (24.7%, SD±2.2; p 0.02) and in the contractile phase (-13.9%, SD 1.5; p 0.018). No significant differences were found in LAS values in the conduit phase (-10.4%, SD 0.9; p 0.21).

Conclusions
According to our data, the implantation of TAVI in patients with severe symptomatic AS is associated with a significant improvement in LAS values, both in the reservoir and contractile phases. Although the net improvement in values is modest, in relative terms the LAS value in the conduit phase improves by 23% compared to baseline and in the contractile phase by 27%. Additionally, it is noteworthy that in this cohort of elderly patients with established heart disease, the LAS (which is an indirect marker of fibrosis at the left atrium level) experiences a significant improvement after a relatively short follow-up (6 months). It would be of interest to analyze the variation of LAS over a longer term in the future and what clinical role it might play (development of atrial fibrillation, heart failure decompensation, etc.).
Is rotational mechanics the link between strain and ejection fraction in patients with ventricular hypertrophy?
Authors: Geraldo Martinez J , Galiana Talavera E , Gil Llopis C , Contreras Tornero M B , Hidalgo Mateos A , Gramage Sanchis P , Queipo Rodriguez A , Garcia Marin G , Rodriguez Gutierrez C , Gomon Dobrochynska T , Callizo Gallego R , Valls Serral A , Roldan Torres I , Mora Llabata V 
Published: January 2025

Abstract

Introduction
The reduction of global longitudinal strain (GLS) is an early marker of myocardial dysfunction. However, low GLS values do not provide information about the left ventricular ejection fraction (LVEF) because they can be decreased in patients with both reduced and preserved LVEF.

Purpose
To analyze the impact of rotational mechanics on the LVEF of patients with left ventricular hypertrophy and myocardial dysfunction.

Methods
We analyzed 248 patients with left ventricular hypertrophy, and divided them in two groups. Group 1 (n=104) with normal GLS (≥ 17%), and Group 2 (n=144) with decreased GLS (&lt; 17%) due to myocardial dysfunction. We analyzed a) the rotational model ["twist" when the base and apex of the LV rotate in opposite directions, vs "rigid rotation" when the base and apex rotate in the same direction], and b) the rotational gradient (in degrees), as a result, in the case of twist, of the sum of basal and apical rotations (coded positive), and in the case of rigid rotation as a result of the difference between basal and apical rotations (coded negative).

Results
The 104 patients (Group 1) with normal GLS (≥ 17%), and therefore LVEF ≥ 50%, presented twist as the rotational model. Among the 144 pts (Group 2) with myocardial dysfunction (GLS &lt; 17%), LVEF was &lt; 50% in 34.7%. Twist was present in 83.3% of cases, and the remaining 16.7% exhibited rigid rotation. In this Group 2 of patients with myocardial dysfunction, the rotational gradient showed a good correlation with LVEF (r = 0.73; p &lt; 0.001), such that in patients with twist, the values of the rotational gradient were progressively lower as LVEF decreased, until adopting negative values (pattern of rigid rotation) in those with more severe depression of LVEF as shown in Figure 2.

Conclusion
In patients with LVH and GLS impairment, the reduction of the rotational gradient translates into a deterioration of LVEF, providing additional information in the stratification of patients with myocardial dysfunction.
Figure 1
Figure 2
Effects of SGLT2i on right ventricule function in HFpEF: an echocardiographic study
Authors: Novo G , Guerra F , Benfari G , Pastore M C , Giannone A , Mazzeo P , Santoro C , Citro R , Inciardi R , Correale M , Carluccio E , Degiovanni A , Lisi M , Pasquini A , Cameli M C 
Published: January 2025

Abstract

Background
several studies have demonstrated the cardioprotective effects of Sodium-glucose co-transporter 2 inhibitors (SGLT-2i) in patients with heart failure (HF), irrespective of the presence of diabetes. These findings have culminated in new recommendations for SGLT2i in the treatment of HF, either with reduced or preserved ejection fraction (EF).

Purpose
the purpose of this study was to analyze the effect of Gliflozin on right ventricular function, in patients with HFpEF, using speckle tracking echocardiography and new echocardiographic surrogates of right ventricular-pulmonary artery (RV-PA) coupling.

Methods
we enrolled 105 symptomatic HF patients (aged 71,143 ± 9,913 years) with EF &gt; 40% (47,9 ± 7,26) into a multicentric prospective observational study; main anamnestic information, NT-proBNP values and complete echocardiographic data were collected in an ambulatory setting, at time of enrolment and after 6 months of therapy with SGLT-2i.
The echocardiographic analysis included conventional, tissue-derived imaging, and myocardial deformation speckle tracking echocardiography of left and right sections. TAPSE/PASP (tricuspid annular plane systolic excursion/pulmonary artery systolic pressure) and RVFWLS/PASP (Right ventricle free wall longitudinal strain) were also collected as surrogates of RV-PA coupling such as

Results
after 6 months of SGLT-2i therapy echocardiographic evaluation revealed improvement of LVEF (47,909 ± 7,260; 49,562 ± 8,784; p value 0.003) LVGLS (-13,312 ± 3,555; -14,894 ± 3,970; p value &lt; 0.001), RVFWLS (-18,324 ± 6,430; -20,705 ± 6,469; p value 0.002). Echocardiographic parameters of diastolic function such as E/E’m (11,270 ± 6,282; 9,782 ± 6,622; p value 0.003) and PASP (36,580 ± 14,879; 31,757 ± 10,740; p value 0.036) were also ameliorated. Both TAPSE/PASP (0,567 ± 0,267; 0,762±0,536; p value 0.036) and RV FWLS/PASP (-0,588 ± 0,299; -0,785 ± 0,663 p value 0.003) showed higher values.

Conclusions
our study has demonstrated a significant impact of SGLT-2i on echocardiographic parameters of LV diastolic function and on both left and right ventricle systolic function in patients with HFpEF in a 6 months follow up. Moreover, our findings of RV-PA coupling echocardiographic surrogates improvement, after SGLT-2I use, could underscore the potential of SGLT-2i in managing RV dysfunction in HFpEF.
Right atrial remodelling in middle- aged patients with atrial fibrillation and without overt heart disease
Authors: Borizanova-Petkova A , Kinova E , Goudev A 
Published: January 2025

Abstract

Background
Atrial fibrillation (AF) is the most common cardiac arrhythmia, where the focus of echocardiographic evaluation is the left atrium (LA), as a substrate for the arrhythmia(1). But AF is not only a disease of the LA, it also affects the right atrium (RA) (2). Available data on structural changes of RA in AF are scarce, and even more in relatively young patients without overt heart disease.

Aim
To assess RA structure and function with volumetric and speckle-tracking analysis in middle-aged symptomatic AF patients without overt heart disease , where conventional 2D echocardiography (2DE) demonstrated structurally normal hearts.

Methods
Prospective consecutive patients with AF (n=936), who had been admitted for sinus rhythm restoriation in our hospital for the period January 2016- December 2018, were screened for participation in the study. A total of 70 patients met the inclusion criteria- stable sinus rhythm, age between 40-60 years, without overt heart disease. They were separated in two groups:with new onset AF(n=33) and reccurent episode of AF(n=37); 30 healthy subjects were enrolled in the control group. All patients underwent 2DE assessment of RA structure and function with volumetric and speckle tracking analyses.

Results
There were significant differences between all groups in RA volumes- table 1. Furthermore, patients with AF had reduced reservoir strain and increased RA stiffness index in comparison to healthy controls. There were no differences between groups in emptying fractions, as well as in expansion index of RA.

Conclusion
In middle- aged AF patients without overt heart disease early structural and functional changes in RA were found. These findings supports the concept of bi-atrial remodelling in AF, where subclinical atrial disease progress to clinical one with first manifestation- AF (3,4)
Distinguishing athletic heart adaptations from cardiomyopathy using myocardial work: new kid on the block
Authors: Baptista Carvalho A , Mendes L 
Published: January 2025

Abstract

Background
Studying the athlete's heart is challenging due to the overlap between physiological adaptations from exercise and cardiomyopathies. Initially, deformation analysis was promising for differentiation, but it became clear that larger ventricular volumes in athletes result in low strain due to chamber geometry. Recently, a non-invasive myocardial work study tool has emerged, integrating load and deformation.

Aim
to determine the additional value of the Myocardial Work (MW) indices determined by echocardiography in the study of the athlete's heart.

Methods
A retrospective analysis of echocardiographic parameters was carried out, measuring myocardial work non-invasively among a group of male athletes (football players - class IC of Mitchell classification), compared with a control group composed of healthy young men. A GE Vivid E95 echocardiographic ultrasound system and EchoPAC V.206 software (GE Vingmed Ultrasound AS, Horten, Norway) were used.

Results
The athletes' group consisted of 121 males with a median age of 24 years (range 21-31), while the control group included 77 healthy individuals with a median age of 26 years (range 23-31). Refer to Table 1 for the descriptive analysis. Compared to the control group, the athletes had significantly lower blood pressure (p = 0.001), larger left ventricular volumes (p &lt; 0.001), and higher left ventricular ejection fractions (p &lt;0.001). Although there was a trend toward lower GLS in the athletes' group, it was not statistically significant (p = 0.203). GWI, GCW, and GWE were similar between the two groups, with GCW being significantly higher in the athletes (p = 0.01).

Conclusion
In our study, myocardial work indices in athletes were comparable to those in healthy individuals. Myocardial work is an intuitive and comprehensive variable that shows promise as a tool to differentiate between normal physiological adaptations to exercise and pathology in athletes.
Descriptive analysis
MW example
Left atrial strain is impaired in pediatric patients with mitral annular disjunction
Authors: Norton D M , Iturralde-Chavez A , Pignatelli R H , Doan T T 
Published: January 2025

Abstract

Background
Mitral annular disjunction (MAD) is characterized by separation of the posterior mitral valve (MV) annulus and left ventricular (LV) myocardium. MAD is reported to have a strong association with ventricular tachyarrhythmia and sudden cardiac arrest (SCA) though the mechanism is not well understood.

Purpose
We aimed to study left atrial strain (LAS) in pediatric patients with MAD, compared with healthy controls. We hypothesized that patients with MAD will demonstrate decreased LAS compared to controls, suggestive of impaired ventricular diastolic function.

Methods
We included consecutive patients &lt;21 years old diagnosed with MAD from January to December 2023 at a tertiary pediatric care center, excluding patients with Marfan or Loeys-Dietz syndrome. All available echocardiographic images were reviewed to determine the earliest presence of MAD, defined as a distance between the LV myocardial crest and posterior MV hinge point at end-systole in the parasternal long axis view ≥2 mm. Demographic and clinical data were collected via retrospective chart review. Patients with MAD were matched by age and sex with healthy controls. We compared LV ejection fraction (EF), degree of mitral regurgitation (MR), biplane LA volume and LAS (reservoir, conduit, and contraction) between groups. Mann-Whitney U and Chi-Square tests were used to compare continuous and nominal variables between groups, respectively.

Results
We included 26 patients with MAD (81% female) diagnosed at a median age of 13.8 years (Q1-Q3: 10.5-17.1). During a median time of 3.8 years (Q1-Q3: 1.1-11.5), 19% (n=5) patients were diagnosed with SCA due to ventricular tachyarrhythmia and an additional 15% (n=4) patients had ventricular tachyarrhythmia without SCA. Patients with MAD more frequently had MR graded mild or greater (p &lt; 0.001) than controls. LAS was significantly decreased in all phases of the cardiac cycle in patients with MAD, including conduit (-28.4% v -37.7% p = 0.003), contraction (-8.1% v -13.8%, p = 0.004) and reservoir (37.0% v 51.9%, p = &lt; 0.001). Mean MAD distance was higher (5.24 v 3.66 mm, p = 0.004) and LVEF was lower (56% v 62%, p=0.032) in patients with MAD and SCA compared to those without SCA. There was a trend toward impaired LAS-contraction (-4.8% v –10.9%, p = 0.091) for patients with MAD and SCA, but this did not reach significance.

Conclusions
All phases of LAS are impaired in pediatric patients with MAD compared to age- and sex-matched controls, suggesting an underlying diastolic impairment. Patients with MAD and SCA had lower LVEF, greater MAD distance, and a trend of lower LAS-contraction. Future studies are needed to better understand the true prevalence of MAD in the pediatric population, its natural history, and its association with arrhythmia and other cardiovascular outcomes.
Mechanical dispersion as a marker of the risk of ventricular arrhythmias in patients who have suffered a left ventricular myocardial infarction
Authors: Doniyorov S H , Bekmetova F M , Ilkhomova L T , Bekmetova S I , Abdullayeva S Y , Valiyeva B S H , Tursunova N B , Usmonova N A , Khotamova M N , Karimov B S 
Published: January 2025

Abstract

Introduction
Purpose. To study the relationship between the indices of mechanical dispersion (MD) of the left ventricle and ventricular arrhythmias (VA) by classification Lown and Wolf in patients who have suffered a left ventricular myocardial infarction

Methods
The study included 80 patients with chronic CAD aged between 38 and 84 years. All patients underwent the following examinations: physical examination, general clinical and laboratory blood tests, 12-lead ECG, 24-hour holter monitoring; standart transthoracic echocardiography, assessment of left ventricular systolic function, speckle-tracking echocardiography with assessment of global longitudinal strain (GLS) and mechanical dispersion (MD) using the auto CMQ program on the Phillips Affinity 70 ultrasound machine. All patients divided into 5 groups: Group I - 22 patients without VA; Group II – 15 patients without ventricular arrhythmias.

Conclusion
The study shows that mechanical dispersion of the left ventricle is a marker of the risk of ventricular arrhythmias in patients who have suffered acute myocardial infarction of the left ventricle and the higher the gradation of arrhythmias, the longer the duration of MD