Myocardial Damage Patterns in Patients with Left Ventricular Systolic Dysfunction with and Without Coronary Artery Disease Referred for Cardiac Magnetic Resonance.

: Cardiac magnetic resonance (CMR) is widely used to determine the underlying cause of left ventricular (LV) systolic dysfunction. Patients with ischemic disease are less frequently referred for CMR, as the underlying disease is often presumed to explain LV systolic dysfunction. However, various etiologies of myocardial impairment may coexist.

Validation assessment of a cuff-based central blood pressure device according to Artery Society recommendations.

Objective: Uscom BP+ is a cuff-based blood pressure (BP) device designed to noninvasively estimate central BP as distinct from conventional brachial BP. This study aimed to assess the accuracy of the Uscom BP+ device compared with invasively measured BP.

Methods: Automated noninvasive cuff central BP (using the Uscom BP+ device) and invasive central aortic BP were recorded simultaneously in 191 participants (65% male, aged 66 ± 11 years) receiving coronary angiography at three independent research sites in Australia, Poland, and Italy.

Prognostic Relevance and Lower Limit of the Reference Range of Left Ventricular Global Longitudinal Strain: A Clinical Validation Study.

Background: The lower limit of the reference normal range (LLN) of left ventricular global longitudinal strain (GLS) for each ultrasound software vendor and its prognostic relevance in the elderly and in asymptomatic patients at risk for heart failure (HF) remain uncertain.

Objectives: In this study, the authors sought to validate the LLN of GLS for each ultrasound software vendor and its prognostic relevance in the elderly and in asymptomatic patients at risk for HF.

Methods: To identify the LLN of GLS with the use of 2-dimensional speckle-tracking transthoracic echocardiography, a meta-analysis of studies including healthy subjects was conducted, followed by a validation study in a large cohort of healthy subjects.

Bicuspid Aortic Valves (BAV) Registry (RE-BAV): Clinical and echocardiographic characteristics of patients with BAV according to novel classification of bicuspid aortic valves.

Background: Bicuspid aortic valve (BAV) is a common congenital heart defect linked to abnormal valve structure and aortic dilatation.

Aims: To present BAV types and valvulo-aortopathy in the Polish population using the latest 2021 classification.

Methods: RE-BAV is a registry of adult ambulatory and hospitalized patients with BAV evaluated in echocardiographic laboratories at 23 tertiary centers in Poland (2021-2023).

Left Atrial Functional and Structural Characteristics in Patients After Total and Bicaval Orthotopic Heart Transplantation.

: Currently, the most popular techniques for orthotopic heart transplantation (OHTx) are bicaval and total OHTx. Although bicaval OHTx has shown advantages over the biatrial approach, comparisons between bicaval and total OHTx reain limited. To compare the functional and morphological characteristics of the left atrium (LA) in patients after bicaval and total OHTx.

Myocardial Fibrosis Quantification Methods by Cardiovascular Magnetic Resonance Imaging in Patients with Fabry Disease.

: The presence of late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) in patients with Fabry disease (FD) is a predictor of adverse cardiac events. The aim of this study was to establish the most reliable and reproducible technique for quantifying LGE in patients with FD. : Twenty FD patients with LGE who underwent CMR on the same scanner and LGE sequence were included.

Association of Reduced Left Atrial Reserve With Exercise Intolerance and Outcome in Hypertension.

Background: Hypertensive heart disease (HHD) is a leading contributor to heart failure with preserved ejection fraction (HFpEF). However, the mechanisms behind the transition to the symptomatic phase remain unclear.

Objectives: We sought to find the association of the exercise response of left atrial (LA) mechanical function with functional capacity, symptoms, and outcome across the heart failure (HF) spectrum in hypertension.

Evolving Applications of Echocardiography in the Evaluation of Left Atrial and Right Ventricular Strain.

Purpose Of Review: Speckle-tracking echocardiography (STE) can assess myocardial motion in non-LV chambers-including assessment of left atrial (LA) and right ventricular (RV) strain. This review seeks to highlight the diagnostic, prognostic, and clinical significance of these parameters in heart failure, atrial fibrillation (AF), diastolic dysfunction, pulmonary hypertension (PH), tricuspid regurgitation, and heart transplant recipients.

Recent Findings: Impaired LA strain reflects worse LV diastolic function in individuals with and without HF, and this is associated with decreased exercise capacity.

Transcatheter aortic valve implantation in severe aortic stenosis does not necessarily reverse left ventricular myocardial damage: data of long-term follow-up.

Aims: Aortic stenosis (AS) is causing myocardial damage and replacement is mainly indicated based on symptoms. Non-invasive estimation of myocardial work (MW) provides a less afterload-dependent too for assessing myocardial function. We sought to look at the impact of transcatheter aortic valve implantation (TAVI) on the myocardium at long-term follow-up and according to current indications.

Evolution and prognostic value of left ventricular deformation and myocardial work parameters in transthyretin amyloid cardiomyopathy.

Aims: Wild-type transthyretin amyloid cardiomyopathy (ATTR-CM) is an increasingly recognized condition. It remains challenging to estimate the extent of disease and the prognosis for most patients. Myocardial work is a sensitive echocardiographic approach that improves the characterization of myocardial damage.

Contribution of reduced skeletal muscle perfusion reserve to exercise intolerance in heart failure with preserved ejection fraction.

Background: Skeletal muscle (SM)-associated mechanisms of exercise intolerance in HFpEF are insufficiently defined, and inadequate augmentation of SM blood flow during physical effort may be one of the contributors. Therefore, we sought to investigate the association of SM perfusion response to exertion with exercise capacity in this clinical condition.

Methods: Echocardiography and SM microvascular perfusion by contrast-enhanced ultrasound were performed at rest and immediately post-exercise test in 77 HFpEF patients in NYHA class II and III, and in 25 subjects with normal exercise tolerance (stage B).

Isolated functional tricuspid regurgitation: how to define patients at risk for event?

Aims: Functional tricuspid regurgitation (TR) is a turning point in cardiac diseases. Symptoms typically appear late. The optimal timing for proposing a valve repair remains a challenge.

Management of valvular heart disease in patients with cancer: Multidisciplinary team, cancer-therapy related cardiotoxicity, diagnosis, transcatheter intervention, and cardiac surgery. Expert opinion of the Association on Valvular Heart Disease, Association of Cardiovascular Interventions, and Working Group on Cardiac Surgery of the Polish Cardiac Society.

The Association on Valvular Heart Disease, Association of Cardiovascular Interventions, and the Working Group on CardiacSurgery of the Polish Cardiac Society have released a position statement on risk factors, diagnosis, and management of patients with cancer and valvular heart disease (VHD). VHD can occur in patients with cancer in several ways, for example, it can exist or be diagnosed before cancer treatment, after cancer treatment, be an incidental finding during imaging tests, endocarditis related to immunosuppression, prolonged intravenous catheter use, or combination treatment, and nonbacterial thrombotic endocarditis. It is recommended to employ close cardiac surveillance for patients at high risk of complications during and after cancer treatment and for cancer treatments that may be cardiotoxic to be discussed by a multidisciplinary team.

Cardioprotection Using Strain-Guided Management of Potentially Cardiotoxic Cancer Therapy: 3-Year Results of the SUCCOUR Trial.

Background: Global longitudinal strain (GLS) can predict cancer therapeutics-related cardiac dysfunction and guide initiation of cardioprotection (CPT).

Objectives: In this study, the authors sought to determine whether echocardiography GLS-guided CPT provides less cardiac dysfunction in survivors of potentially cardiotoxic chemotherapy, compared with usual care at 3 years.

Methods: In this international multicenter prospective randomized controlled trial, patients were enrolled from 28 international sites.

Inhibition of peripheral chemoreceptors improves ventilatory efficiency during exercise in heart failure with preserved ejection fraction - a role of tonic activity and acute reflex response.

Peripheral chemoreceptors (PChRs) play a significant role in maintaining adequate oxygenation in the bloodstream. PChRs functionality comprises two components: tonic activity (PChT) which regulates ventilation during normoxia and acute reflex response (peripheral chemosensitivity, PChS), which increases ventilation following a specific stimulus. There is a clear link between augmented PChS and exercise intolerance in patients with heart failure with reduced ejection fraction.

Functional tricuspid regurgitation: A clustering analysis and prognostic validation of three echocardiographic phenotypes in an external cohort.

Background: Functional tricuspid regurgitation (FTR) is an independent risk factor for morbidity and mortality. New pathophysiological concepts but also new therapeutic options are justifying new knowledges for characterizing FTRs and their prognoses.

Aim: To study echocardiographic criteria associated with prognosis in FTR-patients using a clustering method in two cohorts.

Prognostic Value of the MAGGIC Score, HFPEF Score, and HFA-PEFF Algorithm in Patients with Exertional Dyspnea and the Incremental Value of Exercise Echocardiography.

Background: The strategies for improving outcomes in heart failure with preserved ejection fraction (HFpEF) are insufficiently defined, which affects optimal patient management. The aim of the study was to compare the prognostic value of the previously validated Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) risk score with 2 approaches primarily dedicated to diagnosing HFpEF: the HFPEF score (heavy, 2 or more hypertensive drugs, atrial fibrillation, pulmonary hypertension [pulmonary artery systolic pressure >35 mm Hg], elder age >60, elevated filling pressures [E/e' > 9]) and the HFA-PEFF algorithm (Heart Failure Association diagnostic algorithm-pretest assessment; echocardiography and natriuretic peptide score; functional testing; final etiology) in patients with exertional dyspnea categorized as HFpEF.

Methods: Clinical and biochemical variables and echocardiographic resting and exercise data from 201 enrollees were retrospectively analyzed.

Incremental Value of Myocardial Work over Global Longitudinal Strain in the Surveillance for Cancer-Treatment-Related Cardiac Dysfunction: A Case-Control Study.

The load dependence of global longitudinal strain (GLS) means that changes in systolic blood pressure (BP) between visits may confound the diagnosis of cancer-treatment-related cardiac dysfunction (CTRCD). We sought to determine whether the estimation of myocardial work, which incorporates SBP, could overcome this limitation. In this case-control study, 44 asymptomatic patients at risk of CTRCD underwent echocardiography at baseline and after oncologic treatment.