PurposeThe predictive value of maximum left atrial volume index (LAVI), phasic left atrial strain (LAS) and other standard echocardiographic parameters assessing left ventricular (LV) diastolic function to discriminate a future worsening of diastolic function (DD) in patients at risk is unclear. We aimed to prospectively assess and compare the clinical impact of these parameters in a randomly selected study sample of the general urban female population.Methods and resultsA comprehensive clinical and echocardiographic evaluation was performed in 256 participants of the Berlin Female Risk Evaluation (BEFRI) trial after a mean follow up time of 6.8 years. After an assessment of participants’ current DD status, the predictive impact of an impaired LAS on the course of DD was assessed and compared with LAVI and other DD parameters using receiver operating characteristic (ROC) curve and multivariate logistic regression analyses. Subjects with no DD (DD0) who showed a decline of diastolic function by the time of follow-up showed a reduced LA reservoir (LASr) and conduit strain (LAScd) compared to subjects who remained in the healthy range (LASr 28.0% ± 7.0 vs. 41.9% ± 8.5; LAScd −13.2% ± 5.1 vs. −25.4% ± 9.1; p < 0.001). With an area under the curve (AUC) of 0.88 (95%CI 0.82–0.94) and 0.84 (95%CI 0.79–0.89), LASr and LAScd exhibited the highest discriminative value in predicting worsening of diastolic function, whereas LAVI was only of limited prognostic value [AUC 0.63 (95%CI 0.54–0.73)]. In logistic regression analyses, LAS remained a significant predictor for a decline of diastolic function after controlling for clinical and standard echocardiographic DD parameters, indicating its incremental predictive value.ConclusionThe analysis of phasic LAS may be useful to predict worsening of LV diastolic function in DD0 patients at risk for a future DD development.

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Objective: To know the principal characteristics associated to adolescent pregnancy and value it as a possible risk factor for low birthweight. Materials and methods: To study cases and controls for six months. The cases were selected from nuliparous women aged from 14 years to 19 years admitted to obstetrics during labour. The controls, nuliparous women aged 20 years or more, were admitted to the same center during the same period of time and were chosen randomly from the admissions book. These were coded and later processed using the data of the SPSS V 11.0 programme; descriptive analysis of the data was made, OR was calculated as the measurement of association, with an CI of 95% and the Chi squared test as a contrast of the hypothesis, and assuming the value p < 0.05 to be the statistically significant difference between them. A multivariant analysis was also carried out using a multiple logistic regression model. Results: 242 cases and 484 controls. The risk factors associated with low birth weight identified in the analysis were: the age of the mother < 19 years OR 2.12; CI (1.30-3.44) and antenatal control < 5 visits, OR 5.15 (2.81-9.41). Generally speaking the adolescent mothers were out of the education system and mostly worked as domestic assistants, they also had a higher incidence of low birth weight and prematurity. Conclusions: There is an association between the age of the mother and low weight neonates, which increases amongst those who do not attend the antenatal clinics regularly.

BackgroundTranscatheter annuloplasty is meant to target annular dilatation and is therefore mainly applied in functional tricuspid regurgitation (TR). Due to recent recognition of varying disease pathophysiology and differentiation of ventricular and atrial functional TR (VFTR and AFTR), comparative data regarding procedural success for both disease entities are required.MethodsIn this consecutively enrolled observational cohort study, 65 patients undergoing transcatheter annuloplasty with a Cardioband® device were divided into VFTR (n = 35, 53.8%) and AFTR (n = 30, 46.2%). Procedural success was assessed by comparing changes in annulus dilatation, vena contracta (VC) width, effective regurgitation orifice area (EROA), as well as reduction in TR severity.ResultsOverall, improvement of TR by at least two grades was achieved in 59 patients (90.8%), and improvement of TR by at least three grades was realised in 32 patients (49.2%). Residual TR of ≤2 was observed in 52 patients (80.0%). No significant differences in annulus diameter reduction [VFTR: 11 mm (9–13) vs. AFTR: 12 mm (9–16), p = 0.210], VC reduction [12 mm (8–14) vs. 12 mm (7–14), p = 0.868], and EROA reduction [0.62 cm2 (0.45–1.10) vs. 0.54 cm2 (0.40–0.70), p = 0.204] were reported. Improvement by at least two grades [27 (90.0%) vs. 32 (91.4%), p = 1.0] and three grades [14 (46.7%) vs. 18 (51.4%), p = 0.805] was similar in VFTR and AFTR, respectively. No significant difference in the accomplishment of TR grade of ≤2 [21 (70.0%) vs. 31 (88.6%), p = 0.118] was noted.ConclusionAccording to our results from a real-world scenario, transcatheter annuloplasty with the Cardioband® device may be applied in both VFTR and AFTR with evidence of significant procedural TR reduction.