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Background: Long standing aortic stenosis leads to elevated left ventricular (LV) pressure and as a result LV hypertrophy and myocardial fibrosis shall increase. The left ventricular ejection fraction (EF) usually remains adequately-preserved until advanced and late stages of aortic stenosis. But the preserved muscle of the LV is only limited to a portion of the entire myocardium. Speckle tracking echocardiography has proved its superiority to the standard two-dimensional echocardiography method in the detection of Left Ventricular (LV) function. Global Longitudinal strain (GLS) is considered as the most robust myocardial strain component. Objective: The aim of the study is to assess the early course of left ventricular reverse remodelling after Transcutaneous Aortic Valve Implantation (TAVI) in patients with symptomatic severe aortic valve stenosis. Methods: 50 patients with severe symptomatic valvular aortic stenosis undergoing TAVI as decided by the heart team after comprehensive discussion. Standard transthoracic echocardiography including Doppler analysis was performed. 2D speckle-tracking strain assessment of Global radial, circumferential and longitudinal strain at parasternal mid-ventricular short-axis view (at the level of papillary muscle) and from the apical long-axis, two-chamber and four-chamber views with a frame rate between 40 and 80 frames per second. Tracing of endocardial borders was done. Patients with significant coronary artery disease were fully revascularized by percutaneous coronary intervention prior to the study and the procedure. Results: 23 (46%) patients were males, while 27 (54%) were females. The patients' stratification according to comorbidities/associated risk factors re

This prospective cohort study was conducted on fifty patients presented with STEMI and underwent primary PCI to Assess the impact of primary percutaneous coronary intervention (Primary PCI) on the left ventricular (LV) systolic function in patients with Acute STEMI using speckle tracking Echocardiography within the first 24 hrs and within 1 month after performing PCI. All patients were evaluated by history taking, clinical examination, laboratory investigations and coronary angiography assessment with revascularization of the infarct-related artery (IRA). All patients had CCU admission for 3 days. Conventional 2D echocardiography was performed within 24 h of Primary PCI to assess LV Global longitudinal peak systolic strain (GLPSS). All patients had been discharged to home with the guidelines-based medical treatment including (DAPT, Atorvastatin, ACEIs, Beta blockers). GLPSS was re-assessed after 1 month. The patients were divided into two groups: improved and non-improved, according to the improvement of LV systolic function measured by GLPSS. Improvement is defined by increase of GLPSS ≥ 10%. Our study demonstrated Improvement of LV function was based on GLPSS and was observed in 54% of the patients. Peak cardiac troponin T level, Peak creatine phosphokinase levels (CPK), LV diastolic function, and baseline GLPSS were identified as independent predictors of recovery of LV function. The patients who showed improvement of GLPSS were associated with improvement of EF (using simpson method).

Objective: Early detection of LV mechanical abnormalities in patients with cardiac syndrome X (CSX) by speckle tracking echocardiography (STE). Background: Cardiac syndrome X is a triad of angina pectoris, positive stress test for myocardial ischemia and angiographically free coronary arteries. Two dimensional speckle tracking echocardiography (2D-STE) provides a more sensitive method for evaluation of global and segmental LV function than conventional two dimensional echocardiographic parameters. Subjects and Methods: Seventy patients proved to have CSX and 20 healthy control volunteers were included with a mean age of 49.43 ± 5.92 vs. 49.40 ± 6.27 years respectively with no difference regarding sex for both patients and controls. Patients with hypertension, diabetes mellitus, valvular heart disease, cardiomyopathies, inflammatory diseases, myocarditis and arrhythmias were excluded. All included individuals were subjected to complete conventional echocardiographic assessment and left ventricular global and segmental mechanical function was assessed using 2D based strain and strain rate (longitudinal, radial and circumferential) imaging. Results: There was no statistically significant difference in LV conventional echo parameters between patients and controls. However, global mean longitudinal strain was significantly lower in patients than controls (−15.05 ± 3.28 vs. −20.22 ± 2.49; p < 0.001). For radial and circumferential strain stain, there was no significant changes between patients vs. controls (29.75 ± 18.26 vs. 28.09 ± 15.48; p = 0.74) and (−19.88 ± 8.63 vs. −21.93 ± 5.69; p < 0.05) respectively. Conclusion: In spite of normal conventional echo parameters among patients and controls, LV longitudinal strain and strain rate by 2D speckle tracking imaging were lower in the patients denoting subclinical left ventricular mechanical dysfunction in patients with CSX.

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Background: Although there is a recognized link between cardiovascular hazards and coronary artery disease (CAD), it is still unknown whether aortic sclerosis and CAD are linked.Objective: This study aimed to check whether if there is a link between aortic sclerosis and the existence and severity of coronary artery disease . Patients and methods: 204 individuals were enrolled in the study, transthoracic echocardiographic, and coronary angiography were done. Aortic leaflets were tested for the amount of thickness in the short axis view. The involvement of coronary arteries represented by the gensini score and the association between aortic valve sclerosis score and the degree and severity of coronary affection was investigated using the Gensini score. Results: The individuals were divided into 2 groups grounded on the severity of aortic valve sclerosis. Group A (GP A) included patients with aortic valve sclerosis (AVS) ≥ 2 and group B (GP B) included patients with AVS < 2. In GP A, the right coronary cusp was the most afflicted one, whereas the LAD was the most affected in coronaries. The degree and severity of CAD were more significant in GP A, as evidenced by a higher Gensini score value of 39.27 versus 28.84 in GP B. Conclusion: AVS has been found to be correlated with the presence and severity of CAD and could be used as a potential surrogate marker for the illness.

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Background: Percutaneous mitral balloon valvuloplasty is the main procedure in mitral stenosis (MS). It can replace surgical commissurotomy in many cases; however, mitral regurgitation (MR) remains the major procedure complication. Objectives: This study was conducted to investigate predictors of MR as a complication following percutaneous mitral valvuloplasty (PMV) using multitrack balloon technique. Methods: This cohort study was conducted at both Menoufia University Hospital and Mabaret Misr Elkadima Hospital. We enrolled 121 patients with moderate to severe MS who were subjected to PMV using multitrack balloon technique during the period from October 2017 to October 2019. Transthoracic echocardiographic evaluation was performed for all patients before and after the procedure. Patients who developed severe MR post procedure were compared with other patients to identify important distinction points. Results: Most patients (N = 109, 90.1%) developed no/mild MR (group A), whereas 12 (9.9%) patients developed severe MR (group B) after PMV. Those who developed severe MR had significantly higher weight, height, body mass index, and body surface area (P value < 0.001 for each). Also, there was a significant difference between both groups regarding pre-operative Wilkins score (8.7 ± 1.3 for severe MR versus 7.9 ± 1.2 for No/Mild MR, P = 0.046). Patients who developed severe MR had higher incidence of other valvular lesions such as mild aortic regurgitation (91.7% versus 36.7%, P < 0.001), higher mitral valve (MV) commissural calcification (50.0% versus 14.7%, P = 0.008), pre-operative MR (100.0% versus 35.8%, P < 0.001), higher prevalence of atrial fibrillation (100.0% versus 38.5%, P < 0.001). Regarding balloon sizing, it was significantly higher among patients who developed severe MR compared with those having mild or no MR (P = 0.001). Multivariate regression analysis identified MV balloon sizing How to cite this paper: