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Background: Transthoracic echocardiography (TTE) in prone position is challenging. Innovative use of transesophageal echocardiography (TEE) probe to perform TTE for such patients was described; but reproducibility and correlation of the TTE measurements by this technique with those obtained by the standard supine TTE study are still unknown. Methods: We enrolled 30 non-COVID-19 individuals, with a mean (SD) age 35 (10.9) years and 11 females, to study the agreement between the transthoracic measurements of the left ventricular (LV), left atrial (LA) and aortic dimensions obtained in prone position using an external TEE probe versus the standard supine position using the conventional TTE probe. Results: There were no significant differences between LV end-diastolic and end-systolic diameters, septal wall thickness, posterior wall thickness and aortic root dimensions in the prone versus the supine positions. While the mean ejection fraction (EF) (60.3% vs. 63.1%, P = 0.014) and mean LA dimensions (1.8 vs. 1.9 cm/m2, P < 0.001) were significantly lower in the prone position. The mean time of scans was significantly longer in the prone as compared to the supine (12.5 vs 4.5 minutes, P < 0.001). All supine studies had good quality while in the prone position 4 studies were of poor quality, and one was non-diagnostic. Conclusions: Assessment of cardiac dimensions and systolic function in the prone position using transthoracic TEE probe was feasible. LV and aortic dimensions agreed well with the standard TTE in supine position, however, LA dimensions and EF were lower in the prone position.

Funding Acknowledgements British Heart Foundation (BHF) grants (PG/13/58/30397) Background Young adults with mildly elevated blood pressure are less likely to engage with physical activity. This may be because early hypertension alters myocardial response to moderate exercise, leading to greater perceived exertion and lower levels of enjoyment. As atrial and ventricular function are closely coupled we investigated whether subclinical atrial changes at rest may identify this myocardial response. Purpose To identify whether subclinical changes in left atrial function at rest predict response to exercise by performing left atrial deep-phenotyping in a cohort of young adults with a range of blood pressures. Methods Seventy-one full-term born young adults (25.25 ± 5.13 years) were enrolled in the Young Adult Cardiovascular Health sTudy (YACHT) to undergo baseline clinical and cardiovascular phenotyping including detailed blood pressure measurement. Cardiopulmonary exercise testing combined with echocardiography imaging was performed to assess the myocardial response to physical exercise at 40%, 60% and 80% of peak exercise load for all participants. Left ventricular ejection fraction and global longitudinal strain were measured from an apical four chamber view at each exercise load, and resting left atrial phasic function was assessed by conventional and speckle tracking echocardiography from apical four and two chamber views (figure 1). Results In this young cohort with a range of blood pressure (120.9 ± 12.96/70.85 ± 9.78 mmHg), resting left atrial reservoir and conduit function, but not left atrial structural measures, showed good correlation with left ventricular ejection fraction and global longitudinal strain during 40%, 60% and 80% of peak exercise. The association between resting left atrial conduit with left ventricular deformation at 60% of peak exercise intensity remained significant when adjusted for age, sex and mean arterial pressure (P = 0.007). Conclusion Left atrial phasic function at rest predicts left ventricular responses to physical exercise in this cohort of young adults, which may relate to early subclinical left atrial remodelling in early hypertension. These findings require validation in other cohorts and investigation of whether this exercise limitation can be overcome in young hypertensives. Abstract P374 Figure 1

The present paper presents criteria which allow to identify risk groups including moderately expressed cognitive disorders with the localization of cerebral infarction in the right medial cerebral artery and some changes of lipid metabolism parameters (criteria triad), with the possible transformation of the detected disorders into stroke dementia. These patients are recommended treatment at ambulatory-polyclinacal and home stages.