No abstract

BackgroundArterial hypertension adversely affects left atrial (LA) size and function, effect on function may precede effect on size. Many techniques were used to assess LA function but with pitfalls.ObjectivesEarly detection of left atrial dysfunction with speckle tracking echocardiography in hypertensive patients with normal left atrial size.Patients and methodsThe study was conducted on 50 hypertensive patients and 50 age matched normotensive controls, all with normal LA volume index and free from any other cardiovascular disease that may affect the LA size or function. They were all subjected to history taking, clinical examination and echocardiographic study with assessment of LA functions [total LA stroke volume, LA expansion index by conventional 2D echocardiography and Global peak atrial longitudinal strain by speckle tracking (PALS)], left ventricular (LV) systolic and diastolic functions, and LV mass.ResultsDifferent indices of LA dysfunction (Total LA stroke volume, LA expansion index and global PALS) were significantly lower in the hypertensive group despite the normal LA volume index in all the studied subjects. The presence of diabetes mellitus (DM) and higher grade of LV diastolic dysfunction were significantly associated with lower global PALS. The higher age, systolic blood pressure (BP), body mass index (BMI), LA volume index, and LV mass index and the lower LA expansion index were associated with lower global PALS.ConclusionSpeckle tracking echocardiography is a useful novel technique in detecting LA dysfunction in hypertension even before LA enlargement occurs.

No abstract

No abstract

Background Postoperative atrial fibrillation (POAF) complicates 20–40% of cardiac surgical procedures and 10–20% of non-cardiac thoracic operations. Typical features include onset at 2–4 days postoperatively, episodes that are often fleeting and a self-limited time course. Associated adverse consequences of POAF include hemodynamic instability, increased risk of stroke, lengthened hospital and intensive care unit stays and greater costs (Dobrev et al., 2019). Aim The aim of this work is to detect the echo-cardio graphic parameters for prediction of post-operative atrial fibrillation in patients with ischemic heart disease undergoing isolated coronary artery bypass graft. Methods One hundred patients with multivessel disease for CABG were prospectively enrolled; all of them were in sinus rhythm at the moment of enrollment. LA maximal volume, LV ejection fraction, LVESV &LVEDV and TDI were assessed. Moreover, LA strain and Left Ventricular Global Longitudinal Strain % were analyzed by speckle tracking technique. Patients were followed up for 1 week after surgery in order to identify occurrence of atrial fibrillation. Results We found a statistically significant difference between patients undergoing CABG who are older in age with mean ± SD 64.455 ± 6.254 in group I (AF) vs. 54.577 ± 6.710 in group II with p value <0.001*, we found also that patients undergoing CABG with POAF (group I) 50 % of them had left main diseases vs. 23% in group II (NSR) with other lesions (RCA&LCX), p value = 0.014*. Conclusions There is no significant difference between the two groups regarding conventional echo parameters, TDI & by speckle tracking technique (LA strain & LVGLS %). However, patients who developed POAF were older, & left main lesions are more likely to have left main lesions.