P ulmonary arterial hypertension (PAH) is characterized by pulmonary vascular remodeling, right heart failure, and reduced survival.1 Both symptoms and extent of right heart failure predict mortality. [2][3][4] Measures of RV filling pressure and systolic function have been shown to correlate with clinical disease progression and survival. 5-8 Clinical Perspective on p 755Right ventricular (RV) contraction is a complex process related to a variety of actions, the predominant being longitudinal motion because of the arrangement of ventricular myofibrils.9-12 RV systolic strain assessment by speckle-tracking echocardiography is an angle-independent sensitive measure of RV contraction shown to correlate with clinical symptoms and invasive hemodynamic measures and is predictive of disease progression and mortality. [13][14][15][16][17] PAH is a disease of the pulmonary circulation with resultant effects on the right heart. Conceptually, left heart anatomy and function should be normal in patients with PAH. However, the RV and left ventricle (LV) do not function in isolation, sharing a common pericardial sac and interventricular septum. 18 A delayed relaxation mitral inflow Doppler pattern on echocardiography (a feature seen in normal or low filling pressures and diastolic dysfunction) has been linked to severity of disease in PAH; however, it is unclear whether this Doppler pattern reflects impaired LV filling because of reduced RV output or intrinsic LV dysfunction. 19 We sought to define the clinical and prognostic significance of ventricular interdependence Background-Pulmonary arterial hypertension (PAH) is characterized by pulmonary vascular remodeling and right heart failure. The right (RV) and left ventricles (LV) do not function in isolation, sharing a common pericardial sac and interventricular septum. We sought to define the clinical and prognostic significance of ventricular interdependence in PAH and its association with LV filling patterns through speckle-tracking strain echocardiography. Methods and Results-Echocardiography was performed in 71 adults with a new diagnosis of PAH. To analyze LV and RV function separately, we measured peak systolic longitudinal and circumferential strain of the LV and RV. Survival was assessed >2 years. Patients had dilated right-sided chambers (right atrial volume index, 44±19 mL/m 2 ; RV end-diastolic area, 34±9 cm 2 ), and reduced RV function (RV fractional area change, 28±12%). Speckle-tracking echocardiography revealed significant reductions in RV free wall peak systolic strain (−15±3%). Despite normal LV size and normal conventional measures of LV systolic function (end-diastolic dimension, 42±6 mm; ejection fraction, 65±8%; cardiac index, 2.6±0.8 L/min per m 2 ), patients had reduced LV free wall systolic strain (−15±3%). Decreased LV free wall systolic strain was associated with a delayed relaxation mitral inflow Doppler pattern, P=0.0002. During 2-year follow-up, 19 patients (27%) died. LV strain was associated with increased mortality (unadjusted hazard ratio, 2...

Noninvasive PASE is a simple, rapid, safe, and diagnostically efficient option for patients with permanent PM and suspected or known CAD.

2D-STE predicted outcome and provided incremental prognostic information over the current prognostic staging system, especially in the group without CA.

With stress echo (SE) 2020 study, a new standard of practice in stress imaging was developed and disseminated: the ABCDE protocol for functional testing within and beyond CAD. ABCDE protocol was the fruit of SE 2020, and is the seed of SE 2030, which is articulated in 12 projects: 1-SE in coronary artery disease (SECAD); 2-SE in diastolic heart failure (SEDIA); 3-SE in hypertrophic cardiomyopathy (SEHCA); 4-SE post-chest radiotherapy and chemotherapy (SERA); 5-Artificial intelligence SE evaluation (AI-SEE); 6-Environmental stress echocardiography and air pollution (ESTER); 7-SE in repaired Tetralogy of Fallot (SETOF) ; 8-SE in post-COVID-19 (SECOV); 9: Recovery by stress echo of conventionally unfit donor good hearts (RESURGE); 10-SE for mitral ischemic regurgitation (SEMIR); 11-SE in valvular heart disease (SEVA); 12-SE for coronary vasospasm (SESPASM). The study aims to recruit in the next 5 years (2021–2025) ≥10,000 patients followed for ≥5 years (up to 2030) from ≥20 quality-controlled laboratories from ≥10 countries. In this COVID-19 era of sustainable health care delivery, SE2030 will provide the evidence to finally recommend SE as the optimal and versatile imaging modality for functional testing anywhere, any time, and in any patient.

FCU is a valuable examination tool during early resuscitation of severe sepsis and septic shock.