In the present multicentre study analysing a large cohort of healthy subjects and patients with LVDD, the normal range and the clinical relevance of the myocardial function of the LA using 2DSTE have been determined.

BackgroundThe clinical features of gender differences in takotsubo cardiomyopathy (TC) remain to be determined. The aim of this study was to evaluate the differences in clinical characteristics of male and female patients with TC.MethodsWe obtained the clinical information of 368 patients diagnosed with TC (84 male, 284 female) from the Tokyo CCU Network database collected from 1 January 2010 to 31 December 2012; the Network is comprised of 71 cardiovascular centers in the Tokyo (Japan) metropolitan area. We attempted to characterize clinical differences during hospitalization, comparing male and female patients with TC.ResultsThere were no significant differences in apical ballooning type, median echocardiography ejection fraction, serious ventricular arrhythmias (such as ventricular tachycardia or fibrillation), or cardiovascular death between male and female patients. Male patients were younger than female patients (median age at hospitalization for male patients was 72 years vs. 76 years for female patients; p = 0.040). Prior physical stress was more common in male than female patients (50.0% vs.31.3%; p = 0.002), while emotional stress was more common in female patients (19.0% vs. 31.0%; p = 0.039). Severe pump failure (defined as Killip Class > III) (20.2% vs. 10.6%; p = 0.020) and cardiopulmonary supportive therapies (28.6% vs. 12.7%, p < 0.001) were more common in male than female patients. Multivariate analysis revealed that male gender (odds ratio = 4.32, 95% CI = 1.41–13.6, p = 0.011) was an independent predictor of adverse composite cardiac events, including cardiovascular death, severe pump failure, and serious ventricular arrhythmia.ConclusionsCardiac complications in our dataset appeared to be more common in male than female patients with TC during their hospitalization. Further investigation is required to clarify the underlying mechanisms responsible for the observed gender differences.

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Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp wo-dimensional (2-D) speckle tracking echocardiography (STE) is being increasingly used for the quantification of global and regional left ventricular (LV) mechanics. 1,2 Previous studies have validated the accuracy of STE against cardiac magnetic resonance imaging, a reference standard. 3, 4 The superiority of STE compared with LV ejection fraction has been reported in several clinical settings. 5-7 The rapid advancement of computer technology allows us to measure layer-specific strain across the myocardium using some ultrasound systems and software. 8-10Despite the rapid adoption of this new technology, the normal range of LV 2-D strain has been traditionally measured in a small number of subjects. Little information exists regarding the equivalency of the normal ranges of LV 2-D strains when comparing ultrasound systems from different vendors; moreover, evidence for a good inter-vendor agreement of 2-D strain data from the same subjects remains to be elucidated. 11-14 This inter-vendor agreement of 2-D strain is necessary for conducting a longitudinal follow-up or a cross-sectional assessment of the LV function using 2-D strain, because many ultrasound laboratories utilize a variety of ultrasound systems and analysis software packages from different vendors. Accordingly, in this multicenter study of healthy volunteers, the aims were to (1) establish the normal range of LV 2-D strain in a large number of healthy subjects; and (2) determine the inter-vendor, observer and test-retest variabilities of 2-D strain. Satoshi Nakatani, MD on behalf of the JUSTICE investigatorsBackground: To determine the normal range of left ventricular (LV) 2- dimensional (2-D) strain and vendor-specific differences, a multicenter prospective 2-D strain study endorsed by the Japanese Society of Echocardiography was conducted.

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