Aortic coarctation is a congenital heart disease that causes an increased left ventricular afterload, resulting in increased systolic parietal tension, compensatory hypertrophy, and left ventricular systolic and diastolic dysfunction. The speckle tracking is a new echocardiographic technique that allows the detection of subclinic left ventricular systolic dysfunction. The aim of this study was to detect early left ventricular dysfunction using mechanical deformation by echocardiography in adults with un-repaired aortic coarctation. A total of 41 subjects were studied, 20 patients with aortic coarctation and 21 control subjects, 21 women (51.2%), with an average age of 30 ± 10 years. All patients with aortic coarctation had systemic arterial hypertension (p < 0.001). Seventy percent (14/20) of the patients had bicuspid aortic valve. Statistically significance (p < 0.005) were found in left ventricular mass index, E/e ratio, pulmonary artery systolic pressure and peak velocity and maximum gradient of the aortic valve. The global longitudinal deformation of the left ventricle in patients with aortic coarctation was significative decreased, p < 0.001. The ejection fraction and the global longitudinal deformation of the left ventricle were significantly lower in patients with aortic coarctation compared to the control group, p < 0.003, p < 0.001, respectively. The subgroup of patients with coarctation and left ventricular ejection fraction < 55% had a marked decrease in global longitudinal strain (- 15.9 ± 4%). The radial deformation was increased in patients with aortic coarctation and showed a trend to be significant (r = 0.421; p < 0.06). A significant negative correlation was observed between the global longitudinal deformation and left ventricular mass index (r = 0.54; p = 0.01) in the aortic coarctation group. The patients with aortic coarctation and left ventricular hypertrophy had marked reduction of left ventricular global longitudinal deformation (- 16%, p < 0.05). In our study patients with normal left ventricular ejection fraction had abnormal global longitudinal deformation and also the increased left ventricular mass was related with a decreased left ventricular global longitudinal deformation as a sign of subclinical systolic dysfunction.

This is a case of a 37-year-old woman with uncorrected tetralogy of Fallot with the absence of pulmonary valve and history of heart murmur in childhood who did not have a medical approach. At 29 years of age she started with dyspnoea that in the last 7 months progressed to be of small effort and also referred increase of the abdominal perimeter.

IntroductionHypertension is one of the most important healthy problems, and the prevalence is of around 20% of the population (variable in different regions of the world), and the hypertension is one of the most important risk factor for cardiovascular diseases, which are the leading causes of death in developed countries [1,2]. Both elevation of systolic pressure and diastolic blood pressure shows a continuous relationship with cardiovascular risk of stroke, coronary heart disease, heart failure, renal failure and peripheral arterial disease [3].Hypertension can cause left ventricular hypertrophy and hyperplasia of the smooth muscle cells and increased production of collagen and elastin tissue. Hypertension represents an increase in cardiac afterload and the compensatory mechanism of is the development of left ventricular concentric hypertrophy. However, unlike hypertrophy which occurs in athletes, the hypertrophy in hypertensive patients occurs with an increase of collagen tissue production, a fact that in the long term leads to left ventricular diastolic dysfunction and secondarily atrial dysfunction by increasing filling pressures predisposing to atrial fibrillation, and in advanced stages systolic dysfunction with dilatation of the cavity and the appearance of heart failure and ventricular arrhythmias [4]. In addition, hypertrophy of the ventricular wall increases the oxygen myocardial demands, which together with the increase incidence of coronary lesions favour myocardial ischemia [5].Several studies have found heterogeneous systolic alterations of the left ventricle (in the longitudinal, radial, and circumferential directions) in diverse clinical settings such as diabetes, hypertension, left ventricle hypertrophy, coronary artery disease, and heart failure [4,6]. The main aim of our study was focused in the assessment of left ventricular mechanical deformation in 20 patients with systemic arterial hypertension and 21 healthy controls to establish the differences in the left ventricular mechanical deformation. Materials and MethodsBetween March 2016 and February 2017, a comparative, observational, prospective, descriptive and analytical study was carried out in 41 subjects. The patients were evaluated consecutively in the Out-patients Clinic, National Institute of Cardiology "Ignacio Chávez". Twenty patients had systemic hypertension and 21 correspond to healthy controls. All participants signed the informed consent. Inclusion criteriaPatients older than 18 years NYHA functional class I/II with a diagnosis of systemic hypertension who had not had any prior surgical or interventional procedure and also patients without valvular or myocardial lesion. AbstractBackground: Systemic arterial hypertension represents the mayor risk factor for several cardiovascular diseases. In a large number of patients it affects the left ventricle by a compensating hypertrophy and posteriorly when this mechanism is insufficient, it leads to heart failure and therefore the patient requires regular echocardiographic monitoring. ...

Papillary fibroelastoma is an uncommon tumor. Recognitions of this tumor have been improved thanks to modern imaging advances, which have made more patients to be identified, but at the same time, the management of this disease is still controversial. There aren't enough studies to basic clinical actions. We present 2 interesting cases involving the semilunar valves. The purpose of presenting these cases is to review this rare disease and the superiority of the three-dimensional echocardiography in their diagnosis. KeywordsHeart Tumor, Papillary Fibroelastoma, Pulmonary Valve, Aortic Valve, Echocardiography BackgroundThe valvular papillary fibroelastoma is an uncommon primary cardiac tumor, ranging from 0.002% to 0.02% in prevalence, [1] [2]. Papillary fibroelastoma is the third most common primary cardiac tumor (after myxoma and lipoma), accounting for 7% to 9% of benign primary tumors. Previous studies have shown that papillary fibroelastoma has predilection for left heart valves (ninety-five percent of these tumors arise from; aortic valve-44.5% more than mitral valve-36.4%). Papillary fibroelastoma that affects the right heart is unusual and when it is seen, the pulmonary valve is affected less often than the tricuspid valve and accounts for 8% of cardiac papillary fibroelastomas [1]. The incidence of papillary fibroelastoma of the pulmonary valve is reported in Klarich KW et al. in 1997 to be between 0.00017% and 0.033% at autopsy and 0

Resumen Objetivo: Buscar la presencia de disfunción sistólica temprana del ventrículo izquierdo (VI) en pacientes adultos con coartación aórtica (CoAo) e hipertensión arterial sistémica (HAS), (r = 0.53, p = 0.02; r = 0.52, p < 0.0001, respectively