Aims This study sought to examine the feasibility, accuracy and reproducibility of a novel, fully automated 2D transthoracic echocardiography (2D TTE) parasternal long axis (PLAX) view aortic measurements quantification software compared to board‐certified cardiologists in controlled clinical setting. Methods and results Aortic Annulus (AoA), Aortic Sinus (AoS), Sinotubular Junction (STJ) and Proximal Ascending Aorta (AAo) diameter measurements were performed retrospectively on each of 58 subjects in two different ways: twice using a fully automated software (Ligence Heart version 2) and twice manually by three cardiologists (ORG) and one expert cardiologist (EC). Out of 58 studies AoA was measured in 54 (93%), AoS in 55 (95%), STJ in 55 (95%) and AAo in 54 (93%) studies. Automated measurements had a stronger correlation with EC when compared to ORG with the largest correlation difference of .1 for STJ measurements and lowest difference of .01 for AoS measurements. Automated software was in higher agreement with ground truth intervals (ORG measurements mean +‐ SEM) in three out of four measurements. Conclusion Fully automated 2D TTE PLAX view aortic measurements using a novel AI‐based quantification software are feasible and yield results that are in close agreement with what experienced readers measure manually while providing better reproducibility. This approach may prove to have important clinical implications in the automation of the aortic root and ascending aorta assessment to improve workflow efficiency.

Background: there are many prognostic factors of heart failure (HF) based on their evaluation from imaging, to laboratory tests. In clinical practice, it is crucial to use widely available, cheap, and easy-to-use prognostic factors, such as left ventricular ejection fraction (LVEF), New York Heart Association (NYHA) functional class, 6 min walk test (6MWT), B-type natriuretic peptide (BNP), etc. We sought to evaluate the relationships between whole-heart myocardial mechanics and cardiac morphometrics with the main commonly used prognostic factors of HF in patients with non-ischemic dilated cardiomyopathy (NIDCM). Methods and results: two-dimensional (2D) echocardiography for myocardial mechanics (global longitudinal, radial, and circumferential strains of the left ventricle; right ventricular longitudinal strain; strain values of reservoir, conduit, and contraction function of both atria) and cardiac morphometric (diameters and volumes of both atria and ventricles) parameters were performed, and the HF main traditional prognostic factors were identified. We assessed 109 patients (68.8% male; 49.7 ± 10.5 years) with newly diagnosed NIDCM. Myocardial mechanics and morphometrics were weakly correlated with the patient’s age, gender, and smoking (R = 0.2, p < 0.05). Stronger relationships were observed with NYHA class, 6MWT, and BNP (the strongest correlations were with LVEF: R = −0.499, R 0.462, R = −0.461, p < 0.001, respectively). There were moderately strong correlations with LVEF and other whole-heart myocardial mechanics or morphometrics. Moreover, LVEF with global regurgitation volume (GRV) and right ventricle free wall longitudinal strain (RVFWLS) were the most usually detected parameters in multivariate analysis to be associated with changes in HF prognostic factors. Conclusions: in NIDCM patients, the main prognostic factors of HF are correlated with whole-heart myocardial mechanics and morphometrics. However, LVEF, GRV, and RVFWLS are the most usually found 2D echocardiographic factors associated with changes in HF prognostic factors.

Introduction Mediastinal neuroendocrine tumors are rare malignancies with aggressive behavior and a grim prognosis. These malignancies often go undetected until they are diagnosed at advanced stages. Case report We present the case of 74 -years old man who was hospitalized because of non-ST elevation myocardial infarction and in case of three vessels coronary artery disease, coronary bypass surgery was planned. During preoperative investigation, computer tomography revealed a huge tumor (20 cm × 11 cm × 21 cm in size) in the anterior mediastinum. Successful simultaneous operation coronary bypass surgery and removal of the mediastinal tumor was performed. Discussion Surgery is the treatment of choice for neuroendocrine tumors but the relapse rate ranges between 5% and 30% and is higher (65%) in atypical neuroendocrine tumors and patients with mediastinal node involvement. Despite the poor prognosis of neuroendocrine tumors, the spread to the lymph nodes, the patient continues chemotherapy treatment 49 months after the operation.

Infective endocarditis is a rare but clinically variable and difficult to diagnose disease. Delayed diagnosis of infective endocarditis can lead to total valve damage, which can require surgical treatment. We present a case report of a 36-year-old patient admitted to the hospital because of swelling and pain in the left shin and febrile fever. Two-dimensional transthoracic echocardiography was performed and infective endocarditis was suspec­ted. ¹⁸F-FDG PET-CT did not confirm the diagnosis of infective endocarditis and the patient was discharged as an outpatient with antibiotic therapy. The patient was readmitted with persistent inflammatory markers. Tran­sesophageal echocardiography showed a ruptured mitral valve with severe regurgitation. When the inflammatory parameters were reduced by antibiotic therapy, the patient underwent mechanical mitral valve replacement surgery. The patient had an uncomplicated postoperative period.

Background Pulmonary hypertension (PH) is a significant complication of mitral regurgitation (MR), leading to worse outcomes [1]. PH is not prominent at rest during an early stage of MR, but could be induced during stress. Elevated levels of natriuretic peptides are related to subclinical myocardial injury [2,3] including elevated systolic pulmonary artery pressure (SPAP) and it has a prognostic impact in patients with primary MR [4,5]. Aim The aim of this study was to evaluate correlation between NT-proBNP and SPAP at rest and during stress in asymptomatic patients with primary MR and preserved left ventricular ejection fraction. Methods Resting and stress (veloergometry as per protocol 25+25 W every 3 minutes) 2D transthoracic echocardiography was performed for 60 asymptomatic patients (age 61.45±11.99 years) with moderate–severe MR and preserved left ventricular ejection fraction (&gt;60%) at rest. According to the presence of exercise induced pulmonary hypertension ((EIPH) SPAP &gt;60 mmHg during stress) patients were divided into PH (n=20, 33.33%) and non-PH (n=40, 66.67%) groups. Statistical analysis was performed using the SPSS 27.0 software. The value of p&lt;0.05 was considered as statistically significant. Results Age, gender ratio, clinical characteristics, LV volume and diameter indexes, RV size and conventional functional parameters were similar in both groups. NT-proBNP concentration was significantly higher in PH group than in patients without EIPH (261.50 [138–543] pg/ml vs. 92 [58.95–149.50] pg/ml, p=0.002). Also, NT-proBNP concentration has significant moderate correlation with SPAP at rest (r=0.599, p&lt;0.001) and during peak stress (r=0.652, p&lt;0.001). NT-proBNP &gt;122 pg/ml could predict the presence of EIPH with 91.7% sensitivity and 66.7% specificity in patients with primary moderate–severe MR with preserved left ventricular ejection fraction (Picture 2). Conclusions In patients with primary moderate-severe MR and preserved left ventricular ejection fraction, higher levels of NT-proBNP correlated with higher SPAP at rest and during stress and was related to EIPH. NT-proBNP &gt;122 pg/ml is a sensitive predictive value of EIPH in cases of primary MR and preserved left ventricular ejection fraction. Funding Acknowledgement Type of funding sources: None.