GLS and its deterioration are associated with MACE in asymptomatic hypertensive heart disease. A risk score incorporating strain was useful for predicting risk of MACE.

Third-space endoscopy is technically challenging and time consuming. Third-space procedures are associated with a significant risk of bleeding, both during and after the procedure (Fig. 1A). There are limited data and guidelines available on how to manage bleeding during per-oral endoscopic myotomy (POEM) and other forms of third-space endoscopy. The aim of this video is to demonstrate options for bleeding prophylaxis and Figure 1. A, Bleeding during third-space endoscopy. B, C, Coagulation with an endoscopic submucosal dissection knife. D, Hemostatic forceps to prevent bleeding. E, Hemostatic forceps to stop active bleeding. F, Hemostatic powder to obtain hemostasis.

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