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Objectives: Hypertension is a major risk factor for several cardiovascular diseases, including stroke, atherosclerosis and coronary heart disease. Remodeling of the aortic root may be expected to occur in hypertensive subjects as a result of increased stress on the aortic wall due to the repeated hemodynamic overload. Two-dimensional speckle tracking echocardiography is a promising new imaging modality. The aim of this study is to assess aortic root mechanics in relation to left ventricular mechanics in hypertensive patients by speckle tracking echocardiography. Methods: The study included 50 individuals, 30 patients with hypertension compared with 20 age and sex matched healthy volunteers as control group. For both groups, conventional echo was done and speckle tracking echocardiography of the LV including longitudinal, circumferential, radial strain, LV rotation and the longitudinal strain of the ascending aorta and aortic distensibility were measured. Results: Aortic longitudinal strain of both anterior and posterior walls, and also LV longitudinal peak systolic strain were lower significantly in patient group, and also in the same group, the apical rotation was higher than control; aortic longitudinal strain was negatively correlated with E/E, and LV global longitudinal strain was correlated positively with septal annular E wave peak velocity and with aortic distensibility. Conclusion: Hypertension significantly lowers ascending aortic longitudinal strain and the changes are correlated significantly with LV longitudinal systolic function and with echo parameters of elevated LV filling pressure.

Introduction: Current echocardiographic parameters have a limitation in assessing mitral valve (MV) apparatus in rheumatic mitral stenosis (MS) patient. In the current study, we use 2 dimensional (2D) longitudinal strain (S) and strain rate (Sr) imaging in evaluating the papillary muscle longitudinal strain (LS) as an objective and quantitative echocardiographic parameter with high reproducibility in the assessment of MV apparatus in patients with mild to moderate rheumatic MS with preserved ejection fraction (EF%). Patients and Method: The study included 40 patients with established diagnosis of MS subdivided in to 31 patients with moderate MS (mean age: 32 ± 5) and 9 patients with mild MS (mean age: 31 ± 6). 20 healthy individuals (mean age 31 ± 6) as a control for cases. The mitral valve area (MVA) was estimated using planimetry and pressure half time (PHT) methods. 2D longitudinal systolic S and Sr imaging was carried out for all participants from the apical long axis (LAX), 4 chamber (4C), 2 chamber (2C) views. Global longitudinal systolic S and Sr were estimated by averaging the 3 apical views. Longitudinal myocardial strain of papillary muscle PMs was assessed by the use of the free strain method from apical 4 chamber view for the antrolateral papillary muscle (APM) and apical long axis view for postromedial papillary muscle (PPM). Results: Patients with MS had significantly decreased longitudinal LV systolic S and Sr in comparison with control group (p < 0.001) despite no significant differences in LV EF%, LVESD and LVEDD were determined between the 3 groups. APM-LS and PPM-LS had significantly decreased values in patient with MS in comparison with control group (p < 0.001). Conclusion: Patients with MS and preserved EF% had decreased APM-LS & PPM-LS in comparison with control group, and had decreased longitudinal LV systolic S and Sr when compared with control group. 2D strain as well as Sr imaging might be a useful method for assessment of mitral valve apparatus in patients with MS & preserved EF%.

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Background: Intracoronary thrombus burden is associated with some adverse events and poor prognosis in patients with Acute Coronary Syndrome. Identifying predictors of the intracoronary thrombus burden may contribute to the management of Acute Coronary Syndrome. Objective: To assess the correlation between the Monocyte to HDL Cholesterol ratio with thrombus burden in patients with Acute Coronary Syndrome. Patients and Methods: 138 patients with ACS who were admitted to CCU department in National Heart Institute Cairo and Menoufia University Hospitals, Menoufia, underwent primary percutaneous coronary intervention (PCI). Angiographic thrombus burden was classified based on thrombolysis in myocardial infarction (TIMI) thrombus grades. The patients were grouped into 2 categories of low thrombus burden (grades 0-3) (49.7%) and high thrombus burden (grades 4 and 5) (50.3%). Results: On analysis we found that the MHR was significantly higher in the high thrombus burden group compared with the low thrombus (0.052 ± 0.019 vs 0.014 ± 0.008); P < 0.001. Conclusion: Among Acute Coronary Syndrome patients underwent Primary PCI, MHR was independent predictor of high thrombus burden in patients with Acute Coronary Syndrome.