Purpose The aim of this study was to investigate myocardial dysfunction and mechanical abnormalities in young patients with Graves' disease before therapy, using two‐dimensional speckle tracking echocardiography. Methods We performed a comprehensive transthoracic echocardiographic examination, including segmental and global radial strain, and time‐to‐peak radial strain, in 47 young patients with hyperthyroidism and 34 healthy adults. The time‐to‐peak radial strain was corrected by RR interval. The variables derived from radial myocardial deformation by the six‐basal, six‐mid, and six‐apical segmental model were compared to investigate the difference of the myocardial function between the two groups. Results Early diastolic mitral inflow velocity, E/A ratio, early diastolic mitral annular velocity, and e′/a′ ratio were lower in patients with Graves' disease than in controls. The left ventricular end‐diastolic volume, left ventricular end‐systolic volume, stroke volume, cardiac output, heart rate, late diastolic mitral inflow velocity, and late diastolic mitral annular velocity were slightly higher in patients than in controls. Radial strain, global radial strain, and corrected time‐to‐peak radial strain were lower in the patient group. Conclusions The decreased radial strain, global radial strain, and corrected time‐to‐peak radial strain in young patients with newly diagnosed hyperthyroidism due to Graves' disease could serve as an early sign of subclinical cardiac involvement.

Purpose:We set out to undertake a preliminary assessment of the left ventricular hemodynamic status with right ventricular double-chamber pacing by energy loss (EL), wall shear stress (WSS), and circulation intensity (CIR) of vector flow mapping (VFM). We also planned to evaluate the value of VFM technology by measuring cardiac function after pacemaker implantation. Method: Data from 58 patients living with right ventricular double-chamber (right ventricular septal) pacemakers as well as 58 healthy volunteers matched in age and gender were collected. The EL, numbers of vortex cycles (n), area (A), CIR, and WSS of the left ventricle with different phases of the same cardiac cycle were obtained. Results:The EL of the left ventricle was significantly higher in the pacemaker group than the control group at partial section of atrial contraction (AC), isovolumetric contraction (IVC), and rapid ejection (RE) (P < 0.05). The WSS of the left ventricle was significantly lower in the pacemaker group than the control group at part of the section in the rapid filling (RF), the AC, IVC, and RE phase (P < 0.05). Discussion: EL in the left ventricular was significantly increased, while related WSS was significantly decreased in patients with right ventricular double-chamber pacing. Our exploration of the state of the flow field in the left ventricular cavity revealed that the implantation of the right ventricular double-chamber pacemaker led to an abnormal left ventricular hemodynamic state, reducing the left ventricular systolic efficiency. K E Y W O R D S circulation, energy loss, right ventricle double-chamber pacemaker, vector flow map, wall shear stress Meng and Wang contributed equally to this work and should be considered co-first authors.

Purpose: Left ventricular (LV) contractile reserve is commonly used for LV systolic function assessment, while data on normal LV contractile reserve to exercise and the effect of gender on it are contradictory and limited, especially in Chinese adults. The aims of the present study are to clarify echocardiographic normal reference of LV contractile reserve during treadmill exercise stress echocardiography in healthy Chinese adults and to evaluate the sex-specific impact on it. Patients and Methods:The study population consisted of 157 healthy Chinese adults. All subjects underwent comprehensive echocardiographic assessment at rest and immediately after a symptom-limited treadmill stress test. The impact of gender on LV contractile reserve was analyzed. Results:The study population consisted of 157 healthy Chinese adults. All subjects underwent comprehensive echocardiographic assessment at rest and immediately after a symptomlimited treadmill stress test. The impact of gender on LV contractile reserve was analyzed. Conclusion:Traditional LV contractile reserve of men was much higher than that of women in a healthy Chinese population. The difference might be because of higher BSA in men. ΔGLS was less influenced by METs and CI at rest compared to ΔEF. ΔGLS, and especially the ΔGLS index, might be considered as a more preferable contractile reserve parameter for clinical cardiac function evaluation.

AimsWe sought to objectively assess left ventricular myocardial work (MW) parameters after right ventricular septal pacing (VSP) and His-Purkinje system area pacing (HPSAP) procedures.Materials and methodsPatients undergoing double-chamber pacemaker implantation for III-degree atrioventricular block (III° AVB) were assessed 1 year after implantation. VSP and HPSAP groups (20 and 23 patients, respectively) were compared against 40 healthy age-matched volunteers. Two-dimensional ultrasound speckle tracking imaging was used to obtain the global myocardial work index (GWI), global myocardial work efficiency (GWE), global myocardial constructive work (GCW), global myocardial wasted work (GWW), left ventricular stratified strain, and peak strain dispersion (PSD).ResultsGWI, GWE, and GCW parameters were improved in HPSAP compared to VSP, while GWW was significantly larger in the VSP group compared to the HPSAP group (all p &lt; 0.05). HPSAP outperformed the VSP group in comparisons of global left ventricular longitudinal strain and stratified strain. Compared to controls, the GCW of all segmental myocardium (17/17 segments) in the VSP group was significantly reduced, while 70.59% (12/17 segments) in the HPSAP group was lower than the control group. GCW in the left ventricular segment of the HPSAP group was bigger than the VSP group (29.41%; 5/17 segments) and mainly concentrated in the ventricular septum and inferior wall.ConclusionOur findings suggest that HPSAP performance outcomes are improved over VSP after 1 year, especially in left ventricular contractile synchrony, and HPSAP is beneficial to the effective myocardial work of the left ventricle.