Objective:Identification of patients who are nonresponders to cardiac resynchronization therapy (CRT) with the use of simple and objective parameters may be helpful in tailoring treatment. The aim of this study is to investigate whether E/(Ea×Sa) could be a predictor of CRT nonresponders (E=early diastolic transmitral velocity, Ea=early diastolic mitral annular velocity, Sa=systolic mitral annular velocity). Methods:In total, 53 heart failure patients were evaluated for this study, and 33 patients were included according to the study criteria. Before and six months after CRT-D(CRT with a defibrillator) implantation, E, Ea, and Sa were determined at the medial and lateral mitral annular sites, and the average values were obtained. E/(Ea×Sa) was calculated (medial, lateral, average). The patients were followed for six months to monitor their CRT response. A responder was defined as a patient with a reduction in end-systolic volume of <15% and an increase in six-minute walking distance of 50 meters. Results:At a six-month follow-up, 24(72.7%) of the 33 patients responded to CRT. At the six-month follow-up, in the responder group, the E/Ea ratio, lateral mitral, and average E/(Ea×Sa) indices were significantly reduced (p<0.01 for all). The baseline lateral mitral, medial mitral, and average E/(Ea×Sa) indices were significantly lower in the responder group than in the nonresponder group (p≤0.01 for all). The ROC analysis showed that all the E/(Ea×Sa) indices predict the CRT nonresponder patients. The AUC values were 0.89(lateral E/(Ea×Sa)), 0.85(average E/(Ea×Sa)), and 0.77(medial E/(Ea×Sa))(p≤0.01 for all). Conclusion:We found that the E/(Ea×Sa) index is a novel predictor of CRT nonresponder patients.

We present a case of a 66-year-old male with dyspnea and bilateral lower-extremity edema. Pericardiotomy and biopsy were performed and reported malignant mesothelioma. Primary pericardial mesothelioma is a highly malignant tumor that has unfavorable prognosis, and is extremely rare, even among heart tumors. In our case, despite the large amount of pericardial effusion of the first echocardiography, the infiltrated like pericardium was still detected. In addition, cytology after pericardiocentesis reported suspicion of malignancy, which followed by pericardiotomy and biopsy, lead to our timely diagnosis.

We report a case of a 17-year-old healthy male presenting with multisystem hyperinflammatory shock temporally associated with COVID-19. Cardiac involvement was suspected based on evidence of significant cardiac injury (elevated cardiac biomarkers, electrocardiographic and echocardiographic abnormalities). Cardiac magnetic resonance imaging was performed demonstrating global biventricular systolic dysfunction, as well as a small area of T2 hyperintensity and mid wall late gadolinium enhancement. This case discusses the varied cardiac involvement in pediatric patients with COVID-19 infection and highlights that cardiac injury is not just limited to hyperinflammatory syndrome related global dysfunction but a more focal myocarditis can also be seen.

Abstract Background: Cystic fibrosis may lead to left ventricular dysfunction. This dysfunction can be documented by methods such as tissue doppler echocardiographic imaging and two-dimensional speckle tracking echocardiography in early stage. Patients and Methods: A total of 34 patients diagnosed with cystic fibrosis (mean age and SD 9.9±4.9 years) and 37 healthy control subjects with a comparable gender and age distribution (mean age 9.8±4.3) were studied. The results for the two groups were compared along with the results of published reports. Result: Control group had higher diastolic and systolic dimentions compared to the patient group in M-mode measurements of left ventricle by conventional echocardiography (p <0.05). There was no significant relationship between the groups in terms of the dimensions of systolic and diastolic measurements of interventricular septum and posterior wall of left ventricle, and ejection fraction. Pulmonary artery systolic pressure was significantly higher in the patient group (p<0.001). Myocardial performance indices of left ventricle free wall and interventricular septum were increased in the patient group compared to the control group (p<0.05). ). As measured by speckle tracking echocardiography, 7 segments in left ventricular myocardial longitudinal strain and 3 segments in left ventricular myocardial circumferential strain showed significant reductions in patients with cystic fibrosis compared to controls (p <0.05). Conclusions: Tissue doppler echocardiographic imaging and speckle tracking echocardiography may help identifying subclinical left ventricular dysfunction in cystic fibrosis patients with unremarkable conventional echocardiography. Its may be considered for the routine follow-up of cystic fibrosis patients.

SARS-CoV-2 not only causes viral pneumonia but has major implications for the cardiovascular system. Nevertheless, we assisted to a drastic reduction in the number of ACS during this period. Telemedicine and telecardiology, intended as integration to the traditional management appear precious tools especially in Covid-19 era. Given the decrease in new Covid-19 cases worldwide20, now we are approaching the so-called “Phase 2” challenge of a gradual return to pre-Covid-19 life. The epidemiological and clinical situation is rapidly evolving and practice patterns with policies depend on institutions and local availability.

A 35-year-old male with history of recurrent arrhythmias presented for pulmonary vein isolation. He underwent pre-procedural screening for thromboembolism risk with transesophageal echocardiogram. He had an incidental finding of a rare fenestrated membrane overlying his left atrial appendage. Additional work-up throughout his clinical course revealed genetic mutations in the LMNA and SNTA1 genes. There have been no previous reported genetic mutations reported in cases with LAA membranes.