Speckle-tracking echocardiography for detecting myocardial dysfunction in sepsis and septic shock patients:A single emergency department study

BACKGROUND:Septic cardiomyopathy(SCM)occurs in the early stage of sepsis and septic shock,which has implications for treatment strategies and prognosis.Additionally,myocardial involvement in the early stages of sepsis is difficult to identify.Here,we assess subclinical myocardial function using laboratory tests and speckle-tracking echocardiography(STE).METHODS:Emergency department patients diagnosed with sepsis or septic shock were included for analysis.Those with other causes of acute or pre-existing cardiac dysfunction were excluded.Transthoracic echocardiography(TTE),including conventional echocardiography and STE,were performed for all patients three hours after initial resuscitation.Samples for laboratory tests were taken around the time of TTE.RESULTS:Left ventricular functions of 60 patients were analyzed,including 21 septic shock patients and 39 sepsis patients.There was no significant difference in global longitudinal strain(GLS),global circumferential strain(GCS),or global radical strain(GRS)between patients with sepsis and septic shock(all with P>0.05).However,GLS and GCS were significantly less negative in patients with abnormal troponin levels or in patients with abnormal left ventricular ejection fraction(LVEF)values(all with P<0.05).There were also moderate correlations between GLS and levels of cTnI(r=0.40,P=0.002)or N-terminal pro-B-type natriuretic peptide(NT-proBNP)(r=0.44,P=0.001)in sepsis and septic shock patients.CONCLUSION:Myocardial dysfunction,e.g.,lower LVEF or less negative GLS in patients with sepsis or septic shock,is more affected by myocardial injury.GLS could be incorporated into mainstream clinical practice as a supplementary LVEF parameter,especially for those with elevated troponin levels.

Evaluation of Left Ventricular Function by Three-Dimensional Speckle-Tracking Echocardiography in Patients with Chronic Kidney Failure

Objective:To establish a quantitative evaluation of the left ventricle's systolic function in patients with chronic kidney failure(CKF)by three-dimensional speckle-tracking echocardiography.Methods:Two-dimensional and three-dimensional transthoracic echocardiography was performed on 30 patients with CKF.The ejection fraction,mass and global peak longitudinal strain,global circumferential strain,global area strain,and global radial strain of the left ventricle were calculated.Results:The ejection fraction,mass and global peak longitudinal strain(GLS),global circumferential strain(GCS),global area strain(GAS),and global radial strain(GRS)in the CKF group were significantly lower than those in the control group.Simultaneously,the GLS,GCS,GAS and GRS were well correlated with the ejection fraction.For patients with normal ejection fraction in the CKF group,the GLS,GCS,GAS and GRS were lower than those in the control group,while the left ventricular mass was significantly higher in CKF patients than in the control group.For patients with hypertension in the CKF group,ejection fraction,GLS,GCS,GAS and GRS calculated using three-dimensional echocardiography were significantly lower than those in patients with normal blood pressure;however,the myocardial mass was higher.Conclusions:The parameters(GLS,GCS,GAS and GRS)calculated using three-dimensional speckle-tracking software were lower in the CKF group.Simultaneously,the left ventricular mass was higher in CFK patients than in the control group,thus showing that the myocardial contraction function was impaired and that myocardial remodeling had occurred.

Effects of sevoflurane on left ventricular function by speckletracking echocardiography in coronary bypass patients: A randomized trial

The present study aimed to dynamically observe the segmental and global myocardial movements of the left ventricle during coronary artery bypass grafting by transesophageal speckle-tracking echocardiography,and to assess the effect of sevoflurane on cardiac function.Sixty-four patients scheduled for the off-pump coronary artery bypass grafting were randomly divided into a sevoflurane-based anesthesia(AS)group and a propofolbased total intravenous anesthesia(AA)group.The AS group demonstrated a higher absolute value of left ventricular global longitudinal strain than that of the AA group at both T1(after harvesting all grafts and before coronary anastomosis)and T_(2)(30 min after completing all coronary anastomoses)(P<0.05).Moreover,strain improvement in the segment with the highest preoperative strain was significantly reduced in the AS group,compared with the AA group at both T1 and T_(2)(P<0.01).The flow of the left internal mammary artery-left anterior descending artery graft was superior,and the postoperative concentration of troponin T decreased rapidly in the AS group,compared with the AA group(P<0.05).Compared with total intravenous anesthesia,sevoflurane resulted in a significantly higher global longitudinal strain,stroke volume,and cardiac output.Sevoflurane also led to an amelioration in the condition of the arterial graft.Furthermore,sevoflurane significantly reduced strain improvement in the segmental myocardium with a high preoperative strain value.The findings need to be replicated in larger studies.

Echocardiographic Aspects of Type 2 Diabetics Patients Hospitalized in the Medicine and Endocrinology Department of the Mali Hospital

Introduction: Cardiovascular disease is the leading cause of death in diabetics. The objective of our study was to investigate the echocardiographic aspects of type 2 diabetics. Patients and Method: Descriptive and cross-sectional study of 12 months from June 2020 to June 2021. We included hospitalized type 2 diabetics who underwent transthoracic cardiac ultrasound in the Department of Medicine and Endocrinology at the Mali Hospital. Results: We collected 128 type 2 diabetics. The predominance was male with a sex ratio of 1.2. The mean age of patients was 60.06 ± 11.54 years with extremes of 28 and 84 years. Echocardiographic abnormalities were dominated by abnormal relaxation of left ventricle in 62.5%, increased of left ventricle mass in 54.7% and left atrium dilation in 28.1%. Patients with type 2 diabetes mellitus and hypertension had more left atrium dilation with a p of 0.02. Disorders of global kinetics and systolic dysfunction were more prevalent in smoking patients with statistically significant associations, respectively, p = 0.02;p = 0.03. Dyslipidemia had a statistically significant association with segmental kinetic disorders with a p of 0.008. Duration of diabetes greater than 5 years was associated with left atrium dilation and p-value was 0.04. Conclusion: Diabetes is responsible for cardiovascular manifestations that can be identified with transthoracic echocardiography. Its performance in diabetic patients makes it possible to refine the patient’s management.

Deep learning models semi-automatic training system for quality control of transthoracic echocardiography

Objective To explore the value of deep learning(DL)models semi-automatic training system for automatic optimization of clinical image quality control of transthoracic echocardiography(TTE).Methods Totally 1250 TTE videos from 402 patients were retrospectively collected,including 490 apical four chamber(A4C),310 parasternal long axis view of left ventricle(PLAX)and 450 parasternal short axis view of great vessel(PSAX GV).The videos were divided into development set(245 A4C,155 PLAX,225 PSAX GV),semi-automated training set(98 A4C,62 PLAX,90 PSAX GV)and test set(147 A4C,93 PLAX,135 PSAX GV)at the ratio of 5∶2∶3.Based on development set and semi-automatic training set,DL model of quality control was semi-automatically iteratively optimized,and a semi-automatic training system was constructed,then the efficacy of DL models for recognizing TTE views and assessing imaging quality of TTE were verified in test set.Results After optimization,the overall accuracy,precision,recall,and F1 score of DL models for recognizing TTE views in test set improved from 97.33%,97.26%,97.26%and 97.26%to 99.73%,99.65%,99.77%and 99.71%,respectively,while the overall accuracy for assessing A4C,PLAX and PSAX GV TTE as standard views in test set improved from 89.12%,83.87%and 90.37%to 93.20%,90.32%and 93.33%,respectively.Conclusion The developed DL models semi-automatic training system could improve the efficiency of clinical imaging quality control of TTE and increase iteration speed.

Deep learning models for automatic classification ofechocardiographic views

Objective To observe the value of deep learning (DL) models for automatic classification of echocardiographic views. Methods Totally 100 patients after heart transplantation were retrospectively enrolled and divided into training set, validation set and test set at a ratio of 7 ∶ 2 ∶ 1. ResNet18, ResNet34, Swin Transformer and Swin Transformer V2 models were established based on 2D apical two chamber view, 2D apical three chamber view, 2D apical four chamber view, 2D subcostal view, parasternal long-axis view of left ventricle, short-axis view of great arteries, short-axis view of apex of left ventricle, short-axis view of papillary muscle of left ventricle, short-axis view of mitral valve of left ventricle, also 3D and CDFI views of echocardiography. The accuracy, precision, recall, F1 score and confusion matrix were used to evaluate the performance of each model for automatically classifying echocardiographic views. The interactive interface was designed based on Qt Designer software and deployed on the desktop. Results The performance of models for automatically classifying echocardiographic views in test set were all good, with relatively poor performance for 2D short-axis view of left ventricle and superior performance for 3D and CDFI views. Swin Transformer V2 was the optimal model for automatically classifying echocardiographic views, with high accuracy, precision, recall and F1 score was 92.56%, 89.01%, 89.97% and 89.31%, respectively, which also had the highest diagonal value in confusion matrix and showed the best classification effect on various views in t-SNE figure. Conclusion DL model had good performance for automatically classifying echocardiographic views, especially Swin Transformer V2 model had the best performance. Using interactive classification interface could improve the interpretability of prediction results to some extent.

Echocardiographic predictors and associated outcomes of multiple vegetations in infective endocarditis:A pilot study

BACKGROUND Infective endocarditis(IE)is a life-threatening infection with an annual mortality of 40%.Embolic events reported in up to 80%of patients.Vegetations of>10 mm size are associated with increased embolic events and poor prognosis.There is a paucity of literature on the association of multiple vegetations with outcome.AIM To study the echocardiographic(ECHO)features and outcomes associated with the presence of multiple vegetations.METHODS In this retrospective,single-center,cohort study patients diagnosed with IE were recruited from June 2017 to June 2019.A total of 84 patients were diagnosed to have IE,of whom 67 with vegetation were identified.Baseline demographic,clinical,laboratory,and ECHO parameters were reviewed.Outcomes that were studied included recurrent admission,embolic phenomenon,and mortality.RESULTS Twenty-three(34%)patients were noted to have multiple vegetations,13(56.5%)were male and 10(43.5%)were female.The mean age of these patients was 50.Eight(35%)had a prior episode of IE.ECHO features of moderate to severe valvular regurgitation[odds ratio(OR)=4],presence of pacemaker lead(OR=4.8),impaired left ventricle(LV)relaxation(OR=4),and elevated pulmonary artery systolic pressure(PASP)(OR=2.2)are associated with higher odds of multiple vegetations.Of these moderate to severe valvular regurgitation(P=0.028),pacemaker lead(P=0.039)and impaired relaxation(P=0.028)were statistically significant.These patients were noted to have an increased association of recurrent admissions(OR=3.6),recurrent bacteremia(OR=2.4),embolic phenomenon(OR=2.5),intensive care unit stay(OR=2.8),hypotension(OR=2.1),surgical intervention(OR=2.8)and device removal(OR=4.8).Of this device removal(P=0.039)and recurrent admissions(P=0.017)were statistically significant.CONCLUSION This study highlights the associations of ECHO predictors and outcomes in patients with IE having multiple vegetations.ECHO features of moderate to severe regurgitation,presence of pacemaker lead,impaired LV relaxation,and elevated PASP and outcomes including recurrent admissions and device removal were found to be associated with multiple vegetations.

BILL Strategy:Points to Consider During the Performance and Interpretation of Critical Care Echocardiography

The growing utilization of critical care echocardiography(CCE) by clinicians necessitates a meticulous review of clinical conditions in critically ill patients, both before and during the examination. The reviewing process of clinical conditions minimizes the risk of overlooking or misinterpreting crucial findings. This article proposes a comprehensive strategy, namely BILL strategy, to integrate into the CCE protocol, where "B" represents baseline respiratory and hemodynamic support, "I" signifies information gleaned from invasive monitoring, including central venous pressure and thermodilution-derived cardiac output, the first "L" denotes laboratory results such as central venous oxygen saturation, troponin, and brain natriuretic peptide, and the second "L" refers to lung ultrasound data. Combining the BILL strategy with CCE can enhance comprehensive understanding of critical conditions, potentially leading to improved diagnostic accuracy and patient outcomes.

Z-Score in Fetal Echocardiography–Is there Still Room for New Studies?

Congenital heart disease(CHD)is the most common type of birth defect,representing a significant cause of peri-natal morbidity and mortality.Early diagnosis of such anomalies is crucial for improving outcomes.Current pro-tocols recommend a qualitative assessment of cardiac structures using two-dimensional ultrasound(2DUS)and color Doppler imaging.In cases of suspected abnormalities,quantitative assessments through cardiac structure measurements and reference curves can aid in accurate diagnosis.Similar to centiles widely employed in obste-trics,Z-scores provide more precise quantification of various cardiac structures,particularly at the extremes of the curve.While the development of reference curves and Z-scores has progressed over the past two decades,a lack of standardization in measurements and statistical methodology for their determination is evident.Establishing reference curves requires adherence to specific recommendations to improve their accuracy.The purpose of this study is to provide a narrative review of the major studies that have generated reference values for cardiac struc-tures using 2DUS and Z-scores,to evaluate their methodology,and to provide a summary of the results.

Status of clinical applications of artificial intelligence in echocardiography

Artificial intelligence(AI)technology has been increasingly used in medical field with its rapid developments.Echocardiography is one of the best imaging methods for clinical diagnosis of heart diseases,and combining with AI could further improve its diagnostic efficiency.Though the applications of AI in echocardiography remained at a relatively early stage,a variety of automated quantitative and analytical techniques were rapidly emerging and initially entered clinical practice.The status of clinical applications of AI in echocardiography were reviewed in this article.

Deep learning echocardiographic intelligent model for evaluation on left ventricular regional wall motion abnormality

Objective To observe the value of deep learning echocardiographic intelligent model for evaluation on left ventricular(LV)regional wall motion abnormalities(RWMA).Methods Apical two-chamber,three-chamber and four-chamber views two-dimensional echocardiograms were obtained prospectively in 205 patients with coronary heart disease.The model for evaluating LV regional contractile function was constructed using a five-fold cross-validation method to automatically identify the presence of RWMA or not,and the performance of this model was assessed taken manual interpretation of RWMA as standards.Results Among 205 patients,RWMA was detected in totally 650 segments in 83 cases.LV myocardial segmentation model demonstrated good efficacy for delineation of LV myocardium.The average Dice similarity coefficient for LV myocardial segmentation results in the apical two-chamber,three-chamber and four-chamber views was 0.85,0.82 and 0.88,respectively.LV myocardial segmentation model accurately segmented LV myocardium in apical two-chamber,three-chamber and four-chamber views.The mean area under the curve(AUC)of RWMA identification model was 0.843±0.071,with sensitivity of(64.19±14.85)%,specificity of(89.44±7.31)%and accuracy of(85.22±4.37)%.Conclusion Deep learning echocardiographic intelligent model could be used to automatically evaluate LV regional contractile function,hence rapidly and accurately identifying RWMA.

Reliability of Echocardiographic Pulmonary Vascular Resistance to Screen for the New Definition of Precapillary Pulmonary Hypertension in Uncorrected Secundum Atrial Septal Defect

Background and Objective:The most feared complication of uncorrected secundum Atrial Septal Defect(ASD)is pulmonary arterial hypertension(PAH).Pulmonary vascular resistance(PVR)is crucial in detecting precapil-lary pulmonary hypertension(PH)to guide the need for PAH-specific therapy.There is a change in the cut-off value of PVR according to the recently updated PH guideline.How echocardiographic PVR(PVRecho)correlates to PVR by right heart catheterization(RHC)(PVRcath)according to the new guidelines has not been known.The aim of this study is to determine the reliability of PVRecho in detecting PAH in Uncorrected Ostium Secundum ASD based on the current updated guideline and to help screen the high PVR group.Methods:429 ostium secun-dum ASD in the COngenital HeARt Disease in Adult and Pulmonary Hypertension(COHARD-PH)registry was divided into three groups according to the PVR.PVRecho was calculated using Abbas’Formula and compared the its gold standard,the PVRcath.The correlation between the two methods was analyzed.The Bland-Altman plot was used to analyze the agreement between the two methods.Receiver operating characteristics(ROC)analysis was used to determine the PVRecho cut-off value for high PVR.Results:The majority of the population(63.5%)had high PVR.Female gender dominated the study population(84%).PVR_(echo) was significantly correlated with PVRcath(r=0.6225,p<0.0001).Bland-Altman plot among all groups and in subgroups analysis showed a wide range of agreement.PVRecho underestimated PVRcath 5.124 WU.In subgroup analysis,PVRecho overestimated PVRcath 0.35 WU in those with PVR<2 WU.In the second and third groups,PVR_(echo) underestimated PVRcath 0.52 and 10.77 WU,respectively.Conclusion:PVRecho is reliable in predicting high PVR in uncorrected secun-dum ASD.However,there is a wide range of agreement.PVR_(echo) cut-off value of>1.62 WU showed good dis-criminatory power in determining high PVR.

Intelligent diagnosis of atrial septal defect in children using echocardiography with deep learning

Background Atrial septal defect(ASD)is one of the most common congenital heart diseases.The diagnosis of ASD via transthoracic echocardiography is subjective and time-consuming.Methods The objective of this study was to evaluate the feasibility and accuracy of automatic detection of ASD in children based on color Doppler echocardiographic static images using end-to-end convolutional neural networks.The proposed depthwise separable convolution model identifies ASDs with static color Doppler images in a standard view.Among the standard views,we selected two echocardiographic views,i.e.,the subcostal sagittal view of the atrium septum and the low parasternal four-chamber view.The developed ASD detection system was validated using a training set consisting of 396 echocardiographic images corresponding to 198 cases.Additionally,an independent test dataset of 112 images corresponding to 56 cases was used,including 101 cases with ASDs and 153 cases with normal hearts.Results The average area under the receiver operating characteristic curve,recall,precision,specificity,F1-score,and accuracy of the proposed ASD detection model were 91.99,80.00,82.22,87.50,79.57,and 83.04,respectively.Conclusions The proposed model can accurately and automatically identify ASD,providing a strong foundation for the intelligent diagnosis of congenital heart diseases.

Clinical Value of Echocardiographic Screening and Dynamic Observations for Ductus Arteriosus Closure in Newborns

Objective:To explore and analyze the clinical value of echocardiography screening and dynamic observation for ductus arteriosus closure in newborns.Methods:The study was conducted from August 2022 to December 2023.500 newborns who were admitted to our hospital were selected as research subjects for this study(Kunming Tongren Hospital).All subjects underwent echocardiography to determine the severity of patent ductus arteriosus(PDA).The inner diameter of the pulmonary artery was measured,and the pulmonary artery pressure was estimated through tricuspid regurgitation.If the patient had high pulmonary artery pressure,elective closure surgery was performed.Results:Among the 500 subjects,448 cases of ductus arteriosus closure and 52 cases of PDA were detected by echocardiography,including 23 cases of simple PDA,15 cases with patent foramen ovale,11 cases with atrial septal defect,1 case with muscular ventricular septal defect,1 case with tricuspid valve prolapse,and 1 case with tricuspid valve chordae tendineae rupture.After symptomatic treatment and intervention,their echocardiogram results were reviewed and no abnormalities were found.All measurement results of children with PDA combined with pulmonary hypertension were better than before treatment(P<0.05).Conclusion:Echocardiography is a fast,accurate,and reliable non-invasive imaging examination technology.It can significantly improve congenital heart disease detection rate in infants and young children.Early intervention based on the examination results can dramatically improve the quality of life of infants and young children with PDA.

Self-Appraisal of Clinical Competence in Echocardiography of Chinese Intensivists Post Basic Echocardiography Training

Objectives To learn the echocardiography skills of intensivists after receiving a basic critical care echocardiography training course,and investigate factors that may influence their performance.Methods We completed a web-based questionnaire that assessed the skills in ultrasound scanning techniques of intensivists who took a training course on basic critical care echocardiography held in 2019 and 2020.MannWhitney test was used to analyze the factors which might affect their performance on image acquisition,recognizing clinical syndrome,and measuring the diameter of inferior vena cava,left ventricular ejection fraction and left ventricular outflow tract velocity-time integral.Results We enrolled 554 physicians from 412 intensive care units across China.Among them,185(33.4%)reported that they had 10%-30%chance of being misled by critical care echocardiography when making therapeutic decision,and 34(6.1%)reported that the chance was greater than 30%.Intensivists who performed echocardiography under the guidance of a mentor and finished ultrasound scanning more than 10 times per week reported significant higher scores in image acquisition,clinical syndrome recognition,and quantitative measurement of inferior vena cava diameter,left ventricular ejection fraction and left ventricular outflow tract velocity-time integral than those without mentor and performing echocardiography 10 times or less per week respectively(all P 0.05).Conclusion The skills in diagnostic medical echocardiography of Chinese intensivists after a basic echocardiographic training course remain low,and further quality assurance training program is clearly warranted.

Quantitative Parameters Analysis for Prenatally Echocardiographic Diagnosis of Atrioventricular Septal Defects

Background:Atrioventricular septal defects(AVSDs)are screened and diagnosed usually rely on the imaging characteristics of fetal echocardiography(FE).However,diagnosis on images is heavily depended on sonographers’experience and the quantitative data are rarely studied.Objective:This study aimed to realize the prenatal diagnosis of AVSDs by analyzing the quantitative data on FE.Methods:One hundred and thirteen cardiac quantitative data was analyzed in 370 normal and 49 AVSDs fetuses retrospectively.The top six with the highest diagnostic accuracy rate were acquired according to the area under the curve(AUC),and the diagnostic value of six variables was analyzed.Results:Six parameters obtained on the four-chamber view(4CHV),including the atrial to ventricular length ratio in end-diastole(AVLR-ED),AVLR-ED combined with the atrial to ventricular length ratio in end-systole(AVLR-ES),quantile score(Q score)of AVLR-ED,Q score of AVLR-ES,Q score of ventricle length in end-diastole(VL-ED),and AVLR-ES,were the top six with the highest diagnostic value,and the AUC was 0.99(95%CI 0.99–1.00),0.99(95%CI 0.99–1.00),0.99(95%CI 0.98–1.00),0.95(95%CI 0.91–0.99),0.93(95%CI 0.87–0.99),and 0.91(95%CI 0.83–1.00),respectively.And within the 20%false positive rate,the diagnostic sensitivity was greater than 100%,100%,100%,90%,90%,and 88%,respectively.Conclusions:Six variables could be used for prenatal diagnosis of AVSDs.Among them,AVLR-ED and Q score of AVLR-ED,obtained on the 4CHV,were more convenient to acquire and had higher diagnostic accuracy.

Real-Time Remote-Mentored Echocardiography in Management of Newborns with Critical Congenital Heart Defects

Background:The management of suspected critical congenital heart defects(CCHD)relies on timely echocardiographic diagnosis.The availability of experienced echocardiographers is limited or even non-existent in many hospitals with obstetric units.This study evaluates remote-mentored echocardiography performed by physicians without experience in imaging of congenital heart defects(CHD).Methods:The setup included a pediatric cardiologist in a separate room,guiding a physician without experience in echocardiographic imaging of CHD in the examination of a symptomatic newborn.This remote-mentoring pair was blinded to the diagnosis of the newborn and presented with a simplified patient history.The echocardiographic images were streamed to the laptop of the mentor,along with a webcam feed showing the probe position.The task was to identify CCHD in need of immediate transfer to a pediatric cardiac surgical center.The result was compared to the previously completed echocardiographic report and the clinical decision of the patient-responsible pediatric cardiologist.Results:During 17 months,15 newborns were recruited.All six newborns with CCHD were correctly labeled by the remotementoring pair.One newborn with Tetralogy of Fallot was erroneously labeled as needing immediate transfer.Eight newborns without CCHD were correctly labeled.Conclusions:Remote-mentored echocardiography performed by examiners without experience in imaging CHD identified all newborns with CCHD in need of immediate transfer for specialist care.The setup shows promising results for improving the management of CCHD in hospitals without continuous pediatric cardiology service.

ECG and Echocardiographic Findings of Female Hypertension (fHTN) in the Cardiology Department of the University Hospital Gabriel Touré (UH-GT)

Introduction: In our setting there is a lack of publications on female hypertension in general population motivating this study to look for electro- and echocardiographic findings of female hypertension. Methods: We performed a cross-sectional study during 6 months in the cardiology department of the UH-GT including 324 female patients aged 18 and more seen in the outpatient unit and by whom the diagnosis of hypertension was set. All patients consented to be study participants after receiving clearly information about the study and that care giving will not be affected by their eventual refusal. Data collection has been done with all needed confidentiality rules. A survey formular was used to collect data in order to record them in an Access database. Analysis was done using IBM SPSS software. Quantitative data are presented as mean with standard deviation and qualitative as proportion. Level of significance for statistic test was set at 5%. Results: During the study time 324 among 524 hypertensive patients visited our outpatient unit giving a prevalence of fHTN of 61.8%. The means for age, body mass index (BMI) in female hypertensive patients were respectively 52 ± 14.461 years and 27.35 ± 06.585 Kg/m2. Main ECG findings were left ventricular hypertrophy (LVH) and sinus tachycardia with respectively 93.6% and 46.4% followed by isolated ventricular extrasystole with 33.7%. Echocardiography findings included LVH, relative wall thickness (RWT) and reduced ejection fraction (EF) in respectively 41.05%, 37.35% and 21.91%. The left ventricular mass (LV) mass and geometry were abnormal in 44.4% and 37.3%. Remodeling as geometry modification (18.2%) and mitral flow Type 2 (90.4%) have been the most abnormal findings. Conclusion: Hypertension induced modifications mainly LVH in ECG and Echocardiography in female patients less than encountered among male hypertensive patients.

Epidemiological, Clinical and Echocardiographic Aspects of Non-Obstructive Hypertrophic Cardiomyopathy in the Nephrology and Haemodialysis Department of the POINT G University Hospital

Introduction: LVH is the earliest cardiovascular abnormality in CKD. It is a significant risk factor for mortality and cardiovascular morbidity in patients with chronic kidney disease. The objective of this study was to investigate non-obstructive hypertrophic cardiomyopathy in CKD patients hospitalised in the nephrology and haemodialysis department of the POINT G University Hospital. Methods: This is a prospective study carried out from January 1, 2021 to December 31, 2021 and concerned chronic renal failure patients with non-obstructive hypertrophic cardiomyopathy. Results: During our study, we recorded 89 cases of non-obstructive hypertrophic cardiomyopathy, a prevalence of 42.8%. The sex ratio was 1.2 in favour of men. The average age of the patients was 45 ± 14.4 years with extremes of 16 and 78 years. The risk factors frequently found were anaemia (100%) and hypertension (92.1%). The clinical picture was dominated by the left heart failure syndrome (66.3% of cases). The different types of echocardiographic hypertrophy found were concentric (72%), eccentric (18%) and septal hypertrophy (10%). Conclusion: Non-obstructive hypertrophic cardiomyopathy is the early cardiovascular abnormality encountered in CKD. It is associated with cardiovascular risk factors such as hypertension, anaemia and phosphocalcic disorders.

Current role and future perspectives of artificial intelligence in echocardiography

Echocardiography is an essential tool in diagnostic cardiology and is fundamental to clinical care.Artificial intelligence(AI)can help health care providers serving as a valuable diagnostic tool for physicians in the field of echocardiography specially on the automation of measurements and interpretation of results.In addition,it can help expand the capabilities of research and discover alternative pathways in medical management specially on prognostication.In this review article,we describe the current role and future perspectives of AI in echocardiography.