Correlation between left atrial strain and left ventricular filling pressure in patients suspected of heart failure with a preserved left ventricular ejection fraction.

INTRODUCTION: Despite different ultrasound parameters, left ventricular filling pressures (LVFP) assessment remains inconclusive in some cases. AIM: To determine the contribution of left atrial strain (LAS) in estimating LVFP in patients with exertional symptoms and preserved left ventricular ejection fraction. METHODS: This was a monocentric study, carried out in the cardiology department of the Interior Security Forces Hospital, La Marsa, between October 2021 and March 2022. Patients with exertional symptoms had a physical examination, a biological assessment and an ultrasound examination at rest and, if necessary, during exercise. We investigated the performance of LAS components (Peak atrial longitudinal strain (PALS), peak atrial contraction strain (PACS) and conduit function (FnC) in predicting LVFP rising. Patients were categorized into two final groups according to LVFP: Group A= high LVFP at rest or during exercise (25 patients) and Group B= not-high LVFP at rest and during exercise (48 patients). RESULTS: Seventy-three patients were enrolled in the study, with a mean age of 61±12 years and a majority being female (57%). The median PALS was 29.3% [21.4-32.4]. The mean PACS and FnC values were 13.4%±4.9 and 13.7%±4.7, respectively. Patients with high LVFP demonstrated lower LAS parameters and elevated NT-Pro BNP levels. LAS showed negative correlations with the E/e' ratio and NT-Pro BNP. PALS emerged as an independent predictor of LVFP elevation (HR=0.71; 95% CI: 0.513-0.986; p=0.041). CONCLUSION: This study highlights that LAS, as a simple ultrasound parameter, can effectively predict high LVFP.

[Intestinal parasitosis among non-permanent resident students in Tunisia: a review of 23 years of monitoring in the department of Parasitology-Mycology at the Rabta Hospital of Tunisia]. / Les parasitoses intestinales chez les étudiants non-residents permanents en Tunisie: Bilan de 23 ans de surveillance au laboratoire de Parasitologie-Mycologie à l'hôpital la Rabta de Tunis.

BACKGROUND: In order to fight digestive parasitism in Tunisia, a national program of surveillance of non-permanent resident students in Tunisia has been found to detect these parasitosis in this target population. OBJECTIVE: To determine the prevalence of intestinal parasitosis among non-permanent resident students in Tunisia, to identify the different parasitic species founded and to show the interest of this screening. METHODS: During a period of 23 years (1990-2012), 7386 parasitological examinations of stools has been made among students essentially from or had visited tropical Africa, Maghreb and Middle-East, at the laboratory of Parasitology-Mycology at the Rabta Hospital of Tunis. RESULTS: The prevalence of intestinal parasitism found was 34.45% (i.e. 2545 infested students). Among the protozoa that have been isolated in the majority of cases (78.75%), amoebae were most frequently found (86.4%) represented mainly by Entamoeba coli and Endolimax nanus in respectively, 25.62 and 23.33% of parasites isolated; while Entamoeba histolytica/dispar, only pathogenic Amoeba was found in 8.05% of the total of parasites isolated. Regarding helminths, found in 21.25% of parasites isolated, Ankylostome was predominant (34.5%) represented by the species of Necator americanus. A single case of Ancylostom duodenale has been isolated. Among the identified parasite species, 38.7% were known parasitic pathogens for humans. CONCLUSIONS: These results note the interest of the control of the non-permanent resident students in Tunisia. The precocious tracking and treatment of affected subjects permits to avoid the introduction and the dissemination of parasites already rare and virulent strains in our country.