Abnormal left ventricular longitudinal function assessed by echocardiographic and tissue Doppler imaging is a powerful predictor of diastolic dysfunction in hypertensive patients: the SPHERE study.

BACKGROUND: Through integrated use of echo-Doppler and tissue Doppler imaging (TDI), it is possible to obtain a comprehensive evaluation of both left ventricular (LV) diastolic and longitudinal functions. In this study, we sought to assess the prevalence of LV diastolic dysfunction (LVDD) and its relation with indices of long-axis function in asymptomatic patients with arterial hypertension. METHODS AND RESULTS: A perspective echo-Doppler study was performed in 1556 consecutive asymptomatic patients with grade 2-to-3 arterial hypertension aged 40-80 years enrolled in the SPHERE (multicenter proSPective study of ecHocardiography in hypERtEnsion) study. All patients had a LV ejection fraction (EF)≥50% and no history of heart failure or coronary artery disease. Advanced LVDD was identified by an average mitral-to-peak early diastolic annular ratio (E/e')≥13. Less than advanced LVDD was identified by: 8

Giant left atrium: a condition that is rarely seen today.

Today, giant left atrium is a condition that is rarely observed in clinical practice and diagnosis can be missed. It is prevalent in patients with rheumatic heart disease that has decreased considerably in industrialized countries in the last two decades. However, the immigration flow in the current era can revive its incidence.