فلاح مهدي دنانه الجحيشي

Background: Four-dimensional echocardiography technique results in marked improvements in terms of quality and accuracy in assessing the size and function of heart chambers, especially the left atrium as its geometric variation has a notable impact on the results when using traditional echocardiographic techniques alone. Thus, this study aimed at investigating the probability of significant functional and morphological changes in the left atrium with advancing age using Four-dimension echocardiography. Method: Four-dimensional technique derived left atrial phasic volumes and functions were assessed in (30) healthy subjects with mean age of 73.6 (±3.6) years and (30) young subjects with mean age of 23.17 (±3.5) years. Results: Old age group showed a significant increase in maximum left atrial volume index, minimum left atrial volume index and pre-atrial contraction left atrial volume index compared to young age group (31.52±1.09 vs. 26.44±1.03, P < 0.001), (17.93±0.43 vs. 15.89±0.44, P < 0.00) and (25.73±1.003 vs. 22.34±0.77, P < 0.01), respectively. In the old age group, the passive left atrial emptying function (LAEF) significantly decreased (20.43±0.25% vs. 24.96±0.93%, p<0.00), while the active LAEF significantly increased (37.36±1.33% vs. 32.65±1.13%, P< 0.009) in comparison to the values of the young subjects. Conclusions: These results suggest that left atrial structural as well as functional changes occur with advancing age in absence of evident pathological causes and 4-dimentional echocardiography can be used to evaluate these changes. © 2020 EManuscript Technologies. All rights reserved.

Children suffering from patent ductus arteriosus (PDA) are at high cardiovascular risk in childhood and adulthood. Although there were many studies on left ventricle (LV) function in PDA children, not study was reported using Four-dimensional (4D) echocardiographic speckle tracking (ST) analysis in uncorrected rather than post ligation patients. This work aimed at evaluating LV mechanics of the global longitudinal strain (GLS), the global circumferential strain (GCS) and global radial strain (GRS) in children with uncorrected PDA in comparison with a healthy control people. Sixty-two people (25 with PDA and 37 normal) were involved. Their mean age was 11.52±2.5 months (54% male), and 11.1±2.07 (41% male). All participants were subjected to the clinical evaluation and echocardiographic examination. LV function was also assessed by two-dimensional (2D) ejection fraction (EF), fractional shortening (FS) and 4D echocardiography speckle tracking (STE). Longitudinal and circumferential Myocardial deformation in those with PDA were documented less than in the healthy children while 4D radial strain, 2D EF and FS were higher in PDA patients. For PDA and control groups, GLS was -17.404±1.06 versus -20.66±1.6 (P: 0.000) respectively and the GCS was-17.87±0.62 for PDA patients in contrast to -21.36±1.57 (P: 0.000) for the control groups. The GRS of PDA was +46.5±6.3 while the normal group was +38.26±3.01 (P: 0.000). 2D EF 74.47±3.6 was for the patients with PDA while 72.7±2.9 (P: 0.04) was for the normal ones. The PDA and control groups were 2D FS 37.49±1.7 versus 36.38±1.8 (P: 0.02). A new technique by 4D derived ST showed that children with uncorrected PDA were subjected to early subclinical LV mechanical insults despite the apparently normal or augmented LV systolic function which necessitates early intervention to avoid these consequences. Keyword: Four-dimensional Echocardiography, Speckle Tracking, Left Ventricle Mechanics, Patent Ductus Arteriosus

Mitral regurgitation (MR) is one of the most frequent valvular heart diseases faced in clinical practice and a common finding on echocardiography. Aim: is to evaluate MR in Iraqi patients, focusing attention on its prevalence, mechanism, etiology, severity, and associated valve conditions. Methods: a total of 653 patients were prospectively recruited, presented to Al Sader teaching hospital (Najaf –Iraq). All patients underwent a standard transthoracic echocardiogram. Results: MR was described in 283 patients 43.3 %. Prevalence in female was 30% while in male was 13.3% of total MR patients. Mechanism of MR was primary in 75.3% and secondary in 24.7%. Degeneration was the most common primary cause 51% followed by prolapsed 11.3%, then Barlow ?s disease 9.5% and annular calcification 1.8%, Infective endocarditic, systemic lopuscarditis, Rheumatic heart disease and congenital heart disease, each of them 0.35%. Most common secondary cause of MR was ischemic 16.3% followed by functional in 8.5% from total patients with MR. Trace MR was detected in 21.9%, in 63.6% mild, in 11.7% moderate and in 2.8% sever. 54.4% of patients with MR had concomitant valve disease of at least mild grade. Tricuspid regurgitation (TR) the most prevalent 50.5 % followed by pulmonary regurgitation (PR) 35.3%, aortic regurgitation (AR) 26.1%, aortic stenos is (AS) 0.4%), mitral stenos is (MS) 0.4% . Conclusion: MR is common in Iraqi population. The common mechanism is primary one. Degenerative cause is the most frequent etiology of primary MR, while ischemic is the most common etiology of secondary MR. Most patients had mild MR and significant MR diagnosed in 6% of allcases. Keyword: mitral regurgitation; echocardiography DOI: https://doi.org/10.31838/ijpr/2020.12.02.0166 Download: Request For Article