Aims: Transoesophageal echocardiography (TOE) is often performed before catheter ablation or cardioversion to rule out the presence of left atrial appendage thrombus (LAT) in patients on chronic oral anticoagulation (OAC), despite associated discomfort. A machine learning model [LAT-artificial intelligence (AI)] was developed to predict the presence of LAT based on clinical and transthoracic echocardiography (TTE) features. Methods and results: Data from a 13-site prospective registry of patients who underwent TOE before cardioversion or catheter ablation were used. LAT-AI was trained to predict LAT using data from 12 sites (n = 2827) and tested externally in patients on chronic OAC from two sites (n = 1284). Areas under the receiver operating characteristic curve (AUC) of LAT-AI were compared with that of left ventricular ejection fraction (LVEF) and CHA2DS2-VASc score. A decision threshold allowing for a 99% negative predictive value was defined in the development cohort. A protocol where TOE in patients on chronic OAC is performed depending on the LAT-AI score was validated in the external cohort. In the external testing cohort, LAT was found in 5.5% of patients. LAT-AI achieved an AUC of 0.85 [95% confidence interval (CI): 0.82–0.89], outperforming LVEF (0.81, 95% CI 0.76–0.86, P < .0001) and CHA2DS2-VASc score (0.69, 95% CI: 0.63–0.7, P < .0001) in the entire external cohort. Based on the proposed protocol, 40% of patients on chronic OAC from the external cohort would safely avoid TOE. Conclusion: LAT-AI allows accurate prediction of LAT. A LAT-AI-based protocol could be used to guide the decision to perform TOE despite chronic OAC.

We present numerical and experimental results on a new generation fibre optic perimeter sensor based on a Sagnac and Michelson interferometers configuration. In particular, an original signal processing scheme is presented. The sensor can detect a potential intruder and determine its position along a protected zone. We propose a localization method that offers the inherent properties of both interferometers. After demodulation of the signals from both interferometers, the obtained amplitude characteristic of the Sagnac interferometer depends on a position of a disturbance along the interferometer, while amplitude characteristic of the Michelson interferometer does not depend on this position. So, quotient of both demodulated characteristics makes it possible to localize the disturbance. During investigations of a laboratory model of the sensor, it was possible to detect the position of the disturbance with a resolution of about 40 m along the 6-km-long sensor.

Novel echocardiographic techniques, such as speckle tracking echocardiography (STE) and tissue Doppler imaging (TDI), are sensitive tools for assessing left ventricular (LV) performance. LV global longitudinal strain (GLS), assessed by STE, is a sensitive marker of myocardial systolic function. Cardiovascular complications in patients with Cushing's disease (CD) determine a higher mortality than that in an age- and gender-matched population. Cardiac systolic dysfunction may be detected in early stages by STE. Thus, the aim of this study was to investigate the usefulness of STE in detecting subclinical LV dysfunction in 3 groups of patients: CD group, arterial hypertension group (AHG) and healthy volunteers (HV). Methods: Echocardiographic assessments of LV systolic and diastolic function were performed in 171 subjects (CD – 22, AHG – 114, HV – 35) with no symptoms of heart failure. A statistical comparison included separate analyses for men and women. Results: CD patients showed good blood pressure control (below 140/90mmHg in 82% of cases). However, in comparison AHG and HV groups they exhibited: 1) significantly lower LV contractility expressed by GLS (CD group -17.7%, AHG group -19.2%, HV -20.0%; p=0.004); and 2) higher prevalence of LV diastolic dysfunction (45.0%, 14.2%, 0.0%, respectively; p<0.00001). Men with CD showed significantly more pronounced LV diastolic dysfunction. Cortisol excess in women was related to impaired LV systolic function. Conclusions: Cushing’s disease, even with well-controlled blood pressure, is associated with LV dysfunction which depends individually on sex. These hemodynamic alterations can be detected by modern non-invasive diagnostic tools and may become potential therapeutic objectives.

Background: Acromegaly is a rare disease that requires modern treatment to decrease the risk of mortality, mainly from vascular diseases. Identifying acromegalic patients with increased cardiovascular risk is challenging. Speckle-tracking echocardiography (STE) is a modern, well-validated, and reproducible method of assessing left ventricular longitudinal deformation and providing a sensitive assessment of myocardial contractility. We hypothesized that STE may be useful in evaluating subclinical dysfunction of the left heart in acromegalic patients, especially when a left ventricle (LV) assessment is completed with STE of the left atrium (LA). Purpose: To assess the diagnostic value of speckle-tracking echocardiography in identifying the occurrence of LV and LA functional impairment in patients with acromegaly, in comparison to patients without this rare pituitary disease. Methods: Echocardiographic assessments of LV and LA function using the new STE method were performed in 60 subjects: 30 acromegalic (ACRO group) patients and a CONTROL group with 30 patients matched in terms of age, gender, systolic/diastolic pressure, and history of hypertension for at least 12 months. Results: The ACRO group, compared to the CONTROL group, presented: (1) higher left ventricular mass (left ventricular mass index: 132 vs. 108 g/m², p < 0.001) and, in consequence, more frequent LV hypertrophy (80.0 vs. 53.3%; p = 0.028); (2) impaired LV systolic function measured by both left ventricular ejection fraction (LVEF) (63.4 vs. 66.9%, p < 0.001) and global longitudinal strain (GLS) (−18.1 vs. −19.4%, p = 0.023); (3) greater LA anteroposterior diameter (40.3 vs. 36.9 mm, p = 0.003) and indexed left atrial volume (37.9 vs. 27.6 ml/m², p < 0.001); and (4) impaired echocardiographic strain parameters corresponding with LA function. Conclusions: Acromegaly, even in young patients with good blood pressure control, may be associated with left ventricular hypertrophy and subclinical impairment of the left ventricular and left atrial mechanical function, which may be identified by speckle-tracking echocardiography. Further research in this area is necessary to clarify the prognostic value of these phenomena.