Introduction: Three-dimensional speckle-tracking echocardiography (3DSTE) can be used to accurately measure the dimensions of the left ventricle (LV) and aortic valve anulus (AVA) at the same time. The present study aimed to conduct an extensive 3DSTE-based investigation of simultaneously assessed end-diastolic and end-systolic LV volumes and AVA dimensions in healthy adults with LVs and AVAs of different sizes. Methods: One hundred and seven healthy adults (mean age 35.4 ± 12.2 years, 67 males) were voluntarily enrolled in the present study. Results: With increasing end-diastolic AVA area, tendentious increase in both end-diastolic and end-systolic LV volumes could be detected, resulting in preserved LV-EF. With increasing end-systolic AVA area, similar findings were present. Comparing the smaller than mean and the larger than mean end-systolic AVA area subgroups, the end-systolic LV volume proved to be significantly increased in the latter group. With the increase in end-diastolic LV volume, the AVA dimensions remained preserved. With the increase in end-systolic LV volume, only the highest end-systolic LV volume was associated with larger end-systolic AVA area and perimeter; the other parameters remained preserved. In certain circumstances, end-systolic AVA area and perimeter proved to be significantly increased compared to their end-diastolic counterpart. Conclusions: With the increase in end-diastolic and end-systolic AVA areas, a tendentious increase in both LV volumes could be detected in healthy adults. Larger end-diastolic LV volume was not associated with dilated AVA dimensions, while larger end-systolic LV volume was associated with dilated end-systolic AVA area and perimeter.

The present study was conducted in type 1 diabetic (T1DM) patients to evaluate the metabolic and glycemic control as well as the manifestations of neuropathy. The impact of continuous glucose monitoring (CGM) on the measured parameters was also analyzed. A total of 61 T1DM patients (age: 42.5 ± 1.8 years, DM duration: 22.8 ± 1.6 years, mean ± SE) participated in the study. In total, 24 patients had CGM sensors and 37 did not. Cardiovascular autonomic neuropathy was assessed using cardiovascular reflex tests. Peripheral sensory function was evaluated by a Neurometer and calibrated tuning fork on the upper and lower limbs. Metabolic status was characterized by the determination of triglycerides, high-density lipoprotein (HDL), low-density lipoprotein (LDL), total cholesterol, and glycated haemoglobin (HbA_1c). A positive correlation was found between HbA_1c and triglyceride levels (r = 0.28, p < 0.05). CGM users and non-users differed in triglyceride (0.9 ± 0.1 vs. 1.24 ± 0.12 mmol/L, p < 0.05), HDL cholesterol (1.7 ± 0.1 vs. 1.4 ± 0.1 p < 0.05 mmol/L), and HbA_1c (7.5 ± 0.2 vs. 8.3 ± 0.3%, p < 0.05) levels as well. Significant differences were found for the Valsalva ratio, Neurometer, and calibrated tuning fork results between CGM users and non-users. This study found a significant correlation between HbA_1c and triglyceride levels in T1DM. CGM use resulted in improved metabolic parameters and less autonomic and sensory nerve damage. As a novel finding, CGM is presumed to prevent both micro-, and macrovascular complications and, by this way, potentially reducing mortality rates.

Introduction: The rotational mechanics of the left ventricle (LV) play a significant role in maintaining systemic circulation. In clinical practice, three-dimensional speckle-tracking echocardiography (3DSTE) is one of the first methods to be used that is suitable for routine, non-invasive investigations, even in healthy individuals, allowing the conduction of extensive but easily feasible tests. In routine clinical practice, mitral annular plane systolic excursion (MAPSE) is used as an easy-to-implement parameter to judge the systolic longitudinal function of the LV; its prognostic significance is also clarified. The relationship between 3DSTE-derived LV rotational mechanics and MAPSE determined by M-mode echocardiography has never been assessed. Therefore, the aim of the present study was to investigate it extensively in healthy adults. Methods: The present study consisted of 108 healthy adult volunteers (mean age 28.1 ± 6.3 years, 50 men). Complete two-dimensional Doppler echocardiography with MAPSE measurements and 3DSTE-derived assessment of LV rotational parameters were performed in all cases. Results: Both the apical and basal LV rotations and the consequential LV twist showed trends toward increase, with increasing MAPSE resulting in the LV twist being largest when the MAPSE was largest. While reduced basal LV rotation was associated with reduced MAPSE, a further increase in MAPSE with increasing basal LV rotation could not be demonstrated. With an increase in apical LV rotation, a trend toward an increase in MAPSE was seen, and was largest when the apical LV rotation was largest. No correlations could be demonstrated between MAPSE and basal LV rotation and apical LV rotation. Conclusions: Associations between LV longitudinal shortening, represented by MAPSE, and LV rotational mechanics could be demonstrated in healthy adults. These findings could have implications for assessing LV function in early disease states.

Introduction. Pregnancy is characterized by a significant expansion of plasma volume and an increase in cardiac output, necessitating structural and functional adaptations of the cardiac chambers, including the right atrium (RA). To evaluate these changes, three-dimensional (3D) speckle-tracking echocardiography (STE) was used as a validated and sophisticated modality for the concurrent assessment of RA volumetric and functional alterations. This study aimed to characterize RA volumes, volume-based functional indices, and strain parameters in healthy women during mid-gestation, compared with a cohort of non-pregnant controls. Methods. This retrospective cohort analysis included 20 healthy, asymptomatic women in their second trimester (mean age: 29.9 ± 3.0 years; weight: 81.2 ± 14.2 kg; height: 166.9 ± 5.8 cm; body surface area [BSA]: 1.95 ± 0.17 m²). The control group consisted of 30 age-matched healthy non-pregnant women (mean age: 29.9 ± 4.1 years; weight: 58.7 ± 6.5 kg; height: 166.0 ± 5.4 cm; BSA: 1.68 ± 0.11 m²). All subjects underwent comprehensive two-dimensional Doppler echocardiography and 3DSTE. Results. Early and late diastolic RA volumes were significantly reduced, despite preserved end-systolic RA volume. Pregnant subjects exhibited reduced active RA stroke volume and increased passive RA emptying fraction, while all other parameters remained comparable between the groups. No significant differences were observed between groups in end-systolic peak RA global or mean segmental strains, nor in RA strains measured during atrial contraction. However, end-systolic peak regional RA strain analysis revealed decreased basal RA circumferential strain (CS) and increased superior RA-CS in pregnant participants compared with controls. Furthermore, during late diastole (at atrial contraction), superior RA-CS, RA-3D strain, and RA-area strain were significantly higher in healthy pregnant subjects than in controls. Conclusions. Substantial regional changes in RA function were detected by 3DSTE, likely reflecting adaptation to pregnancy-induced plasma volume expansion, and resulting in significant RA volumetric changes.

Background/Objectives: During the cardiac cycle, the left ventricle (LV) exhibits not only a complex contraction–relaxation pattern, but also a wringing-like motion known as LV twist or rotational mechanics. Concurrently, the aortic valve and its annulus (AVA), representing the LV outlet, undergo spatial displacement throughout the cycle, which can be quantified as AVA plane systolic excursion (AAPSE). While three-dimensional speckle-tracking echocardiography (3DSTE) enables the simultaneous assessment of these functional parameters, the relationship between AAPSE and basal/apical LV rotation—particularly across different ranges of these values—remains poorly characterized in healthy subjects. Therefore, the present study aimed to characterize this relationship in detail. Methods: This study included 110 apparently healthy adult volunteers (mean age: 35.1 ± 11.9 years; 68 males). All subjects underwent two-dimensional Doppler echocardiography and 3DSTE, with the latter enabling simultaneous quantification of LV rotational parameters and AAPSE. Results: A tendency toward increased basal LV rotation and decreased apical LV rotation was observed in healthy subjects with mean AAPSE, while LV twist remained preserved compared to those with lower- or higher-than-mean AAPSE. AAPSE tended to be higher in healthy subjects with mean basal LV rotation compared with those with lower- or higher-than-mean values. Furthermore, AAPSE was significantly increased in subjects with elevated apical LV rotation. AAPSE did not correlate with any LV rotational parameters, including basal LV rotation (r = −0.008, p = 0.932), apical LV rotation (r = 0.065, p = 0.593), LV twist (r = 0.061, p = 0.632), and LV twist time (r = 0.181, p = 0.073). Conclusions: There are no significant correlations between AAPSE and LV rotational parameters, but the trends observed in subgroup analyses could serve as hypothesis-generating observations for future studies.

Introduction. Volumetric changes in the left atrium (LA) and left ventricle (LV) are strongly associated in healthy circumstances, as recent three-dimensional speckle-tracking echocardiographic (3DSTE) studies confirmed. However, the complex relationship of LA and LV deformation in systole has never been assessed in healthy individuals. The present study purposed to perform comparative simultaneous analysis of systolic LA and LV strains in healthy adults by 3DSTE. Methods. The study consisted of 165 healthy adults (mean age: 33.2 ± 12.3 years; 90 males). Complete two-dimensional Doppler echocardiography with 3DSTE was performed in all cases. Results. The increase in global LA radial strain (RS) and longitudinal strain (LS) showed no associations with LV strains. The largest global LA circumferential strain (CS) was associated with the largest basal LV-RS. Lowest basal and global LV-CS could be demonstrated in the presence of mean global LA-CS as compared to the presence of lower than mean global LA-CS. Global LA-RS showed an increase, with global LV-RS being largest when global LV-RS was the largest. Basal and global LA-RS were largest in the case of lowest global LV-CS. Basal LA-LS was largest in the case of mean global LV-CS. With the increase in global LV-LS, basal and global LA-LS showed an increase but only up to a point; in the case of larger than mean global LV-LS, no further increase was detected in basal and global LA-LS. Conclusions. Complex associations between simultaneously assessed LA and LV deformations represented by 3DSTE-derived strains could be demonstrated in healthy adults.