Early detection of left ventricle (LV) systolic dysfunction is essential for management of patients with aortic stenosis (AS). Two- dimensional speckle tracking derived global longitudinal peak strain (GLPS) is more sensitive than ejection fraction (EF) but requires good image quality and is not easily accessible. The aim of the study was to compare GLPS with traditional echocardiographic parameter- mitral annular plane systolic excursion (MAPSE) in AS.

Brugada syndrome (BrS) is an arrhythmogenic disorder increasing the risk of syncopal episodes and sudden cardiac death. BrS usually runs through families with reduced penetrance and variable expression. We analyzed the multigenerational family of a patient who died after sudden cardiac arrest with post-mortem diagnosis of BrS. We analyzed clinical history, comprehensive arrhythmic risk, genetic findings, and additional tests, including electrocardiogram (ECG), detailed 24-hour Holter ECG results, and standard echocardiography findings, and followed up the patients in the ambulatory clinic. We analyzed a pedigree of 33 members of four generations of the family (19 male and 14 female patients). In this family, we identified 7 patients with BrS (median Modified Shanghai Score and Sieira model: 4.5 (4–6) and 1 (0–4) points, respectively), including both parents of the deceased patient, and 8 relatives with negative sodium channel blocker drug challenge test. Genetic testing revealed a novel mutation in sodium voltage-gated channel alpha subunit 5 (SCN5A) c.941A>G, (p.Tyr314Cys) inherited from the father of the proband. Patients with BrS were characterized by longer P-wave duration (120 (102–155) vs. 92.5 (88–110) ms, p = 0.013) and longer PR intervals (211.3 ±26.3 vs. 161.6 ± 18.9 ms, p = 0.001), along with more frequent positive aVR sign, but did not differ in terms of QRS duration or T-wave characteristics in resting ECGs. BrS patients were characterized by lower mean, minimal, and maximal (for all p ≤ 0.01) heart rates obtained from Holter ECG monitoring, while there was no difference in arrhythmias among investigated patients. Moreover, visual diurnal variability of ST segment changes and fragmented QRS complexes were observed in patients with BrS in Holter ECG monitoring. There were no major arrhythmic events during median follow-up of 68.7 months of alive BrS patients. These results suggest ECG features which may be associated with a diagnosis of BrS and indicate a novel SCN5A variant in BrS patients. Twelve-lead Holter ECG monitoring, with modified precordial leads placement, may be useful in BrS diagnostics and risk stratification in personalized medicine.

Background: This systematic review and meta-analysis aimed to assess the burden of carotid atherosclerosis, including the prevalence of carotid plaques and stenosis, among individuals with familial hypercholesterolemia (FH). Methods: PubMed, Embase, and Scopus were searched up to 3 August 2025 to identify full-text, peer-reviewed articles published in English reporting the prevalence of carotid atherosclerotic plaques and/or stenosis in adult (≥18 years) patients with either a clinical or genetic diagnosis of FH. The methodological quality of the included studies was assessed using the Mixed Methods Appraisal Tool. Results were synthesized using random-effects meta-analysis and presented as pooled prevalence estimates with 95% confidence intervals (95% CI) displayed in forest plots. Publication bias was assessed using the Doi plot and the Luis Furuya-Kanamori index. Results: For the analysis of carotid plaque prevalence, seventeen studies including a total of 2870 patients were included (weighted age 47.2 ± 13.4 years, 47.3% male). No statistical difference in the pooled prevalence of carotid plaques was observed between clinically and genetically diagnosed FH (both 53%; 95% CI: 40–65%), however sub-analyses suggested a higher plaque burden in genetic FH. For the analysis of carotid stenosis prevalence, four studies comprising 704 participants were included; however, the available data were less consistent, yielding a pooled prevalence of 9% (95% CI: 0–40%). In conclusion, the results should be interpreted with caution due to several limitations, including the relatively low quality of the included studies, potential publication bias, considerable heterogeneity between the studies, and low to moderate certainty of evidence for the pooled estimates. These findings further emphasize the need for large-scale, standardized, multicenter studies to better characterize the burden of carotid atherosclerosis in this population.

We would like to thank Dr. Imamura for their interest in our study and their valuable comments on diagnostics and risk stratification in Brugada syndrome (BrS)

Background and aim:Alcohol is a potent risk factor for heart diseases. Alcohol consumption can damage myocytes earlier than overt LV dysfunction occurs. We aimed that two-dimensional speckle tracking echocardiography (2DSTE) can be used for early detection of heart failure caused by alcohol intake.Methods:A 100 chronic alcoholics were enrolled into the study. All patients underwent physical examination, biochemical analysis and echocardiography. Following parameters were assessed: LV diameters, LV systolic and diastolic function. Also RV diameters, LA and RA volumes were measured. LV and RV global longitudinal strain (GLS), LA and RA strain were calculated. The results were compared with control group, composed of 20 healthy subjects.Results:The mean LVEF was 57.55±6.99%, the mean E/A ratio 1.09±0.32 and E/E` 7.36±2.4 in the study group. Mean LA volume was 35.4±10.78 mL, RA volume 34.7±10.25 mL. The 2DSTE of LA was 29.1±10.0, LVGLS was -15.03±2.07. The RA strain was 30.46±10.25 and RVGLS -16.22±6.27. All strain parameters were lower than in the control group. Graded reduction of global longitudinal strain of the both ventricles and both atria in dose-dependent manner was found, lower strain was observed in heavy alcoholics than light/moderate drinkers. Conclusions:The study proved that chronic alcohol consumption leads to myocardial injury in dose-depended manner, the deterioration of global strain of the ventricles and atria can be the sensitive marker of myocardial injury.