thank you very much for these invitation
to be here today it's a pleasure
for me team to took him out
at this study
and this study really focus on their
clinical significance of left battling involvement in
patients swede that age academy it was
isn't
and dat the they aim was at
first to characterize their less starts with
pathology in expanded hearts we have patience
with cancer i can read it all
season
the second lame was the really go
deeper into l a mechanic so using
echocardiography speckled tracking in a large court
patients we dated yeah could you my
your petty
and then we assessed day association between
the l a mechanics and immortality
so what we deed there we assess
a cool took nine hundred and six
patients with eighty can't of you my
your city so we had five hundred
and fifty one patients with wild type
a teacher can do my your pussy
and ninety three patients week t six
the a a to you a your
pussy two hundred and forty one week
v wanted to why did ya could
do my your pussy and twenty one
patients head outta mourad mutations and then
we also assessed the five expanded heart
patients with the teacher to are cutting
the york city
and what we found a index landed
hard sir we found that the was
an extensive eighty yeah i'm adding infiltration
in the five each year
and the filtration was associated with the
loss of norma architecture vessels remodeling capital
disruption and desk when dakota fibrosis
and so the was really a loss
of the normal my cardio structure index
planted hard to define patients
and when we assess with echo speckled
tracking get then and under it and
six patients with it he can could
you are ya se we found that
there was a decrease in a know
and functional faces that the eight or
contraction
which is their breasts about fazer the
conduct face and the contraction phase and
and it was a significant increase in
the age of stiffness sir and these
remained independent less a seat with prognoses
after adjusting for know predictors of and
he was a very significant finding because
he was really focusing their
and highlighting the important so of the
atrium function in debt or the repository
see all the g patience we did
ya to me to do was with
so and is is not surprising because
he know restrictive physiology with the last
drop volume the eight will function that
is emerging as a really important face
with the kotick cycle
to contribute still brutal cutting performance
and furthermore what we found which was
very interesting and surprising finding that was
thirteen twenty two percent of patients seen
signs freedom at a contraction was absent
so what was happening is that on
the easy gee we could see a
p way for in keeping with sinus
rhythm
but there was no evidence or mechanical
contraction on the strain and on this
season and we defined this group of
patients sas patients with atra electromechanical dissociation
because there was at the cessation between
what we could see on the easy
g
and day and a contraction itself set
which strain and most importantly eight electromechanical
dissociation was associated with put a problem
was is compared to patients with sinus
rhythm and effective a mechanic a contraction
and the prognosis was similar to only
it patients we gotta feed relation so
these me is that what we really
need to look at when we see
patients so with eighty kadhimiya do is
that intend to lead role function is
not really these easy g betty's their
actual presence of mechanical contraction because say
patients in sinus freedom might not have
eight when mccain for control
action own as assessed by strain analysis
and they britain was is is identical
to patients in atrophy relation
so what we concluded was that the
phenotype of a to jeopardy the way
or the includes significant infiltration in nature
walls with progressive last week of function
the christie from answer which is a
strong independent predictable mortality
and then that each electromechanical dissociation really
emerged as a distinctive phenotype her that
identified that this sub group patients in
sinus rhythm with the poor prognosis
had the most common question about this
study is what are the clinical implications
for me day and most relevant clinical
implications of this study is there to
weekend now define patients sir
in two different groups according to the
it will function so we have patience
the not accumulation and then we can
not divide pieces in centers read them
in two different groups said patients incentives
read them with effective eight a mechanic
a contraction and that patients in son
is freedom with no effective
it'll mechanic contraction and these group of
patients have a similar proposes to patients
in atrophy relations so he spite of
having evidence a sinus rhythm on the
easy g from a click of point
of view patients in son is read
the we know effective a mechanic of
are actually very similar to patients he
not have a relation
and he says important because not only
struck the federal rules a that but
also gives you information on their relative
contribution of the atrium function to the
overall kotick performance at an individual level
so
eight real strain assessments should be really
an integral part of the could a
graphic examinations of all patients with eight
academy to doses
the second question which is i am
which is which and colleagues as be
very frequently about the study isa does
this come to have any direct implications
on anticoagulation therapy so for example so
we think about starting anticoagulation in patients
with
an evidence of sinus rhythm back no
eight on the country contraction
so i would say it tastes very
interesting questions be his anticoagulation spacious we
did get ya to me it was
is that is a very debated topic
and that date or no wilds different
clinicians have different opinion i think the
reason know good recommendation based on that
strong evidence said that we should use
a practice different from what are the
guidelines you know the county pathology but
they would say that far the studies
is a will be a needed to
assess eighth in patients with sinus rhythm
and absence at an age make like
a contraction we should start i fibrillation
so am d studies really shifting day
and kind of the attention from their
simple assessment of the ease
he ci to the assessment of day
it a contraction using strain probably desk
will be a very important to an
element to consider in the future when
we think about articulation strategy but as
yet the study doesn't give us enough
information to actually make a decision on
that differ
and from what is currently recommended by
guidelines
i think this study will affect finishes
today be his there and he really
shifted pension from the easy g today
echo a as concerned they earn eight
a contraction so if we have for
example patients scenes
scientists return but with no eight it'll
mechanical contraction not which happens to good
in ethiopia relation then we shouldn't think
about for example dwayne procedure as cardio
version just to basically add again they
ate her contribution to the overall cutting
performance if they're and rate
a east way controlled is that in
occasions where the is good evidence said
that the eat a contraction could be
significantly to the a all kotick performance
and depression go was enough to fibrillation
then that out we should think about
to kind of version as a strategy
which could improve people overall kotick performance
in a little cottage
count put
the next i did see research that
would be to perform a study where
recess the value of anticoagulation new patients
with sinus read them and absence of
and eight a contraction as this is
a very important topic and we know
that the occurrence of thrown by in
there a
left that with appendage and in the
last teach him is not a knock
uncommon occurrence in patients with a kid
jacobi me off with the so ah
study focus on to use of anticoagulation
the sampson population would be very important
i think that air
it is important to be aware that
in retreat cutting of these like he
did ya to meet it was is
a agent function is as important as
their in by the chief receive public
function
the ice kind of imaging and cardiologist
in general we are usually more fuck
in assessing the left at a not
your function and less used to really
assess the it will function
but despite the really states the important
so of the eight mechanic seen the
a little correct preference in eighty ti
ah to me it was easy
and debt and really shows how a
routine assessment to with acl speck of
tracking the of day it'll mechanics i
should be considered routine in old pictures
we did ya could you may your
pussy