Risultati per: Sindromi coronariche acute

Circulation, Volume 146, Issue Suppl_1, Page A13057-A13057, November 8, 2022. Background:European Society Cardiology guidelines recommend that the 0-hour/1-hour (0-1h) algorithm using high sensitivity cardiac troponin T (hs-cTnT) improves the early triage of patients with chest pain. To avoid the unnecessary admission including coronary angiography leads to decrease in medical costs. However, the economic consequences of applying the algorithm are unknown.Purpose: We compared the medical expenses to be affected by the implementation of this algorithm.Methods:We compared two prospective cohort study (one hospital has been implemented the 0-1h algorithm (cohort A), and the other has not (cohort B)) using a de-identified electronic medical record based on the database of health claims in Japan. Eligible patients were measured of hs-cTnT because of chest pain. We excluded patients with STEMI, heart failure or terminal kidney function. The 0-1h algorithm stratified patients into “rule-out,” “rule-in,” and “observation” based on the measurements of hs-cTnT levels at baseline and absolute changes at 1hour. Resource utilization (RU) and predicted diagnostic accuracy of the 0-1h algorithm compared to usual care in the emergency department (ED) were estimated. We then assumed that we implemented the 0-1h algorithm in cohort B by applying the diagnostic accuracy of the 0-1h algorithm to cohort B and compared it with the collected data achieved within 30 days of the index visit.Results:Consecutive 472 in cohort A (69.6 +/- 14.1 years old, 59.5% male) and 427 in cohort B (65.8 +/- 14.4 years old, 59.0% male) were followed. The prevalence rates of AMI were 7.4% and 3.3%. The sensitivity and specificity for the 0-1h algorithm in cohort A were 100% (91.1%-100%) and 95.0% (94.3%-95.0%), compared to 92.9% (69.6%-98.7%) and 89.8% (89.0%-90.0%) for usual care in cohort B. Assuming that the 0-1 algorithm is implemented in cohort B with the same diagnostic accuracy, emergency CAG is expected to be reduced by 50%, with a reduction in healthcare costs of approximately $ 1,500 to $ 2,500 per person. As a result, the implementation of the 0-1hr algorithm is expected to reduce medical costs by $ 31,500 to $ 52,500 in cohort B.Conclusions:The 0-1h algorithm dose not only efficiently stratifies risks, but can also be expected to reduce medical costs.

Circulation, Volume 146, Issue Suppl_1, Page A9704-A9704, November 8, 2022. Introduction:Several risk factors and scores have been studied to predict in-hospital mortality [IHM] and rehospitalization [RH] in patients with AHF.Hypothesis:The impact of the initial therapies implemented for AHF on the variables of the acid base gases (ABG) has not been evaluated for prognostication of IHM and RH.Methods:We prospectively evaluated 216 patients admitted in CICU with AHF from 2015 to 2021. Demographic, clinical and ABG variables were analyzed on admission and at 24 hours. Patients were grouped according to whether they presented improvement in respiratory failure, defined as improvement in SaO2, PaO2 and PaCO2 as well as de-escalation of respiratory support devices (NIV or high flow). The aim of the study was to identify whether the improvement in ABG variables, O2 requirement or respiratory support within 24 hours of admission is associated with lower IHM and RH at 60 days. Data was analyzed using bivariate and multivariate analyzes by logistic regression.Results:Mean age was 75 years (44% female), normal EF 62% and reduced 38%. Mean NT-pro-BNP was 9280 ng/dl. RH at 60 days was 25% and IHM was 8.7%. Mean PaO2 on admission was 75 mmHg and at 24 hours 82 mmHg, PaCO2 on admission was 38 mmHg and at 24 hours 40 mmHg, mean SaO2 on admission was 94% and at 24 hours 95%. In bivariate analysis, the highest elevation of the PaCO2 on admission as well as PaCO2 at 24 hours were identified as predictors of IHM (38.42 vs 40.26 mmHg, p = 0.025) and (40.17 vs 46.84 mmHg, p = 0.002) respectively. In multivariate analysis, AKI on CKD (p = 0.03), cardiogenic shock (p =

Circulation, Volume 146, Issue Suppl_1, Page A13880-A13880, November 8, 2022. Introduction:There are conflicting data on COVID-19 outcomes in pregnant women. Using the AHA COVID-19 CVD Registry we evaluated COVID-19 outcomes in pregnant vs non-pregnant women with COVID-19.Methods:Women 18-40 years old hospitalized from March 2020 to December 2021 with symptomatic COVID-19 were included (n=2,068), with 110 (5.3%) pregnant at admission. Women with unknown pregnancy status were excluded. Vaccine data were limited (2.8% of participants), therefore omitted from analysis. Baseline demographics and symptoms at presentation were compared between pregnant and non-pregnant women (Table). Rates of death, mechanical ventilation, ICU admission, hospital stay ≥5 days, myocardial infarction, stroke, DVT, PE, and a composite of all outcomes were determined. Multivariable Cox regression analyses were performed, adjusting for comorbidities and prior CVD.Results:Pregnant women hospitalized with COVID-19 had fewer comorbidities than non-pregnant women (Table). There were no deaths in the pregnant group and 44 (2.3%) in the non-pregnant group. Fewer pregnant women were hospitalized ≥5 days (29.1% vs 41.2% non-pregnant); this difference was not statistically significant after multivariable adjustment [adjusted HR (95% CI), 0.67 (0.43-1.02)]. There were no significant differences between the groups in the composite outcome [adjusted HR (95% CI), 0.72 (0.48-1.07)] or its components (Table).Conclusions:Pregnant women hospitalized with symptomatic COVID-19 had fewer comorbidities compared with non-pregnant women. There were fewer deaths and lower rates of hospitalization ≥5 days in pregnant vs non-pregnant women which was no longer statistically significant after multivariable adjustment. The potential for residual confounding due to healthier pregnant women presenting with milder COVID-19 illness or being admitted for non-COVID-19 indications compared to non-pregnant women must be considered when interpreting these findings.

Circulation, Volume 146, Issue Suppl_1, Page A13893-A13893, November 8, 2022. Introduction:Timely management of acute myocardial infarction (AMI) significantly improves outcomes. Patient and community-level characteristics are strong determinants of survival following AMI. The Social Vulnerability Index(SVI) is a robust community assessment tool that reliably ranks counties based on several parameters on a scale from 0 to 1. More vulnerable communities have higher SVI scores.Hypothesis:Higher levels of SVI scores will be associated with higher AMI-related deaths in the USA.Methods:Using the multiple causes of death database from the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research(1999-2020), we extracted county-level deaths with any mention of AMI with ICD-10 codes I21 and I22. County-level SVI was obtained from CDC/ATSDR. We fitted segmented regression models to evaluate the association between quintiles of SVI scores and AMI-related age-adjusted mortality rate (AAMR, expressed per 100,000 persons). Analysis was done using STATA v17 and Joinpoint segmented regression softwares with p-values

Circulation, Volume 146, Issue Suppl_1, Page A13502-A13502, November 8, 2022. Introduction:In patients with acute myocardial infraction (AMI), multivessel coronary artery disease (CAD) is associated with worse prognosis than single-vessel CAD. Several observational studies have reported worse clinical outcomes in AMI patients with non-infarct-related artery chronic total occlusion (n-IRA CTO). We performed a systematic review and meta-analysis to evaluate the prognostic significance of n-IRA CTO in patients with AMI.Methods:Systematic review was performed querying PubMed, Google Scholar, Cochrane and clinicaltrials.gov from Inception through May 2022. Studies comparing AMI patients with and without n-IRA CTO were included. Outcomes included in-hospital, 30-day and long-term mortality, cardiac mortality, major adverse cardiovascular events (MACE), and major bleeding. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using random effects models.Results:Five prospective, eight retrospective and 3 subgroup analyses of randomized control trials (RCTs) (n-IRA CTO n=2,521, no CTO n=18,397) were identified. Presence of n-IRA CTO was associated with higher in-hospital (RR 2.86, 95% CI 1.77-4.62, p

Circulation, Volume 146, Issue Suppl_1, Page A15628-A15628, November 8, 2022. Background:Acute myocardial infarction may concomitantly occur with acute ischemic stroke. The incidence,complications and outcomes of acute Non- ST elevation Myocardial infarction in acute ischemic stroke are not well studied.Methods:We examined hospitalized patients (n = 1,726,265) with acute ischemic stroke that were included in National Inpatient Sample 2016-2019. Acute ischemic stroke and NSTEMI were defined by using International classification of disease (ICD -10). STEMI patients were excluded. Multivariable logistic regression analysis was used to examine association of NSTEMI with outcomes. A subgroup analysis of NSTEMI patients that underwent PCI (with or without angioplasty) was also performed.Results:Of the total stroke patients, 27630 (1.6%) patients (mean age 73.5, 52.2% females) had NSTEMI diagnosed during the hospitalization. Of these, 3890 (6.32%) died in NSTEMI group and 57670 (93.68%) died in non NSTEMI group. The commonest complications in NSTEMI group were cardiogenic shock 25% , cardiac tamponade 13.8% , and septic shock 12.1%. NSTEMI in stroke patients were associated with several complications and mortality (OR 2.73, 95% CI 2.57-2.90, p value

Circulation, Volume 146, Issue Suppl_1, Page A15435-A15435, November 8, 2022. Introduction:Women are less likely than men to be promptly diagnosed with acute coronary syndrome (ACS) and have worse post-ACS outcomes. These diagnostic failures are partially due to ACS findings on surface ECG manifesting differently in women, which may result in unnecessary delays in treatment. To narrow health disparities, we aim to investigate the sex-specific signatures of ACS as they appear on ECGs.Methods:This was a prospective observational cohort study of chest-pain patients evaluated for suspected ACS at 3 UPMC-affiliated tertiary care hospitals. After featurization, all ECG data were separately fed into 7 machine learning classifiers to predict ACS. We examined the results by sex. We also investigated two other methods: (1) building two independent models based respectively on the female and male subgroups and (2) building a model based on the initial total sample supplemented by the patients’ sex. We used Shapley values to explain the decision-making criteria of the models. We report the results for random forest, the best performing classifier.Results:Our sample consisted of 4132 patients (Age 59 ± 16; 47% female; 15% ACS). Machine learning models continue to disproportionately underperform in females across all classifiers evaluated. The sensitivity, specificity and false negative rate in the global model blinded to sex were 82.89%, 76.22% and 17.11% for men, and 67.39%, 74.16% and 32.61% for women (p

Circulation, Volume 146, Issue Suppl_1, Page A11227-A11227, November 8, 2022. Introduction:Contrast agents in echocardiography are used frequently to enhance endocardial border visualization and assessment of structural heart disease. Sulfur hexafluoride lipid type A injectable suspension is a generally well-tolerated class of contrast. Anaphylaxis to these agents is exceedingly rare. We now report the first case of acute coronary syndrome in the setting of echo contrast anaphylactic shock.Case:A 49-year-old woman was hospitalized for an ST-elevation myocardial infarction (STEMI) for which a drug-eluting stent had been placed in the left anterior descending artery (LAD). An echocardiogram was performed to evaluate for structural heart disease. Shortly after administration of echo contrast the patient developed sudden-onset tachypnea and suffered a pulseless electrical activity cardiac arrest. She was treated for anaphylactic shock with epinephrine and high-dose steroids and achieved return of spontaneous circulation. Following the arrest an electrocardiogram revealed an anterolateral STEMI. The patient immediately underwent repeat angiography which revealed a 100% in-stent thrombosis of the LAD. The occlusion was successfully revascularized with a drug eluting stent with an Impella CP (Abiomed, Danvers MA) support. Subsequent laboratory exam demonstrated an elevated blood tryptase level consistent with an anaphylactic event.Discussion:We present a unique case of anaphylactic shock with acute coronary syndrome following administration of sulfur hexafluoride echo contrast. The incidence of anaphylaxis to echo contrast is less than one per million, and therefore it may not be immediately recognized as a mechanism of shock. Any prior reactions to polyethylene glycol should be noted before using these agents as this ingredient is thought to be the cause of anaphylaxis. In our case, diagnosis of anaphylaxis was confirmed by measuring the serum tryptase level. Tryptase is released from mast cells during allergic events, so this laboratory test with high specificity for anaphylaxis can be a useful tool in challenging cases such as this. Additionally, mast cell and platelet activation secondary to anaphylaxis may be an important mechanism of acute coronary syndrome with in-stent thrombosis.

Circulation, Volume 146, Issue Suppl_1, Page A12364-A12364, November 8, 2022. Our previous work has shown that chronic exposure to ceramide, a sphingolipid that when elevated in plasma is an independent risk factor major adverse cardiac events, causes microvascular endothelial dysfunction in arterioles collected from healthy adult patients. This presents as a change in the mediator of flow-induced dilation (FID) from the vasoprotective nitric oxide (NO) to the pro-atherosclerotic hydrogen peroxide (H2O2). Despite the known detrimental effects of ceramide, its metabolite sphingosine-1-phosphate (S1P) can promote NO formation. However, shear-induced ceramide formation is also necessary for maintaining NO-mediated FID, as arterioles from healthy individuals transition to H2O2-mediated FID during inhibition of the ceramide-forming enzyme neutral sphingomyelinase (NSmase). We hypothesize that the transition in mediator is due to the loss of acute S1P production, and thus addition of exogenous S1P can prevent microvascular endothelial dysfunction during inhibition of NSmase. Human arterioles (100-250μm) were dissected from otherwise discarded adipose tissue from healthy patients undergoing surgery. Videomicroscopy was used to assess vascular functionin vitro. Microvessels were pre-constricted with endothelin-1, and changes in internal diameter were measured following exposure to increased levels of flow. Dilation to flow was significantly impaired in the presence of the NO-synthase inhibitor L-NAME (100μM, 30 min) when healthy human arterioles were treated acutely with S1P (1μM, 30 min) in the presence of the NSmase inhibitor, GW4869 (10μM, 30 min), compared to GW4859 alone (% maximal diameter±SEM, 5.1±8.7, n=4 vs 70.1±5.3, n=4; p=0.001, 2-way ANOVA). Whereas, the presence of PEG-catalase, an enzyme that breaks down H2O2, had no effect (85.0±4.3; n=3). These data highlight the importance of S1P in maintaining NO signaling during exposure to shear and strengthens the concept that the conversion of ceramide to S1P is critical in promoting a quiescent endothelium.

Circulation, Volume 146, Issue Suppl_1, Page A11951-A11951, November 8, 2022. Introduction:Cardiac contractility modulation (CCM) is a medical device therapy whereby non-excitatory electrical simulations are delivered to the myocardium during the absolute refractory period. We previously evaluated the effects of the standard CCM pulse parameters in isolated rabbit ventricular cardiomyocytes and 2D human induced pluripotent stem cell-derived cardiomyocyte (hiPSC-CM) monolayers, on flexible substrate.Hypothesis:In the present study, we sought to extend these results to 3D microphysiological systems to develop a human-based model to evaluate various clinical CCM pulse parameters in vitro.Methods:HiPSC-CMs were studied in conventional 2D monolayer format, on stiff substrate (i.e., glass), and as 3D human engineered cardiac tissues (ECTs). Cardiac contractile properties were evaluated by video-based analysis and custom force analysis. CCM pulses were assessed at varying clinical ‘doses’ using a commercial pulse generator. Robust response was observed at physiological Ca concentrations [1.8 mM] for 3D ECTs.Results:Under standard acute CCM stimulation 3D ECTs displayed enhanced contractile properties including increased peak contraction amplitude (i.e., force), and faster contraction and relaxation kinetics. Moreover, 3D ECTs displayed enhanced contractility in a CCM pulse parameter dependent manner. The observed effects subsided when the acute CCM stimulation was stopped and gradually returned to baseline. Under comparable conditions, conventional 2D monolayer hiPSC-CMs, on stiff substrate, displayed neutral response.Conclusions:These data represent the first study of acute CCM stimulation in a 3D hiPSC-CM model and provides a preclinical model to assess various CCM signals in human cardiac tissues prior to in vivo animal studies.

Circulation, Volume 146, Issue Suppl_1, Page A11912-A11912, November 8, 2022. Introduction:Pregabalin, a structural analog to λ-aminobutyric acid, is prescribed for neurological disorders. Through actions to cause sodium/water retention, the agent may increase the risk of acute heart failure (AHF).Methods:We performed a retrospective cohort study using a repository of healthcare records obtained from a large U.S. academic healthcare system. HF patients were identified between 1/1/2016-12/31/2020. Patients who had initiated treatment with pregabalin were compared to patients with no post-HF pregabalin over a 365-day post-pregabalin period or post-HF period. Study outcomes were per-patient per-year (PPPY) emergency department (ED) admissions or PPPY hospitalizations, time-to first ED admission, and time-to hospitalizations. Outcomes encounters were adjudicated by a HF diagnosis (ICD-10, I50.x) at any position. We tested the association between the pregabalin exposure and outcomes using generalized linear regression and Cox-proportional hazard regression approach.Results:The study cohort included 483 pregabalin-HF patients and 21,150 pregabalin-naïve HF patients. The pregabalin-HF patients age was (mean±SEM: 62.2±0.7 vs. 66.2±0.1 years,p

Circulation, Volume 146, Issue Suppl_1, Page A10865-A10865, November 8, 2022. Introduction and Hypothesis:Evaluation of the right heart function is known to have value in assessment of patients with acute pulmonary embolism (PE). The right atrium (RA) is directly impacted by right ventricular pressures. Strain analysis is an evolving area of echocardiography, and can be applied to evaluate the RA. To date, limited studies have evaluated RA strain in the setting of PE, and we hypothesized that RA strain analysis would be prognostic of outcomes in patients with acute PE.Methods:We performed a retrospective cohort study of 177 patients with acute pulmonary embolism. Strain analysis was performed on echocardiograms completed within 48 hours of admission. Peak longitudinal RA strain was applied using TomTec®. The primary outcome was 30-day all-cause mortality and in-hospital mortality. Receiver operating characteristic (ROC) curves and Kaplan-Meier curves were used for evaluation.Results:Study quality was sufficient to perform peak longitudinal RA strain analysis in 151 patients (86.8%). In-hospital mortality was 8.9% and 30-day mortality was 12.7%. Peak longitudinal RA strain was significantly reduced in patients with all-cause death up to 30 days and in-hospital death compared to survivors (30-day mortality: 20.9% ± 4.9% vs 30.7% ± 7.8%, p < 0.001. In-hospital mortality: 21.1% ± 5.0% vs 30.1% ± 8.0%, p < 0.001). Using ROC curves, we chose a peak longitudinal RA strain value of 26.5% (sensitivity 95%, specificity 73%) for detecting all-cause mortality up to 30 days. When dividing patients into 2 groups using this cut-off value, low peak longitudinal RA strain was associated with worse prognosis (HR 33.0, 95% CI= 4.4-248.8, p < 0.001. Figure).Conclusions:RA strain have significant prognostic value in patients with acute PE, and identifying those at increased risk of death which may indicate the need for more aggressive treatment. Assessment of RA strain has promise for clinical applications.

Circulation, Volume 146, Issue Suppl_1, Page A11248-A11248, November 8, 2022. Introduction:Patients with acute coronary syndromes (ACS) are known to have a higher risk of target vessel revascularization after percutaneous coronary intervention (PCI) and worse long-term prognosis than patients with stable angina. Neoatherosclerosis is one of the significant factors at very late stent thrombosis. And the presence of in-stent neoatherosclerosis is independently associated with major adverse cardiac event. Although many studies have been reported on neoatherosclerosis, few have been reported on short-term in-stent neoatherosclerosis. Moreover, none have evaluated the impact of ACS. We investigated the impact of ACS on in-stent neoatheroscrelosis using Optical Coherence Tomography (OCT) in the present study.Methods:From March 2017 to November 2020, we investigated 102 patients (122 lesions) who had undergone PCI using drug eluting stent during that period and were followed up for OCT within one year. Subjects were categorized as ACS or non-ACS according to clinical findings at the time of target lesion intervention. We used OCT to investigate the presence of early in-stent neoatherosclerosis.Result:ACS group consisted of 21 (20.6%). In patients with ACS, women tended to be more common (38% vs 19%,P=0.0777). There were no differences in age or presence of diabetes or dyslipidemia during treatment. There were also no significant differences in LDL-C levels at the time of PCI (88 (73-114) mg/dL vs 100 (85-124) mg/dL,P=0.319) and when observed by OCT (67 (55-81) mg/dL vs 68 (57-89) mg/dL,P=0.622). The ACS group was significantly more likely to have a previous history of ACS (38% vs 12%,P=0.0104). Stent length was significantly shorter in ACS patients (24 (18-28) mm vs 32 (23-38) mm,P=0.0365). The mean dulation from PCI was 292 days. In-stent neoatherosclerosis was more frequent in the ACS group (31.8 % vs 9.9 %,P=0.014).Conclusion:This observational study using OCT indicates that stenting for ACS lesion is associated with early in-stent neoatherosclerosis.

Circulation, Volume 146, Issue Suppl_1, Page A125-A125, November 8, 2022. Introduction:Acute kidney injury (AKI) is a common complication following cardiac arrest (CA) and is associated with poor outcomes. Early detection of AKI is crucial; serum creatinine (sCR) is the most commonly used indicator of AKI, despite low sensitivity and specificity for early detection of AKI.Hypothesis:Kidney-specific serum biomarkers neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and cystatin-C could better predict post-CA AKI than sCR.Methods:Adult CA patients who had kidney-specific biomarkers of AKI collected shortly after return of spontaneous circulation (ROSC) as part of four randomized trials and one observational study were included. Patients with Kidney Disease Improving Global Outcome (KDIGO) stage III AKI or end-stage renal disease, or renal replacement therapy at the time of enrollment were excluded. The association between renal biomarker levels (sCR, NGAL, KIM-1, cystatin-C) shortly after ROSC and the development of KDIGO stage III AKI within 7 days of enrollment were assessed as well as their predictive value of future AKI development.Results:Of 155 patients, 46 (29.7%) developed stage III AKI within 7 days, and 98 (63.2%) died prior to hospital discharge. Patients who developed stage III AKI, compared to those who did not, had higher median levels of sCR (1.4 mg/dL [IQR: 1.2, 1.9] vs. 1.2 [IQR: 1.0, 1.5]; p=0.001), NGAL (868,208 pg/mL [IQR: 412,547.1, 1,341,597] vs. 298,928.3 [IQR: 170,786.6, 594,389.7], p

Circulation, Volume 146, Issue Suppl_1, Page A15618-A15618, November 8, 2022. Introduction:Several studies have described trends toward increasing complexity and illness-severity of patients admitted to the cardiac intensive care units (CICU). This has necessitated the development of training pathways in critical care cardiology (CCC). Hybrid training in combinations of interventional cardiology (IC), advanced heart failure and transplant cardiology (AHFTC), and CCC have also gained interest. This review sought to outline current and proposed pathways for hybrid training in acute cardiovascular care.Methods:We performed a systematic review of articles describing training pathways for dual certification in CCC, as well as hybrid models for training in a combination of IC, CCC, and AHFTC. PubMed, EMBASE, and CINAHL were searched from 01/01/2000 to 04/28/2022. Pathways through pediatric and adult non-internal medicine specialties were excluded.Results:Of 2,236 citations, 18 studies were included in the final analysis. Most pathways included sequential CCC training, i.e. traditional cardiovascular fellowship and 1-2 additional years of critical care medicine, although integrated 4-year programs were noted to be emerging. Hybrid models for advanced training in two or more complementary subspecialties, including CCM, AHFTC, and IC, have been described, each with their own strengths and limitations. Additional expertise in advanced therapies such as mechanical circulatory support, the longitudinal AHFTC practice, and the combination of procedural and intensivist skills for management of diseases such as acute coronary syndromes were the stated benefits of these combined models. Alternatively, some advocate for incorporating focused CC training into a single year of IC or AHFTC fellowship. However, this may limit the time required to gain expertise in all areas of advanced training and is insufficient for board certification in CCM.Conclusion:Despite the growing need, there are limited dedicated pathways to train the contemporary acute care cardiologists. Further study is needed to consolidate training to encourage the growth and development of this field.

Circulation, Volume 146, Issue Suppl_1, Page A11880-A11880, November 8, 2022. Introduction:We evaluated differential contribution of the left atrial (LA) function by cardiovascular magnetic resonance (CMR) and left ventricular (LV) fibrosis to pulmonary arterial systolic pressure in hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy (DCM) and reperfused acute myocardial infarction (AMI).Hypothesis:The differential role of the LA function and LV fibrosis indices for pulmonary pressure elevation would be different in various myocardial diseases and there would be a predictive value in addition to the conventional echocardiographic parameters.Methods:Data of 370 patients with HCM (n=133), DCM (n=114) and reperfused AMI (n=123) who underwent both echocardiography and CMR were comprehensively reviewed. Phasic LA volumes, LA-global longitudinal strain (GLS), LA stiffness index, defined as E/e’/LA-GLS and extracellular volume fraction (ECV) of LV were measured using CMR.Results:E/e’ was correlated with PASP in all groups; however, the predicted value was significantly attenuated after adjusting for LA volume and LA strain in HCM and DCM, but remained significant in AMI. The LA stiffness index was related to PASP in HCM (p=0.01) and DCM (p=0.03) independent of LA volume index and E/e’, but not in AMI. In DCM, ECV was significantly related to PASP (p