005 for all parameters). The most powerful predictor for MACE among our study population is 4D-GAS, with the best cutoff value of 4D-GAS >-17 ( = 0.008; odds ratio = 20.668; confidence interval = 2.227-191.827). The novel 4D-GAS echocardiography predicts adverse clinical events in STEMI patients managed by successful primary PCI. The novel 4D-GAS echocardiography predicts adverse clinical events in STEMI patients managed by successful primary PCI. Obesity-related pulmonary arterial hypertension (PAH) is associated with hypoxia and metabolic abnormalities. Although right heart catheterization is the gold standard method for the diagnosis of PAH, Doppler echocardiography is more common. On the other hand, there is no definite echocardiographic parameter for PAH diagnosis. Novel echocardiographic parameter, pulmonary pulse transit time (pPTT), is assumed to be a surrogate marker for the assessment of PAH. The aim was to evaluate whether pPTT might be valuable for evaluating pulmonary vascular hemodynamics in obese patients. A cross-sectional observational study. A total of 130 consecutive obese patients and 50 controls were included. Obese patients were divided into three groups according to body mass index (BMI) 25 < BMI <30 kg/m formed Group 1, 30 < BMI <35 kg/m formed Group 2, and 35 <BMI kg/m formed Group 3. All patients underwent a standard echocardiography including pPTT measurement. pPTT was defined as the interval betwetermination of the pulmonary hemodynamics in obese patients. pPTT might be a useful parameter in terms of predicting pulmonary hemodynamics and vascular alterations in obese patients. Further studies are warranted to evaluate the association between obesity and PAH. The results of this study suggest that obesity leads to an increase in PAH, and pPTT allows noninvasive determination of the pulmonary hemodynamics in obese patients. pPTT might be a useful parameter in terms of predicting pulmonary hemodynamics and vascular alterations in obese patients. Further studies are warranted to evaluate the association between obesity and PAH. Cardiac resynchronization therapy (CRT) has a morbidity and mortality benefits in moderate to severe heart failure. It reduces mortality and hospitalization and improves cardiac function. It can be used according to the European guidelines in severely depressed left ventricular ejection fraction (i.e., ≤35%) and complete left bundle branch block. However, 30% of patients may show no benefit from CRT therapy. Therefore, prediction of CRT response seems to be an important subject for study in the current researches. We aimed to study the correlation between Surface ECG QRS complex duration (QRS) duration and cardiac output measured by ventricular outflow tract velocity time integral (LVOT VTI) as a predictor of response in patients with CRT implantation. We studied 100 consecutive patients prospectively with biventricular pacing system. The patients were studied at the pacemaker follow-up clinic. Each patient was subjected to Full medical history, general and local examination, a 12 lead electrocardiogram a < 0.001). CRT response is more in patients with lower BSA, and without previous history of ischemic heart disease or smoking. There is a significant negative correlation between QRS duration and LVOT VTI. CRT response is more in patients with lower BSA, and without previous history of ischemic heart disease or smoking. There is a significant negative correlation between QRS duration and LVOT VTI. Left ventricular (LV) diastolic dysfunction is a common condition. Tumor necrosis factor (TNF) alpha is an inflammatory cytokine that plays a role in the development of cardiac structural changes leading to LV diastolic dysfunction. The aim of this study was to examine the relationship between serum levels of TNF alpha levels and LV diastolic function. A case-control study that included 40 patients with echocardiographic evidence of LV diastolic dysfunction and 40 healthy controls. Standard transthoracic echocardiography was performed to assess LV and left atrial volumes, systolic and diastolic function according to the current recommendations. Serum TNF alpha levels were assessed using a specific enzyme-linked immunosorbent assay kit. Mean serum TNF alpha level was significantly higher in the study group 3.48 ± 1.06 versus 1.22 ± 0.36 pg/ml in the control group, < 0.001. It was also higher in patients with Grade 2 diastolic dysfunction ( = 16) 3.91 ± 1.21 versus 3.18 ± 0.86 pg/ml in those with Grade 1 diastolic dysfunction ( = 24), = 0.03. TNF alpha showed a strong correlation with indexed left atrial volume (LAVI) in the study group but not in controls. Mean serum TNF showed a trend toward increase with worsening heart failure symptoms in the form of increased the New York Heart Association functional class. Serum TNF alpha level is elevated in patients with LV diastolic dysfunction and is correlated to LAVI in such patients. Patients with Grade 2 diastolic dysfunction have higher serum levels of TNF alpha compared to those with Grade 1 diastolic dysfunction. TNF alpha levels increase with worsening heart failure symptoms. Serum TNF alpha level is elevated in patients with LV diastolic dysfunction and is correlated to LAVI in such patients. Patients with Grade 2 diastolic dysfunction have higher serum levels of TNF alpha compared to those with Grade 1 diastolic dysfunction. TNF alpha levels increase with worsening heart failure symptoms. Low-gradient aortic stenosis (LG-AS) is characterized by the combination of an aortic valve area compatible with severe stenosis and a low transvalvular mean gradient with low-flow state (i.e., indexed stroke volume <35 mL/m ) in the presence of reduced (classical low-flow AS) or preserved (paradoxical low-flow AS) ejection fraction. Furthermore, the occurrence of a normal-flow LG-AS is still advocated by many authors. https://www.selleckchem.com/products/pixantrone-maleate.html Within this diagnostic complexity, the diagnosis of severe AS remains challenging. The general objective of the Discordant Echocardiographic Grading in Low-gradient AS (DEGAS Study) study will be to assess the prevalence of true severe AS in this population and validate new parameters to improve the assessment and the clinical decision-making in patients with LG-AS. The DEGAS Study of the Italian Society of Echocardiography and Cardiovascular Imaging is a prospective, multicenter, observational diagnostic study that will enroll consecutively adult patients with LG-AS over 2 years. AS severity will be ideally confirmed by a multimodality approach, but only the quantification of calcium score by multidetector computed tomography will be mandatory.