Evaluation Of Cardiac Function Research Articles

Effects of myocardial ischemia/reperfusion injury on plasma metabolomic profile during aging.

BackgroundHeart disease is a frequent cause of hospitalization and mortality for elderly patients. A common feature of both heart disease and aging itself is the involvement of metabolic organ alterations ultimately leading to changes in circulating metabolite levels. However, the specific contribution of aging and ischemic injury to the metabolic dysregulation occurring in older adults with ischemic heart disease is still unknown.AimTo evaluate the effects of aging and ischemia/reperfusion (I/R) injury on plasma metabolomic profiling in mice.MethodsYoung and aged mice were subjected to a minimally invasive model of I/R injury or sham operation. Complete evaluation of cardiac function and untargeted plasma metabolomics analysis were performed.ResultsWe confirmed that aged mice from the sham group had impaired cardiac function and augmented left ventricular (LV) dimensions compared to young sham‐operated mice. Further, we found that ischemic injury did not drastically reduce LV systolic/diastolic function and dyssynchrony in aged compared to young mice. Using an untargeted metabolomics approach focused on aqueous metabolites, we found that ischemic injury does not affect the plasma metabolomic profile either in young or old mice. Our data also demonstrate that age significantly affects circulating metabolite levels (predominantly amino acids, phospholipids and organic acids) and perturbs several pathways involved in amino acid, glucid and nucleic acid metabolism as well as pyridoxal‐5′‐phosphate salvage pathway in both sham and ischemic mice.ConclusionsOur approach increases our understanding of age‐associated plasma metabolomic signatures in mice with and without heart disease excluding confounding factors related to metabolic comorbidities.

Cardiac evaluation of Covid-19 patients with post-discharge dyspnoea

Background: Dyspnoea is one of the common symptoms in COVID-19 patients after discharge fromthe hospital. So evaluation of cardiac function becomes necessary in COVID patients after hospitaldischarge. AIM: To study the cardiac function of COVID 19 patients presenting with dyspnoea afterdischarge from hospital within 3 months of symptom onset. Materials and methods: 245 post-hospital discharge COVID-19 patients enrolled in the study. The patients with abnormalechocardiography are further divided into three groups, A) patients with PAH±RVD, B) patients withLV diastolic dysfunction C) patients with LV systolic dysfunction. Data of the three groups werecompared. Results: Out of 245 patients, 64% (157) patients show abnormal echocardiogram.75(30.6%) patient show PAH±RVD,61(24.8% ) patients shows LV diastolic dysfunction and 21(8.57%)patients shows LV systolic dysfunction. patients with ventricular dysfunction significantly associatedwith multiple risk factors and comorbidity. Grade 1,2,3,4 diastolic dysfunction seen in27.8%,34.4%,29.5%,8.1% in group B respectively. LV systolic dysfunction is mild in 13 (61.9%),moderate in6(28.5%), severe in 1 (4.7 %) in group C patients. Ntprobnp, tropnin significantlyhigher in all groups. Also, CRP, D dimer significantly higher in group A, but non significantly higher ingroup B, C. Conclusion: RV dysfunction is the most common pattern seen in around 30% ofpatients. LV diastolic dysfunction is not uncommon, seen in ¼ the patients. Patients with cardiacdysfunction have a high level of cardiac and inflammatory biomarkers, which can lead to grievouscardiovascular complications. So close follow up required.

Protective role of matrine in sepsis-associated cardiac dysfunction through regulating the lncRNA PTENP1/miR-106b-5p axis

BackgroundMatrine has attractive cardioprotective effects in some diseases. This study aimed to evaluate the therapeutic potential of matrine against cardiac dysfunction induced by sepsis in vivo and in vitro, and further explore the related mechanisms. MethodsCecal ligation and puncture (CLP) was used to induce a sepsis mice model, and H9C2 cells treated with lipopolysaccharide (LPS) were used as a cardiac myoblast injury model. The evaluation of cardiac function of mice was performed by measuring cardiac function biomarker levels and hemodynamic indicators. An ELISA method was used to examine inflammatory cytokine levels. H9C2 cell viability was measured using MTT assay. The expression of non-coding RNAs that might be involved in matrine function was analyzed using real-time quantitative PCR. ResultsMatrine could significantly improve the cardiac function and attenuate the inflammatory response of the mice model, and could increase H9C2 viability and inhibit inflammation in the cell model. By matrine administration, the expression of PTENP1 was downregulated, but miR-106b-5p expression was upregulated both in vivo and in vitro. The cardioprotective effects of matrine in mice and cell models could be reversed by the overexpression of PTENP1 or the knockdown of miR-106b-5p, and the overexpression of miR-106b-5p could significantly abolish the effects of PTENP1 on cardiac function and inflammation. ConclusionAll the data revealed that matrine can alleviate sepsis-related cardiac dysfunction by enhancing cardiac myoblast viability and attenuating inflammatory responses through the PTENP1/miR-106b-5p axis.

Evaluation of cardiac autonomic functions of non diabetic offsprings of diabetic parents

Occurrence of autonomic imbalance is not very uncommon in diabetic patients and evidences of subclinical autonomic imbalance in their offsprings are also reported. Objective: To study the effect of parental diabetes on cardiac autonomic functions of their non diabetic children. aterials and Methods: The study was conducted in the department of Physiology SSIMS and RC, Davangere, after the approval of the institutional ethical committee, on 100 subjects. 50 non diabetic offsprings of diabetic parents (cases) and 50 non diabetic offsprings of non diabetic parents (controls). The subjects were in the age group of 18-25 years and were selected on the basis of predetermined inclusion exclusion criteria. The study protocol was explained and informed written consent was taken from the subjects. Battery of six conventional cardiac autonomic function tests were done which included, resting HR, HR response to deep breathing, HR response to Valsalva, DBP response to IGHT, BP and HR response to change in posture, BP response to CPT. Statistical analysis was done using Student’s unpaired t test. Result: Our results show decreased parasympathetic activity as indicated by increased basal HR (p Conclusion: Our results show that there is a state of sympathovagal imbalance in the non diabetic offsprings of diabetic parents that can be inferred from an increased sympathetic activity and decreased parasympathetic activity. Keywords: Diabetes mellitus, Autonomic function.

Levels of toll-like receptors 2 and 4 in serum of men with stable coronary artery disease and postinfarction cardiosclerosis and conection with echocardiographic evaluation of cardiac structure and function

Background and Aims: Coronary artery disease (CAD) takes first place in the structure of morbidity and mortality of the working age population. Some studies have shown that in mechanisms of coronary artery damage, myocardial hypertrophy, cardiac fibrosis involve toll-like receptors 2 (TLR2) and 4 (TLR4). The aim is to study the levels of TLR2, TLR4 in the serum and to evaluate the association with cardiac structure and function in men with CAD with postinfarction cardiosclerosis.

Cardiac magnetic resonance image diagnosis of hypertrophic obstructive cardiomyopathy based on a double-branch neural network

Objective: Cardiac magnetic resonance (CMR) imaging is a well-established technique for diagnosis of hypertrophic obstructive cardiomyopathy (HOCM) and evaluation of cardiac function, but the process is complicated and time consuming. Therefore, this paper proposes a cardiomyopathy recognition algorithm using a multi-task learning mechanism and a double-branch deep learning neural network.Method: We implemented a double-branch neural network CMR-based HOCM recognition algorithm. Compared with the traditional classification algorithms such as the ResNet, DenseNet network, contrast the accuracy of network classification of cardiomyopathy is higher by 10.11%.Result: The loss curve of the algorithm basically converges in 100 rounds, and the convergence speed of the algorithm is twice that of the traditional algorithm. The accuracy of this algorithm to classify cardiomyopathy is 96.79%, and the sensitivity is 95.24%, which is 10.11% higher than the conventional algorithm.Conclusion: The CMR imaging automatic recognition algorithm for HOCM capture static morphological and motion characteristics of the heart, and comprehensively enhances recognition accuracy when the sample size is limited.

An 8-layer residual U-Net with deep supervision for segmentation of the left ventricle in cardiac CT angiography

Accurate segmentation of left ventricle (LV) is a fundamental step in evaluation of cardiac function. Cardiac CT angiography (CCTA) has become an important clinical diagnostic method for cardio-vascular disease (CVD) due to its non-invasive, short exam time, and low cost. To obtain the segmentation of the LV in CCTA scans, we present a deep learning method based on an 8-layer residual U-Net with deep supervision. Based on the original 4-layer U-Net, our method deepened the network to eight layers, which increased the fitting capacity of the network, thus greatly improved its LV recognition capability. Residual blocks were incorporated to optimize the network from the increased depth. Auxiliary paths as deep supervision were introduced to supervise the intermediate information to improve the segmentation quality. In this study, we collected CCTA scans of 100 patients. Eighty patients with 1600 discrete slices were used to train the LV segmentation and the remaining 20 patients with 400 discrete slices were used for testing our method. An interactive graph cut algorithm was utilized reliably to annotate the LV reference standard that was further confirmed by cardiologists. Online data augmentation was performed in the training process to improve the generalization and robustness of our method. Compared with the segmentation results from the original U-Net and FC-DenseNet56 with Dice similarity coefficient (DSC) of 0.878±0.230 and 0.897±0.189, respectively, our method demonstrated higher segmentation accuracy and robustness for varying LV shape, size, and contrast, achieving DSC of 0.927±0.139. Without online data augmentation, our method resulted in inferior performance with DSC of 0.911±0.170. In addition, compared with the provided results from other existing studies in the LV segmentation of cardiac CT images, our method achieved a competitive performance for the LV segmentation. The proposed 8-layer residual U-Net with deep supervision accurately and efficiently segments the LV in CCTA scans. This method has potential advantages to be a reliable segmentation method and useful for the evaluation of cardiac function in the future study.

Evaluation of cardiac function in the recipient twin in successfully treated twin-to-twin transfusion syndrome using a novel fetal speckle-tracking analysis.

This study was designed to evaluate ventricular size, shape, and function in recipient twins following laser therapy for twin-twin transfusion syndrome (TTTS), using novel speckle-tracking techniques. This retrospective study enrolled patients that underwent fetal laser surgery for TTTS and had fetal echocardiograms (FE) performed pre- and post-operatively (op), with adequate resolution in the 4-chamber view for analysis, using a speckle-tracking software, to compute the size, shape, and function of both the right (RV) and left (LV) ventricles. Values were indexed to published normal values. Pre- and post-laser Z-score values for each of the measurements were compared using the Student's t-test, with significance defined as P < 0.05. Fifteen TTTS candidate pregnancies that underwent laser therapy between 2010 and 2017, with adequate pre- and post-op FE, were selected for the analysis. Post-op FE at 28.5 ± 8.3 days showed a significant decrease in RV base dimension, increased LV base dimension, and improvements in many functional measurements: LV global and free wall strain, LV fractional area change, LV basal-apical fractional change, and LV and RV 24-segment fractional shortening (FS) of the basal segments. Cardiac remodeling, following laser surgery in TTTS recipient twins, was demonstrated in the basal portion of both the RV and LV with improved biventricular function.

Heart rate variability in Dorper sheep in the fetal and neonatal periods until 120 days of age: Use of the technique in the field.

The evaluation of the autonomic cardiac functions may be performed through the analysis of the heart rate variability. Heart rate variability is defined as the fluctuations in the heart rhythm or rate, and represents a useful tool in the evaluation of the autonomic nervous system through the sympathetic and parasympathetic components, as well as its balance and its reflexes on the cardiorespiratory control system. Fetal electrocardiography provides important information regarding the well-being of the fetus since, in human fetuses, there are changes in the behavior of the fetal heart rate during the second and third trimesters of pregnancy due to an increase in parasympathetic activity. Therefore, considering the importance of evaluating fetal viability, this study aims at evaluating the behavior of fetal heart rate and heart rate variability in Dorper sheep, as well as the activity of the autonomic nervous system during fetal life and in newborn lambs. The species is often used in experimental studies and autonomic nervous system activity is a prognostic index, therefore, the diagnosis of modifications in the sympathovagal balance may represent an early index for fetal viability and well-being in lambs. The analyses were performed in 10 Dorper sheep during pregnancy and in 10 lambs after birth until 120 days of age. There was a decrease in the fetal heart rate and heart rate variability indexes during the fifth month of pregnancy, but without statistical significance for the period evaluated. The heart rate of the lambs decreased gradually until they were 21 days old. The indexes SDNN (standard deviation of RR intervals) and RMSSD (square root of the mean of successive differences between adjacent RR intervals) diverged according to age, being high at day 60. Fetal viability is relevant in sheep fetuses to avoid losses during pregnancy and risks to the health of the mother. In the species, there seems to be a predominance of parasympathetic activity starting from the 21st day of age. Heart rate variability may be employed as a tool in the evaluation of the fetus and development of lambs, since changes in its behavior may represent an adverse effect to fetal and neonatal health.

Evaluation of cardiac function in children after percutaneous closure of atrial septal defect using speckle tracking echocardiography.

BACKGROUNDAtrial septal defect (ASD) is among the most common congenital anomalies that its neglect may cause severe right ventricular (RV)-associated cardiac dysfunction. Percutaneous closure of ASD is an efficient technique used commonly worldwide. Varieties of techniques have been used to assess postoperative changes of cardiac function. The current study has aimed to assess outcomes of percutaneous ASD closure using two-dimensional speckle tracking echocardiography (2D-STE).METHODSThis non-experimental research was conducted on 22 patients who volunteered for percutaneous ASD closure between 2016 and 2018. Cases were assessed three times including prior to percutaneous ASD closure, after 24 hours, and a month after procedure. Cases outcomes were assessed and compared during the time.RESULTSStrain rate in RV middle septal wall was significantly different (P < 0.050) between before and one month after the procedure. Comparison of indices post procedure and one month later showed better RV strain pattern but they did not have a significant difference (P > 0.050).CONCLUSIONBased on this research, STE is a quick simple method of assessing cardiac chambers and function in details. It seems that this method can replace other traditional echocardiographic methods for cardiac function tests; thus, further studies with larger groups and longer follow-up duration are strongly recommended.

CT evaluation of unrepaired/incidental congenital cardiovascular diseases in adults

Congenital heart disease (CHD) affects approximately one million people in the USA with the number increasing by 5% each year. Patients are usually both diagnosed and treated in infancy, however many of them may have subclinical CHD that remains undiagnosed until late adulthood. Patients with complex CHD tend to be symptomatic and are diagnosed at a younger age than those with a single defect. CHDs can be divided into three categories, including cardiac, great vessels and coronary artery anomalies. Recent advances in computed tomography (CT) technology with faster acquisition time and improved spatial resolution allow for detailed evaluation of cardiac morphology and function. The concomitant increased utilization of CT has simultaneously led to more sensitive detection and more thorough diagnosis of CHD. Recognition of and understanding the imaging attributes specific to each anomaly is important for radiologists in order to make a correct and definite diagnosis. This article reviews the spectrum of CHDs, which persist into adulthood that may be encountered by radiologists on CT.

VP18.11: Evaluation of cardiac function by auto FS in normal fetuses and recipient twins of TTTS

VP18.11: Evaluation of cardiac function by auto FS in normal fetuses and recipient twins of TTTS

VP15.20: Evaluation of ventricular systolic function in fetuses of overweight or obese mothers by two‐dimensional speckle‐tracking technique

Using left and right ventricle global longitudinal strain (GLS) and right ventricle free wall strain (FWSt) evaluate cardiac systolic function in fetuses of mothers with overweight and obese. 80 patients underwent fetal echocardiography in Tangdu Hospital from June 2019 to February 2020 were included (30 normal pregnant women, 27 overweight pregnant women and 23 obese pregnant women). Regular and two-dimensional speckle-tracking echocardiography (2D-STE) were performed for evaluation of fetal cardiac structure and function. All the echocardiographic parameters were compared among groups. Compared with the fetus whose mother have normal BMI before pregnancy, the myocardial strain of the fetus in overweight pregnancy is decreased, and declining further in the obese group. 2D-STE can sensitively reflect fetal myocardial deformability and can be used as a new method to evaluate the changes of early fetal myocardial systolic function.

VP15.09: Evaluation of cardiac function of fetus with different estimated body weight by two‐dimensional speckle‐tracking strain technique

VP15.09: Evaluation of cardiac function of fetus with different estimated body weight by two‐dimensional speckle‐tracking strain technique

Impact of aortic stiffness by velocity-encoded magnetic resonance imaging on late gadolinium enhancement to predict cardiovascular events.

BackgroundIncreased aortic stiffness has been established as a marker in various cardiovascular diseases. Previous reports revealed a significant correlation between aortic stiffness and myocardial scarring using the late gadolinium enhancement cardiovascular magnetic resonance (LGE-CMR). However, prognostic data concerning aortic stiffness combining myocardial scarring remains limited.MethodA total of 402 patients who had undergone clinical CMR for the evaluation of cardiac function, LGE, and aortic pulse wave velocity (PWV) using velocity encoded-CMR (VE-CMR) were included. Patients were classified into 4 groups using mean PWV and the presence of LGE as elevated or non-elevated PWV and positive or negative LGE. Patients received follow-up for major adverse cardiovascular events (MACE) comprising cardiovascular death, non-fatal myocardial infarction, hospitalization for heart failure, coronary revascularization, and ischemic stroke. Predictors of MACE and hard cardiac events (cardiovascular death or non-fatal myocardial infarction) were evaluated.ResultsDuring the average follow-up period of 47.7 months, 58 MACE occurred. Patients who had elevated PWV and positive LGE experienced the highest rate of MACE compared to the group with non-elevated PWV and negative LGE (HR 11.90, p < 0.001). Among patients who had LGE, those who had elevated PWV experienced a 2.4-times higher rate of MACE compared to those who had non-elevated PWV. Multivariate analysis showed that PWV and LGE were independent predictors of MACE and hard cardiac events. PWV had excellent intra- and inter-observer reproducibility (intra-: ICC = 0.98, p < 0.001, inter-: ICC = 0.97, p < 0.001).ConclusionAortic stiffness using VE-CMR had prognostic value to predict cardiovascular events, with the added benefits of LGE.

Intraoperative transoesophageal echocardiography in Cardiovascular Surgery. Consensus document from the Spanish Society of Anaesthesia and Critical Care (SEDAR) and the Spanish Society of Endovascular and Cardiovascular Surgery (SECCE)

Transesophageal echocardiography is a semi-invasive technique that allows an evaluation of cardiacmorphology and function in real time and it is a quality standard in cardiovascular surgery. It has becomea fundamental tool for both monitoring and diagnosis in the intraoperative period that allows decide thecorrect surgical planning and pharmacological management. The goal of this document is to answer the questions of when and how the perioperative TEE shouldbe performed in cardiovascular surgery, what are their applications in the intraoperative, who shouldperform it and how the information should be transmitted. The authors made a systematic review ofinternational guidelines, review articles and clinical trials to answer by consensus to these questions. La ecocardiografía transesfofágica es una técnica semiinvasiva que permite una evaluación de la mor-fología y función cardiaca a tiempo real y que constituye, a día de hoy, un estándar de calidad en lasintervenciones de cirugía cardiovascular. Se ha convertido en una herramienta fundamental tanto demonitorización como de diagnóstico en el perioperatorio que permite la correcta planificación quirúrgicay manejo farmacológico dirigido. El objetivo de este documento es dar respuesta de forma consensuada y avalada por la evidenciacientífica de cuándo y cómo debe hacerse la ecocardiografía transesfofágica intraoperatoria en cirugíacardiovascular, qué aplicaciones tiene en el intraoperatorio, quién debe realizarla y cómo debe transmi-tirse la información obtenida durante el estudio. Los autores han hecho una revisión sistemática de lasguías internacionales, artículos de revisión y ensayos clínicos para dar respuesta a estas preguntas.

Ecocardiografía transesofágica intraoperatoria en cirugía cardiovascular. Documento de consenso de la Sociedad Española de Anestesiología y Reanimación (SEDAR) y Sociedad Española de Cirugía Cardiovascular y Endovascular (SECCE)

Transesophageal echocardiography is a semi-invasive technique that allows an evaluation of cardiac morphology and function in real time and it is a quality standard in cardiovascular surgery. It has become a fundamental tool for both monitoring and diagnosis in the intraoperative period that allows decide the correct surgical planning and pharmacological management.The goal of this document is to answer the questions of when and how the perioperative TEE should be performed in cardiovascular surgery, what are their applications in the intraoperative, who should perform it and how the information should be transmitted. The authors made a systematic review of international guidelines, review articles and clinical trials to answer by consensus to these questions.

The Potential Effect of Aqueous Extract of Detarium microcarpum Bark on Certain Metabolic Disorders Associated with an Atherogenic Diet in Rats

Atherosclerosis is the leading cause of the cardiovascular disease (CVD). This study aimed to evaluate the effect of the aqueous extract of Detarium microcarpum on metabolic disorders in rats fed with an atherogenic diet. The extract at two doses (200 mg/kg and 400 mg/kg) was co-administered in rats with an atherogenic diet. After 28 days, rats were sacrificed, blood collected in ethylene diamine tetraacetic acid (EDTA) tubes for plasma preparation, and the heart used for homogenate preparation. These plasma and heart homogenates were used to assess lipid profile, cardiac function (NO, ASAT), and hepatic function (ALAT, ASAT, and totals proteins). The results obtained showed that treatment (200 mg/kg and 400 mg/kg extract) led to a significant decrease in TG, VLDL-c, LDL-c, HDL-c, and non-HDL-c compared to untreated rats (positive control) (p &amp;lt; 0.001). Similarly, the cardiovascular risk index (IR, CRR, AC and AIP), were significantly low in the treated groups compared to untreated groups (p &amp;lt; 0.001). Meanwhile, the CPI was higher in threated groups (p &amp;lt; 0.001). The percentage of vascular protection in rats receiving the extract was higher compared to rats treated with atorvastatin. The evaluation of cardiac function showed high levels of NO and ASAT in the heart of rats treated with the extract (p &amp;lt; 0.05). The plasma activity of ASAT and ALAT was low in the groups treated with the extract (p &amp;lt; 0.05). A low plasma level of total protein was also observed in the same groups (p &amp;lt; 0.001). Therefore, the aqueous bark extract of D. microcarpum administered orally showed anti-atherogenic, cardioprotective, and hepatoprotective potential.

Evaluation of left ventricular function in patients with acute ischaemic stroke using cine cardiovascular magnetic resonance imaging.

AimsHeart failure (HF) is frequent in patients with acute ischaemic stroke (AIS) and associated with higher morbidity and mortality. Assessment of cardiac function in AIS patients using cardiovascular MRI (CMR) may help to detect HF. We report the rate of systolic and diastolic dysfunction in a cohort of patients with AIS using CMR and compare cine real‐time (CRT) sequences with the reference of segmented cine steady‐state free precession sequences.Methods and resultsPatients with AIS without known atrial fibrillation were prospectively enrolled in the HEart and BRain Interfaces in Acute Ischemic Stroke (HEBRAS) study (NCT 02142413) and underwent CMR at 3 Tesla within 7 days after AIS. Validity of CRT sequences was determined in 50 patients. A total of 229 patients were included in the analysis (mean age 66 years; 35% women; HF 2%). Evaluation of cardiac function was successful in 172 (75%) patients. Median time from stroke onset to CMR was 82 h (interquartile range 56–111) and 54 h (interquartile range 31–78) from cerebral MRI to CMR. Systolic dysfunction was observed in 43 (25%) and diastolic dysfunction in 102 (59%) patients. Diagnostic yield was similar using CRT or segmented cine imaging (no significant difference in left ventricular ejection fraction, myocardial mass, time to peak filling rate, and peak filling rate ratio E/A). Intraobserver and interobserver agreement was high (κ = 0.78–1.0 for all modalities).ConclusionsCardiovascular MRI at 3 Tesla is an appropriate method for the evaluation of cardiac function in a selected cohort of patients with AIS. Systolic and diastolic dysfunction is frequent in these patients. CRT imaging allows reliable assessment of systolic and diastolic function.

Subtle cardiac dysfunction in nephropathic cystinosis: insight from tissue Doppler imaging and 2D speckle tracking echocardiography.

Nephropathic cystinosis is a rare autosomal recessive lysosomal storage disorder that initially affects the kidney progressing to multi-organ failure due to accumulation of cystine in all tissue compartments. The main objective of this study is the evaluation of cardiac function in cystinosis patients using non-conventional echocardiographic modalities like pulsed wave tissue Doppler imaging (PW-TDI) and 2D speckle tracking echocardiography (2D-STE). This is a case control study conducted on fifteen patients with cystinosis and 15 normal controls. Echocardiography was done for all participants and PW-TDI was performed for measurement of S', E', A' velocities and myocardial performance index (MPI) at basal parts of septal, left ventricle (LV), and right ventricle (RV) free walls. 2D-STE was done for evaluation of global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) of LV. Mitral E and A velocities and tricuspid annular plane systolic excursion (TAPSE) were also measured. The GLS, GRS, and S' velocity at basal septum and LV lateral wall were significantly lower in patients denoting LV systolic dysfunction (p = 0.005, p < 0.0001, p = 0.001, p = 0.006, respectively), while E/E' were significantly higher in patients group denoting LV diastolic dysfunction (p < 0.001). For RV function, TAPSE, S', and E' velocity were significantly lower in patients group (p 0.013, p < 0.01, p = 0.05, respectively) indicating RV systolic and diastolic dysfunction. The TDI-derived MPI for both LV and RV were significantly higher in patients group (p < 0.0001, p < 0.01, respectively) indicating both ventricular systolic and diastolic dysfunction. For prediction of cardiac dysfunction among patients, the receiver operating characteristic (ROC) curve showed that GRS ≤ 29% had sensitivity 93.3% and specificity 100%, GLS > - 20.1% had sensitivity 66.7% and specificity 93.3%, LV-E/E' >7.87had sensitivity 73.3% and specificity 93.3%, and MPI-LV > 0.36 had sensitivity 100% and specificity 93.3% while MPI-RV > 0.29 had sensitivity 80% and specificity 93.3% and TAPSE ≤ 19mm had sensitivity 80% and specificity 73.3%. Patients with cystinosis have significant both left and right ventricular dysfunction, which can be better evaluated using the non-conventional echocardiographic modalities like TDI and 2D-STE for early detection of subtle cardiac dysfunction.