Simpson's Rule Research Articles

Evaluating the Association Between the Three Different Ejection Fraction Measurement Techniques and Left Ventricle Global Strain.

The prognosis of cardiovascular diseases (CVDs) is directly associated with systolic function based on the measurement of ejection fraction (EF), and many studies have indicated that the left ventricular global strain (LVGS) provides better predictivity than the EF measurement in the diagnosis, prognosis, survival, and CVD staging. However, these studies did not investigate the correlation between the EF measurement and the LVGS parameters, or which parameters are better correlated with LVGS, but we analyzed the association between three EF measurement methods and LVGS. This study included 62 patients that applied to the clinic between October 2015 and March 2016. An echocardiography examination of these patients was performed. The exclusion criteria were atrial fibrillation and suboptimal image quality. Sixty-two patients (the average age 61.0±12.6 years; 56% male and 44% female) were enrolled in the study. A statistically significant association was found between the visual EF and Simpson EF measurements and the LVGS parameters (p<0.001). While the visual EF was moderately correlated with the LVGS parameters (r=0.44), there was a good correlation between the Simpson EF and the LVGS parameters (r=0.710). In this study, we demonstrate that the Simpson's rule LVEF correlates better with LVGS than the Teicholtz method or visual EF and that it has a better area under the curve value for determining an abnormal LVGS. Therefore, we recommend the use of the Simpson EF for the EF measurement that has a better correlation with the LVGS values in the patients whose ventricle functions should be evaluated.

Analysing the porous structure of packed beds of spheres using a semi-analytical approach

In this paper methodologies are described for the analysis of the porous structure of cylindrical and annular packed beds consisting of spheres when the coordinates and sizes of the spheres are known. Methodologies to determine the overlap between adjacent spheres and between the spheres and the walls of the container; axial variation in the porosity and hydraulic diameter; and the radial variation in the porosity are described. The determination of the overall bulk porosity, as well as the average porosity of selected regions, from the results are also discussed. The methodologies are based on analytical geometry and Simpson's rule is used to perform the numerical integration of the relevant integrals. The validity of the methodologies is demonstrated and the application of the methodologies to analyse the porous structure of selected packed beds is illustrated.

Modeling the transmission dynamics of flagellated protozoan parasite with Atangana–Baleanu derivative: Application of 3/8 Simpson and Boole’s numerical rules for fractional integral

A multi-analysis of transmission dynamic of Trichomonas was undertaken in this study. A model describing the spread dynamic of flagellated protozoan parasite with a triadic considered. A sensitivity analysis study of parameters involved in the mathematical model with local differentiation is presented in detail using some statistical methods. Conditions for the existence and unicity of the exact solutions of the non-linear system are constructed and proofs presented in detail. New numerical methods based on the 3/8 Simpson rule and Boole’s rule approach for the new fractional differentiation based on the generalized kernel is used to solve the transmission model with non-local operator of differentiation. Some numerical simulations are presented for different values of fractional operators. The numerical simulation of the modified model revealed that, the non-locality of fractional derivative could be used as uncertainties analysis. This explains why the fractional differentiation is a powerful mathematical tool for modeling real world problems.

Evaluation of Fetal Left Ventricular Size and Function Using Speckle‐Tracking and the Simpson Rule

This study was conducted to evaluate left ventricular (LV) size and function in healthy fetuses and to test a cohort of fetuses at risk for abnormal function using speckle-tracking software. Two hundred control fetuses were examined between 20 and 40 weeks' gestation. With the use of offline speckle-tracking software, the end-diastolic and end-systolic volumes were measured and the following computed: stroke volume (SV), SV per kilogram, cardiac output (CO), CO per kilogram, and ejection fraction. These were regressed against 7 independent variables related to the size, weight, and age of the fetuses. Five fetuses with risk factors for LV dysfunction were examined to sample the validity of the data from the control group. The R2 values for measurements of the end-diastolic volume, SV, and CO correlated with the 7 independent variables of fetal size and age (0.7-0.78), whereas the SV/kg, CO/kg, and ejection fraction had lower R2 values (0.02-0.1). The measurements were normally distributed (Shapiro-Wilke > 0.5). The 5 fetuses at risk for abnormal LV function had measurements of LV size and function that were consistent with the expected pathologic condition. Speckle tracking can provide a comprehensive evaluation of the size and function of the fetal LV.

Driving Two Numerical Methods to Evaluate the Triple Integrals R(MSM),R(SMM) and Compare Between Them

The main objective of present work is the conclusion of two new numerical methods to evaluate the triple integrals with continuous integrands and their partial derivatives are continuous too, the first method through using Mid-point rule on the interior dimension X, Simpson's rule on the middle dimension Y and Mid-point rule on the exterior dimension Z, which denoted by the symbol MSM. The second method by using Mid-point rule on both two dimensions of interior X and middle dimension Y and Simpson's rule on the exterior dimension Z which denoted by SMM, where the number of divisions on the three dimensions are equals. We have concluded two theorems with their proves to find their rules and the correction terms that we found it and to improve the results we used Romberg acceleration which denoted by R(MSM),R(SMM) where we got high accuracy in the results by little sub-intervals relatively and short time.

Comparison of integration rules in the case of very narrow chromatographic peaks

Theory of peak integration is revised for very narrow peaks. It is shown, that Trapezoidal rule area is efficient estimate of full peak area with extraordinary low error. Simpson's rule is less efficient in full area integration. Theoretical conclusions are illustrated by digital simulation and processing of experimental data. It was shown that for Gaussian peak Trapezoidal rule requires 0.62 points per standard deviation (2.5 points per peak width at baseline) to achieve integration error of only 0.1%, while Simpson's rule requires 1.8 times higher data rates. Asymmetric peaks require higher data rates as well. Reasons of poor behavior of Simpson's rule are discussed; averaged Simpson's rules are constructed, these rules coincide with those based on Euler-Maclaurin formula. Euler-Maclaurin rules can reduce error in the case of partial peak integration. Higher peak moments (average retention time, dispersion, skewness, etc.) also exhibit extraordinary low errors and can potentially be used for evaluation of peak shape.

Usefulness of Left Atrial Remodeling in Predicting CardiacToxicity During Trastuzumab Therapy for Breast Cancer

Trastuzumab is a key therapy for patients with human epidermal growth factor receptor 2 positive breast cancer (BC). However, it may cause left ventricular dysfunction, resulting in withdrawal of therapy. Left atrium (LA) enlargement has proven to cue subclinical ventricular dysfunction in various clinical setting. Aim of the study was to investigate the association between LA volume index (LAVI) change over time and the development of Cancer Therapeutics Related Cardiac Dysfunction (CTRCD). Consecutive human epidermal growth factor receptor 2 positive BC patients were retrospectively included. Transthoracic echocardiography was performed before starting Trastuzumab and at every 3 up to 12 months. LA volume was measured using the modified Simpson's rule and indexed for body surface area. Ninety patients formed the study population. All patients had a complete 12 months follow-up. Mean baseline LAVI was 27 ± 8 ml/m2 and it was dilated (≥34 ml/m2) in 10 patients (11%). During follow-up, CTRCD occurred in 19 (21%) patients and there was modest LAVI enlargement, with a mean increase of 3 ± 2 ml/m2 (p = 0.0002vs. baseline). LAVI dilation was significantly higher in patients with CTRCD (average increase at the time of CTRCD vs. baseline: 7 ± 6 ml/m2, p = 0.008), versus patients without CTRCD (average increase at 12 months of follow-up 2±1, p = 0.02), p for comparison = 0.004. LAVI dilatation over time predicted CTRCD independently from baseline LAVI values and the presence of systemic arterial hypertension (OR for 5 ml/m2 dilation was 1.56 [95%CI 1.09 to 2.37], p = 0.01). Trastuzumab related CTRCD is associated with significant LAVI morphological remodeling in BC patients.

Thermodynamic insights into membrane fouling in a membrane bioreactor: Evaluating thermodynamic interactions with Gaussian membrane surface

While membrane bioreactor (MBR) technology is generally considered as one of the most promising technologies for wastewater treatment and recovery, membrane fouling remains the major obstacle limiting its applications. Interfacial interactions, which critically determine adhesion process and membrane fouling, were investigated in this study. It was found that, natural membrane surface was of a Gaussian surface obeying Gaussian distribution. A Gaussian approach integrating Fourier transform technique, Gaussian distribution and spectrum method was deduced to simulate rough surface topography of membrane. Thereafter, surface element integral (SEI) method, together with composite Simpson rule and triangulation of Gaussian surface was proposed to calculate interfacial interactions. By using the unified method, quantification of interfacial interactions with a Gaussian membrane surface was realized for the first time to date. It was further found that, membrane surface topography had profound impacts on interfacial interactions and adhesive fouling in the MBR. The deduced method can be used to address impacts of various factors on interfacial interactions and adhesive fouling, posing in-depth thermodynamic insights into membrane fouling and pointing towards its widespread potential in fouling research in MBRs.

Efficacy of erbium-doped yttrium aluminum garnet laser with casein phosphopeptide amorphous calcium phosphate with and without fluoride for remineralization of white spot lesions around orthodontic brackets.

Objective:This study aimed to assess the efficacy of erbium-doped yttrium aluminum garnet (Er:YAG) laser, pastes containing casein phosphopeptide amorphous calcium phosphate (CPP-ACP) with and without fluoride and their combination for prevention of white spot lesions in the enamel.Materials and Methods:This in vitro experimental study was conducted on 90 extracted sound premolars. The teeth were then randomly divided into six groups of 15: (1) Control, (2) laser, (3) CPP-ACP with fluoride (GC MI Paste, Recaldent™ 900 ppm as NaF), (4) CPP-ACP without fluoride (GC Tooth Mousse Recaldent™), (5) laser + CPP-ACP with fluoride, and (6) laser + CPP-ACP without fluoride. In each group, enamel surface was exposed to the remineralizing agent. The teeth were then subjected to pH cycling for 14 days. The teeth were then sectioned, polished, and underwent cross-sectional microhardness testing at 20–160 μ depth quantitatively. Using the Simpson's rule, the amount of mineral loss was calculated in each group. Statistical Analysis Used: ANOVA was used for the comparisons, and Tukey's test was applied for pairwise comparisons.Results:The highest mean volume percentage of microhardness at 20–60 μ depth belonged to the group laser + CPP-ACP with fluoride and the lowest belonged to the control group (P = 0.001). The differences were not significant at 80-120 μ depth (P > 0.05). These finding are confirmed according to △Z (mineral loss).Conclusion:Based on these results, Er: YAG laser was able to decrease demineralization and was a potential alternative to preventive dentistry and was more effective when combined with CPP-ACP products.

Numerical algorithms for approximation of fractional integral operators based on quadratic interpolation

We present numerical algorithms calculating compositions of the left and right fractional integrals. We apply quadratic interpolation and obtain the fractional Simpson's rule. We estimate the local truncation error of the proposed approximations, calculate errors generated by presented algorithms, and determine the experimental rate of convergence. Finally, we show examples of numerical evaluation of these operators.

SWRT: A package for semi-analytical solutions of surface wave propagation, including mode conversion, across transversely aligned vertical discontinuities

Abstract. We present a suite of programs that implement decades-old algorithms for computation of seismic surface wave reflection and transmission coefficients at a welded contact between two laterally homogeneous quarter-spaces. For Love as well as Rayleigh waves, the algorithms are shown to be capable of modelling multiple mode conversions at a lateral discontinuity, which was not shown in the original publications or in the subsequent literature. Only normal incidence at a lateral boundary is considered so there is no Love–Rayleigh coupling, but incidence of any mode and coupling to any (other) mode can be handled. The code is written in Python and makes use of SciPy's Simpson's rule integrator and NumPy's linear algebra solver for its core functionality. Transmission-side results from this code are found to be in good agreement with those from finite-difference simulations. In today's research environment of extensive computing power, the coded algorithms are arguably redundant but SWRT can be used as a valuable testing tool for the ever evolving numerical solvers of seismic wave propagation. SWRT is available via GitHub (https://github.com/arjundatta23/SWRT.git).

Diminished Cardiac Performance and Left Ventricular Dimensions in Neonates with Congenital Diaphragmatic Hernia.

Newborns with congenital diaphragmatic hernia (CDH) have varying degrees of pulmonary hypoplasia and pulmonary hypertension (PH), and there is limited evidence that cardiac dysfunction is present. We sought to study early neonatal biventricular function and performance in these patients by reviewing early post-natal echocardiography (ECHO) measurements and comparing them to normal term newborns. Retrospective case-control study reviewing clinical and ECHO data on term newborns with CDH and normal controls born between 2009 and 2016. Patients were excluded if major anomalies, genetic syndromes, or no ECHO available. PH was assessed by ductal shunting and tricuspid regurgitant jet velocity. Speckle-tracking echocardiography was used to assess myocardial deformation using velocity vector imaging. Forty-four patients with CDH and 18 age-matched controls were analyzed. Pulmonary pressures were significantly higher in the CDH cohort (systolic pulmonary arterial pressure to systolic blood pressure of 103 ± 13 vs. 78 ± 29%, p = 0.0001). CDH patients had decreased RV fractional area change (FAC - 28.6 ± 11.1 vs. 36.2 ± 9.6%, p = 0.02), tricuspid annular plane of systolic excursion (TAPSE-5.6 ± 1.6 vs. 8.6 ± 1.6mm, p = 0.0001), and RV outflow tract stroke distance (8.6 ± 2.7 vs. 14.0 ± 4.5cm, p = 0.0001) compared with controls. The left ventricular (LV) ejection fraction was similar in both groups, but CDH patients had a decreased LV end-diastolic volume by Simpson's rule (2.7 ± 1.0 vs. 5.0 ± 1.8mL, p = 0.0001) and LVOT stroke distance (9.7 ± 3.4 vs. 12.6 ± 3.6cm, p = 0.004). Biventricular global longitudinal strain (GLS) was markedly decreased in the CDH population compared to controls (RV-GLS: - 9.0 ± 5.3 vs. - 19.5 ± 1.4%, p = 0.0001; LV GLS: - 13.2 ± 5.8 vs. - 20.8 ± 3.5%, p = 0.0001). CDH newborns have evidence of biventricular dysfunction and decreased cardiac output. Abnormal function may be a factor in the non-response to pulmonary arterial vasodilators in CDH patients. A two-pronged management strategy aimed at improving cardiac function, as well as reducing pulmonary artery pressure in CDH newborns, may be warranted.

Uncertainty modelling and analysis of volume calculations based on a regular grid digital elevation model (DEM)

The accuracy of earthwork calculations that compute terrain volume is critical to digital terrain analysis (DTA). The uncertainties in volume calculations (VCs) based on a DEM are primarily related to three factors: 1) model error (ME), which is caused by an adopted algorithm for a VC model, 2) discrete error (DE), which is usually caused by DEM resolution and terrain complexity, and 3) propagation error (PE), which is caused by the variables' error. Based on these factors, the uncertainty modelling and analysis of VCs based on a regular grid DEM are investigated in this paper. Especially, how to quantify the uncertainty of VCs is proposed by a confidence interval based on truncation error (TE). In the experiments, the trapezoidal double rule (TDR) and Simpson's double rule (SDR) were used to calculate volume, where the TE is the major ME, and six simulated regular grid DEMs with different terrain complexity and resolution (i.e. DE) were generated by a Gauss synthetic surface to easily obtain the theoretical true value and eliminate the interference of data errors. For PE, Monte-Carlo simulation techniques and spatial autocorrelation were used to represent DEM uncertainty. This study can enrich uncertainty modelling and analysis-related theories of geographic information science.

Some refinements of hermite-hadamard inequality and an open problem

We presented here a refinement of Hermite-Hadamard inequality as a linear combination of its end-points. The problem of best possible constants is closely connected with well known Simpson's rule in numerical integration. It is solved here for a wide class of convex functions, but not in general. Some supplementary results are also given.

Functional ischemic mitral regurgitation in acute myocardial infarction: Importance of changes in left ventricular shape and regional function

Functional ischemic mitral regurgitation (IMR) is common in patients with ischemic left ventricular dysfunction after myocardial infarction, and significantly worsens prognosis. The aim of this study is to determine the relative importance of the global and regional left ventricular (LV) remodelling in the occurrence of IMR. Eighty-one patients (mean age = 61 ± 11 years) admitted with acute myocardial infarction (AMI) were screened. Patients with atrial fibrillation and organic valvular diseases were excluded from the study. Echocardiography (two-dimensional and Doppler echocardiograms) was performed in the first week after admission. The 81 patients were divided in 2 groups: with IMR (group 1 = 39 patients) and without IMR (group 2 = 42 patients). LV volumes were calculated by apical biplane Simpson's rule. The LV wall-motion score (WMS) index was obtained in a 17-segment model according to established methods. To identify the influence of regional wall-motion impairment for each individual LV segment, the mean WMS was calculated for each segment and compared between the 2 groups. The echocardiographic parameters that were associated with IMR were: LV dilatation and sphericity ( P < 0.0001), reduced ejection fraction ( P < 0.0001), inferior ( P < 0.001) inferolateral ( P = 0.01) and anterolateral ( P = 0.02) asynergy. The results of this study indicate the importance of abnormalities of both LV geometry and regional wall motion in the pathogenesis of IMR after myocardial infarction. Clinically, these findings imply that myocardial salvage by early coronary revascularisation may improve outcome by preserving LV function and decreasing the incidence of IMR.

Do we overestimate left ventricular ejection fraction by two-dimensional echocardiography in patients with left bundle branch block?

Left bundle branch block (LBBB) causes a dyssynchronized contraction of left ventricle. This is a kind of regional wall-motion abnormality and measuring left ventricular ejection fraction (LVEF) by two-dimensional (2D) echocardiography could be less reliable in this particular condition. Our aim was to evaluate the role of dyssynchrony index (SDI), measured by three-dimensional (3D) echocardiography, in assessment of LVEF and left ventricular volumes accurately in patients with LBBB. In this case-control study, we included 52 of 64 enrolled participants (twelve participants with poor image quality were excluded) with LBBB and normal LVEF or nonischemic cardiomyopathy. Left ventricular ejection fraction (LVEF) and left ventricular volumes were assessed by 2D (modified Simpson's rule) and 3D (four beats full volume analysis) echocardiography and the impact of SDI on results were evaluated. In patients with SDI ≥6%, LVEF measurements were significantly different (46.00% [29.50-52.50] vs 37.60% [24.70-45.15], P<.001) between 2D and 3D echocardiography, respectively. In patients with SDI<6%, there were no significant differences between two modalities in terms of LVEF measurements (54.50% [49.00-59.00] vs 54.25% [40.00-58.25], P=.193). LV diastolic volumes were not significantly different while systolic volumes were underestimated by 2D echocardiography, and this finding was more pronounced when SDI≥6%. In patients with LBBB and high SDI (≥6%), LVEF values were overestimated and systolic volumes were underestimated by 2D echocardiography compared to 3D echocardiography.

Design of reinforced areas of concrete column using quadratic polynomials

Designing of reinforced concrete columns mostly carried out by a simple planning method which uses column interaction diagram. However, the application of this method is limited because it valids only for certain compressive strenght of the concrete and yield strength of the reinforcement. Thus, a more applicable method is still in need. Another method is the use of quadratic polynomials as a basis for the approach in designing reinforced concrete columns, where the ratio of neutral lines to the effective height of a cross section (ξ) if associated with ξ in the same cross-section with different reinforcement ratios is assumed to form a quadratic polynomial. This is identical to the basic principle used in the Simpson rule for numerical integral using quadratic polynomials and had a sufficiently accurate level of accuracy. The basis of this approach to be used both the normal force equilibrium and the moment equilibrium. The abscissa of the intersection of the two curves is the ratio that had been mentioned, since it fulfill both of the equilibrium. The application of this method is relatively more complicated than the existing method but provided with tables and graphs (N vs ξN) and (M vs ξM) so that its used could be simplified. The uniqueness of these tables are only distinguished based on the compresssive strength of the concrete, so in application it could be combined with various yield strenght of the reinforcement available in the market. This method could be solved by using programming languages such as Fortran.

UTILITY OF NON-INVASIVE CORONARY FLOW PATTERN VERSUS FRACTIONAL FLOW PRESSURE DROP FOR LEFT ANTERIOR CORONARY ARTERY STENTING

Background and Aim: To assess the usefulness of coronary flow reserve as a guide in patient with left anterior descending coronary artery lesion during percutaneous coronary intervention in comparison with fractional flow reserve. Methods: The study included 80 patients with left anterior descending artery stenotic lesions, proved by coronary angiography, in the cardiac catheterization laboratory of the Faculty of Military Hospital, during the period from November 2012 to June 2014. All patients were subjected to all of the following: Complete history taking, full general and local examination, ECG analysis. All our patient were assessed by Doppler wire to measure pressure drop at LAD lesion and also by non-invasive coronary flow pattern utilizing transthoracic echo-Doppler study. Then we compare the results of both values on the basis of the improvement in left ventricular ejection fraction( by biplane Simpson rule) to find the cut point at which we can document that this LAD lesion deserve stenting . Results: FFR was negatively correlated with significant correlation with EF improvement with R value of -0.575 and P-value of 0.008,figure. Also there is strong inversed relation with lesion percent with R-value of-0.468 and P-value of 0.01. The correlation between FFR and improvement in wall motion score was significantly inversed with R-value of -0.519 and P-value of 0.03. Also there was strong correlation between FFR and CFR ,P-value was 0.00 and R-value was+0.436. CFR has strong reciprocal correlation with FFR (P-value was 0.00 and R-value was. inve+0.436. There is significant correlation of CFR with EF improvement with R value of -0.583and P-value of 0.002. Also there is significant correlation of CFR with lesion percent with R-value of -0.585and P-value of 0.001, figure. The correlation between CFR and wall motion score was significant with R-value of-0.393 and P-value of 0.03. The optimal cutoff values for coronary flow reserve of <1.75 was the best value for indication of stenting of an intermediate coronary lesion. A sensitivity of 92% and a specificity of 87%. On the other hand the best cut-of value of fractional flow reserve was <0.75 for indication of stenting for an intermediate coronary artery lesion with a sensitivity of 94% and specificity of 86%. Conclusions: The current study showed Coronary flow reserve measurements by TTE in the distal to mid LAD were feasible in most patients with an optimal cut-off value < 1.75 showed high accuracy to detect angiographically significant stenoses in the LAD. This is comparable to <0.75 as an optimal cut-off value of FFR to detect angiographically significant stenoses. CFR measurement utilizing TTE might be considered as a simple non-invasive tool for functional status of an intermediate coronary artery lesion for stenting. Key Words: LAD (left anterior descending artery ), coronary flow reserve, fractional flow reserve.

The modeling of attraction characteristics regarding passenger flow in urban rail transit network based on field theory.

Aimed at the complicated problems of attraction characteristics regarding passenger flow in urban rail transit network, the concept of the gravity field of passenger flow is proposed in this paper. We establish the computation methods of field strength and potential energy to reveal the potential attraction relationship among stations from the perspective of the collection and distribution of passenger flow and the topology of network. As for the computation methods of field strength, an optimum path concept is proposed to define betweenness centrality parameter. Regarding the computation of potential energy, Compound Simpson’s Rule Formula is applied to get a solution to the function. Taking No. 10 Beijing Subway as a practical example, an analysis of simulation and verification is conducted, and the results shows in the following ways. Firstly, the bigger field strength value between two stations is, the stronger passenger flow attraction is, and the greater probability of the formation of the largest passenger flow of section is. Secondly, there is the greatest passenger flow volume and circulation capacity between two zones of high potential energy.

112 - The Ascent Component of Mitral Annular Motion Mainly Reflects the Left Ventricular Diastolic Function

Background: M-mode interrogation of the mitral annular plane systolic excursion (MAPSE) and tissue Doppler imaging (TDI) of the MA systolic velocity are accepted surrogate measures of left ventricular (LV) systolic function. Since the MA continues to move during diastole and not only determines the MA ascent (MAa) component but also maximal MAPSE; our study intended to investigate the overall contribution of MAa to LV systole and diastole in patients with normal LV systolic function and in sinus rhythm. Methods: A total of 106 echocardiograms were retrospectively evaluated. LV systolic function was assessed using the modified Simpson's rule, MAPSE and MA TDI measures. LV diastolic function was investigated using standard Doppler criteria. Finally, MAa data was measured as shown in Fig. 1. The studied population was divided according to age: Group 1 included 16 patients (24–39 years); Group 2 contained 52 patients (40–55 years) while Group 3 comprised 38 patients (56–89 years). Results: All measured echocardiographic data is shown in Table 1. In our study sample, while there was no difference in terms of MAPSE; MAa was lowest in Group 1. In a multiple regression analysis, MAa correlated best with MAPSE (<0.001), both early and late diastolic MA velocities (<0.001) and mitral valve inflow early to late diastolic flows (<0.001). No correlation was seen with regards to age, LV systolic function by Simpson’s, or MA TDI systolic velocity. Conclusions: In this study, MAa only correlated with Doppler parameters of LV diastolic and with none of the systolic measures of LV function, except maximal MA systolic excursion. The latter association might simply reflect normal atrio-ventricular dependency that exists between LV systole and diastole. Specifically, the final end diastolic MA resting position determines were the next LV cardiac systolic cycle starts. Additional studies are now required to better examine this atrio-ventricular dependence between LV systole and diastole.Table 1Echocardiographic data of the study population.VariablesGroup 1 (n = 16)Group 2 (n = 52)Group 3 (n = 38)ANOVAAge31 ± 548 ± 467 ± 8<0.001LVEF69 ± 568 ± 973 ± 100.034MV E/A ratio1.6 ± 0.81.3 ± 0.51.0 ± 0.6<0.001MA S' velocity10 ± 38 ± 28 ± 30.009MA E' velocity14 ± 59 ± 38 ± 2<0.001MA A' velocity7 ± 28 ± 210 ± 40.004MA E'/A' ratio2.1 ± 0.81.2 ± 0.50.9 ± 0.4<0.001MAPSE1.4 ± 0.21.3 ± 0.21.3 ± 0.30.102MAa0.4 ± 0.10.6 ± 0.20.6 ± 0.20.017 Open table in a new tab