HIT Poster session 3P915Direct access to transthoracic echocardiography in a district general hospital: are referrals appropriate?P916Surveillance echocardiography for valve disease; have the AHA valve guidelines translated in clinical practice? A retrospective study from a large general hospital in the United KingdomP917Effects of immediate echo guided AV and VV CRT optimization on left ventricular function and hemodynamicsP9183D echocardiography estimation of ventricular performance : correlation between 3D strain and elastancesP919 Right ventricular reverse remodeling after balloon pulmonary angioplasty in patients with non operable chronic thromboembolic pulmonary hypertensionP920Pseudonormal and restrictive left ventricular filling patterns are associated with lower effectiveness of pulmonary vein isolation in patients with paroxysmal atrial fibrillationP921Impact of new guidelines on diastolic dysfunction classification of HFrEF patients and correlation with cardiopulmonary exerc

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Results.After IEGM optimization, immediate echo guided optimization was performed with following results: septal flash was present in 55.8% (N¼19) pts before, and in 8.82% (N¼3, p¼0.000) after echo optimization; LV EF has improved from 28.72% to 32.81% (p¼0.002),GLS from -7.64% to -9.07%(p¼0.002),GRS from 13.57% to 17.21% (p¼0.025).There was no change in diastolic function, pulmonary artery pressure, transmitral E wave velocity, MV VTI, nor in MVDFT.Noninvasive parameters of cardiac output measured from LVOT flow were improved: LVOT VTI increased from 13.21cm to 15.99cm (p¼0.001),LVOT maximal velocity from 0.71m/s to 0.86m/s (p¼0.003) and ET from 247.74ms to 270.74ms (p¼0.000).SPWMD was shortened from 143.12ms to 90.04ms (p¼0.005) while other dyssynchrony parameters (interventricular mechanical delay, TDI septal to lateral delay and RS anteroseptum to posterior wall delay) showed no statistical difference.Conclusion.Transthoracic echocardiography after IEGM CRT optimization showed residual septal flash in more than half of the patients as a sign of mechanical dyssynchrony despite narrowing of QRS width due to CRT.Immediate echo guided CRT optimization significantly improves LV function and cardiac output (LVEF, GLS, GRS, VTI LVOT and ET) in addition to IGEM settings. P9183D echocardiography estimation of ventricular performance : correlation between 3D strain and elastances

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