Subclinical left ventricular systolic dysfunction in patients with naive acromegaly - assessment with two-dimensional speckle-tracking echocardiography: retrospective study.

INTRODUCTION: The aim of the study was to evaluate global longitudinal strain (GLS) in patients with naive acromegaly with normal left ventricular (LV) ejection fraction (EF). MATERIAL AND METHODS: Forty-three consecutive patients with naive acromegaly with normal LV systolic function as measured by EF, examined from 2008 to 2016, and 52 patients of a control group matched for age and sex underwent two-dimensional speckle-tracking echocardiography to assess GLS. RESULTS: The median GLS was significantly lower in the acromegaly group than in the control group (in %, -16.6 vs. -20.7; p < 0.01). The majority of acromegalic patients (n = 26; 60.5%) had abnormal GLS. Patients with impairment in GLS had a longer median duration of acromegaly symptoms (in years, 10.0 vs. 5.0; p < 0.05) and greater LV thickness (posterior wall in mm, 12.5 vs. 12.0; p < 0.05) compared to those with normal GLS. Patients with abnormal GLS had higher IGF-1 concentration, but without statistical significance. Diabetes mellitus and arterial hypertension, which are more common in acromegaly, were not significant determinants of abnormal GLS. The mean left ventricular mass index (LVMI) was increased in the acromegaly group compared to controls (in g/m², 136 vs. 97; p < 0.01). There was a significant negative correlation between LVMI and GLS (R = -0.47; p < 0.01). CONCLUSIONS: Naive acromegalic patients presented abnormal GLS, which indicates subclinical systolic dysfunction in these patients. It has not been proven that arterial hypertension and diabetes mellitus are significant determinants of abnormal GLS.

[Left main coronary artery stenting in a ninety year old female with recurrent acute coronary syndrome -- a case report]. / Stentowanie pnia lewej tetnicy wiencowej u 90-letniej chorej wracajacej do szpitala z powodu ostrego zespolu wiencowego. Opis przypadku.

A case of a ninety year old female with recurrent acute coronary syndrome is presented. Coronary angiography revealed critical left main coronary artery stenosis which was successfully treated with angioplasty and stent implantation. Data from literature on the left main stenting in the elderly are discussed.

[Dilatation of superior vena cava and internal jugular vein following implantation of prosthetic mitral and aortic valves - a case report]. / Poszerzenie zyly glównej górnej i zyly szyjnej wewnetrznej po wszczepieniu sztucznych zastawek w ujscie mitralne i aortalne.

A case of a 47 year old male with a history of closed mitral commissurotomy performed in 1991 and implantation of prosthetic mitral and aortic valves in 1999, is presented. Three years after the second procedure the patient developed dilatation of superior vena cava and internal jugular vein.