RESUMEN
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.
Asunto(s)
Acromegalia/diagnóstico por imagen , Acromegalia/fisiopatología , Volumen Sistólico/fisiología , Disfunción Ventricular Izquierda/diagnóstico por imagen , Anciano , Estudios de Casos y Controles , Ecocardiografía/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Disfunción Ventricular Izquierda/fisiopatología , Función Ventricular Izquierda/fisiologíaRESUMEN
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.
Asunto(s)
Angioplastia Coronaria con Balón , Estenosis Coronaria/diagnóstico , Estenosis Coronaria/terapia , Enfermedad Aguda , Anciano de 80 o más Años , Angiografía Coronaria , Femenino , Humanos , Prevención Secundaria , Resultado del TratamientoRESUMEN
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.