scholarly journals Associations of the Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay diet with cardiac remodelling in the community: the Framingham Heart Study

2021 ◽  
pp. 1-9
Author(s):  
Maura E. Walker ◽  
Adrienne A. O’Donnell ◽  
Jayandra J. Himali ◽  
Iniya Rajendran ◽  
Debora Melo van Lent ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Root Diameter ◽  
Left Ventricular ◽  
Cardiac Remodelling ◽  
Lv Function ◽  
The Mediterranean ◽  
Diet Score ◽  
Mind Diet

Abstract Normal cardiac function is directly associated with the maintenance of cerebrovascular health. Whether the Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) diet, designed for the maintenance of neurocognitive health, is associated with cardiac remodelling is unknown. We evaluated 2512 Framingham Offspring Cohort participants who attended the eighth examination cycle and had available dietary and echocardiographic data (mean age 66 years; 55 % women). Using multivariable regression, we related the cumulative MIND diet score (independent variable) to left ventricular (LV) ejection fraction, left atrial emptying fraction, LV mass (LVM), E/e’ ratio (dependent variables; primary), global longitudinal strain, global circumferential strain (GCS), mitral annular plane systolic excursion, longitudinal segmental synchrony, LV hypertrophy and aortic root diameter (secondary). Adjusting for age, sex and energy intake, higher cumulative MIND diet scores were associated with lower values of indices of LV diastolic (E/e’ ratio: logβ = −0·03) and systolic function (GCS: β = −0·04) and with higher values of LVM (logβ = 0·02), all P ≤ 0·01. We observed effect modification by age in the association between the cumulative MIND diet score and GCS. When we further adjusted for clinical risk factors, the associations of the cumulative MIND diet score with GCS in participants ≥66 years (β = −0·06, P = 0·005) and LVM remained significant. In our community-based sample, relations between the cumulative MIND diet score and cardiac remodelling differ among indices of LV structure and function. Our results suggest that favourable associations between a higher cumulative MIND diet score and indices of LV function may be influenced by cardiometabolic and lifestyle risk factors.

scholarly journals Performance indicators of left ventricular strain, wall stress and serum brain natriuretic peptide levels in chronic hemodialysis patients

2021 ◽  
pp. 22-39
Author(s):  
Abeer M. SHAWKY ◽  
Rehab M. HAMDY ◽  
Asmaa A. ELMADBOULY
Keyword(s):  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Wall Stress ◽  
Serum Levels ◽  
Left Ventricular ◽  
Chronic Hemodialysis ◽  
Lv Function ◽  
Endstage Renal Disease

Background: Left ventricular (LV) global longitudinal strain (GLS) is a reliable determinant of LV systolic function. The precise relationship between LV wall stress and serum brain natriuretic peptide (BNP) concentrations in hemodialysis (HD) patients require clariϐication. BNP levels are raised in patients with endstage renal disease (ESRD) and could reflect LV impairment amongst HD patients. Objective: This study sought to evaluate the clinical utility of LV–GLS, wall stress and serum BNP levels in chronic HD patients. The correlations between BNP levels with both LV wall stress and LV–GLS were assessed. Methodology: A total of 30 ESRD patients on regular HD – divided into 15 patients with LV ejection fraction (EF) <50% and 15 patients with LV EF > 50% – and 15 agematched healthy subjects were assessed. LV function and structure were measured using conventional echocardiography, including LV meridional wall stress (LVMWS), LV mass index (LVM I) and two-dimensional speckle tracking echocardiography for determination of LV–GLS. Serum BNP levels were evaluated after HD sessions. Results: There were significant increases in LVM SW (189.2 ± 81 vs. 72.2 ± 20.6 dynes/cm 2 2 1000, P < 0.0001), higher levels of BNP (1238 ± 1085.5 vs. 71 ± 23.4 pg/ml, P<0.0001), w hilst LV–GLS was signiϐicantly reduced (15.1 ± 3.1 vs. 20.8 ± 1.7%, P <0.0001) in HD patients, when compared to the controls. Higher values of LVMWS (246.9 ± 67.5 vs. 131.5 ± 43.6 dynes/cm 2 2 1000, P <0.0001) and BNP (1925.4 ± 1087 vs. 550.5 ± 496.5pg/ml, P < 0.0005) with further impairment of LV–GLS (13.8 ± 2.5 vs. 16.4 ± 5.4%, P < 0.05) were found in patients with LV EF 0 50% than those with LV EF > 50%. Serum levels of BNP were positively correlated with LVM I (r = 0.896, P < 0.0001) and LVMW S (r = 0.697, P < 0.0001), but negatively correlated with LV–GLS (r = 0 0.587, P < 0.0001). Conclusion: LV–GLS and LVMWS are useful imaging markers for detection of LV dysfunction in HD patients. Serum BNP level is influenced by LV structural abnormalities, being regarded as a crucial hemodynamic biomarker in those patients.

P4134Impaired left ventricular systolic function in alcohol abusers expressed by both 3D calculated ejection fraction and longitudinal strain by AFI

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
P Hamala ◽  
J D Kasprzak ◽  
P Lipiec ◽  
K Wierzbowska-Drabik
Keyword(s):  
Alcohol Abuse ◽  
Ejection Fraction ◽  
Longitudinal Strain ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Harmful Effect ◽  
Left Ventricular ◽  
Control Group ◽  
Lv Function ◽  
Alcohol Abusers

Abstract Aim Despite knowledge regarding the existence of alcohol cardiomyopathy the exact impact of alcohol abuse in consecutive subject is poorly examined. We aimed to evaluate the left ventricle (LV) function in chronic abusers group and compared classical and novel echocardiography parameters in alcohol abusers (ALC) and control group (C). Methods We compared 75 adults (mean age 48±12, 60 male) without other overt heart disease, coronary artery disease excluded, but with alcohol abuse history: average alcohol intake 32 alcohol unit per week (AUW) with control group consisted of 40 subjects without history of excessive drinking, abstinents or drinking ≤8 AUW (mean age 50±4, 16 men). One unit was defined as 10 grams of pure etanol. All patients underwent TTE examination including ejection fraction (EF) calculation with 3D and longitudinal strain assessment by AFI method. Results ALC group showed LV systolic dysfunction expressed as EF 48±14 vs 60±9%, global longitudinal strain (AFI GLS) −15.6±6.6 vs −18.7±3.4; p<0.0001 and p 0.0064, respectively. On the other hand the LV and left atrial diameters as well as diastolic function were similar in both groups, indicating on relatively low advancement of heart remodeling. ALC vs Control group comparison ALC N75 C N40 p value Age 48±12 50±4 ns BMI 24±6 28±6 0.0009 LVd 48±13 47±4 ns LVs 34±15 32±4 ns LA 38±9 38±3 ns EF 48±14 60±9 <0.0001 E/A 1.1±0.6 1.1±0.3 ns E' lateral 10.6±3.9 10.6±2.9 ns AFI 2ch −15.9±6.9 −18.8±4.8 0.0143 AFI 3ch −15.9±6.9 −18.9±3.6 0.0116 AFI 4ch −15.2±7.1 −18.6±3.5 0.0053 AFI GLS −15.6±6.6 −18.7±3.4 0.0064 Conclusions Chronic alcohol abuse revealed harmful effect on LV systolic function which can be assessed quantitatively by both decreased EF and absolute values of myocardial longitudinal strain. This systolic function impairment seems to anticipate the overt remodelling of the heart.

scholarly journals Effects of Empagliflozin in Different Phases of Diabetes Mellitus-related Cardiomyopathy

2020 ◽  
Author(s):  
Satoshi Oka ◽  
Takahiko Kai ◽  
Katsuomi Hoshino ◽  
Kazunori Watanabe ◽  
Jun Nakamura ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cardiac Fibrosis ◽  
Volume Fraction ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Extracellular Volume ◽  
Left Ventricular ◽  
Lv Function ◽  
Positive Effects ◽  
Lv Dysfunction

Abstract Background: In diabetes mellitus-related cardiomyopathy (DMCMP), hyperglycemia causes endothelial dysfunction, fibrosis, and myocardial injury, which result in left ventricular (LV) dysfunction. Treatment with sodium–glucose co-transporter 2 inhibitor (SGLT2i) reduces the risk of exacerbation of heart failure (HF). The beneficial effects of SGLT2i on HF depend not only on indirect actions such as osmotic diuresis but also direct actions on the myocardium leading to improvements in LV function. However, it remains unclear whether SGLT2i treatment is equally effective in any phase of DMCMP. The aim of this observational study was to compare the efficacy of SGLT2i treatment on LV dysfunction between early and advanced DMCMP.Methods: Thirty-five symptomatic non-ischemic HF patients with LV ejection fraction (EF) greater than 40% and type 2 diabetes mellitus (T2DM) treated with administration of empagliflozin (10 mg/day) were enrolled. According to the myocardial extracellular volume fraction (ECV), a reliable marker of cardiac fibrosis quantified by cardiac magnetic resonance, the patients were divided into the early DMCMP group (n = 16, ECV ≤ 30%) and advanced DMCMP group (n = 19, ECV > 30%) and followed-up prospectively. Echocardiography was performed at baseline and after 12 months. LV systolic function assessed as LV global longitudinal strain (GLS) and diastolic function assessed as the ratio of early diastolic mitral inflow velocity to early diastolic mitral annular velocity (E/e’) were compared.Results: ECV was strongly correlated with T2DM duration (r2 = 0.65, p < 0.001). At baseline, both groups had similar backgrounds (LVGLS: 7.9 ± 2.4% vs. 6.7 ± 3.0%, p = 0.207, and E/e’: 13.2 ± 6.1 cm/s vs. 12.6 ± 3.8 cm/s, p = 0.694). After 12 months, the early DMCMP group showed greater improvement in LVGLS (ΔLVGLS: 4.6 ± 1.5% vs. 1.6 ± 3.3%, p = 0.003) and E/e’ (ΔE/e’: -3.4 ± 5.5 cm/s vs. -0.1 ± 3.5 cm/s, p = 0.043) than in the advanced DMCMP group.Conclusion: The positive effects of empagliflozin on LV dysfunction were more remarkable in DMCMP with mild cardiac fibrosis than with advanced fibrosis. Early intervention of SGLT2i for DMCMP is preferable.

scholarly journals Prognostic Value of Left Ventricular Function and Mechanics in Pulmonary Hypertension: A Pilot Cardiovascular Magnetic Resonance Feature Tracking Study

Medicina ◽  
2019 ◽  
Vol 55 (3) ◽  
pp. 73 ◽  
Author(s):  
Lina Padervinskienė ◽  
Aušra Krivickienė ◽  
Deimantė Hoppenot ◽  
Skaidrius Miliauskas ◽  
Algidas Basevičius ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Cardiovascular Magnetic Resonance ◽  
Feature Tracking ◽  
Prognostic Value ◽  
Longitudinal Strain ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Lv Function ◽  
Lv Systolic Function

Background and objective: Cardiovascular magnetic resonance (CMR) - based feature tracking (FT) can detect left ventricular (LV) strain abnormalities in pulmonary hypertension (PH) patients, but little is known about the prognostic value of LV function and mechanics in PH patients. The aim of this study was to evaluate LV systolic function by conventional CMR and LV global strains by CMR-based FT analysis in precapillary PH patients, thereby defining the prognostic value of LV function and mechanics. Methods: We prospectively enrolled 43 patients with precapillary PH (mean pulmonary artery pressure (mPAP) 55.91 ± 15.87 mmHg, pulmonary arterial wedge pressure (PAWP) ≤15 mmHg) referred to CMR for PH evaluation. Using FT software, the LV global longitudinal strain (GLS) and global circumferential strain (GCS), also right ventricular (RV) GLS were analyzed. Results: Patients were classified into two groups according to survival (survival/non-survival). LV GLS was significantly reduced in the non-survival group (−12.4% [−19.0–(−7.8)] vs. −18.4% [−22.5–(−15.5)], p = 0.009). By ROC curve analysis, LV GLS > −14.2% (CI: 3.229 to 37.301, p < 0.001) was found to be robust predictor of mortality in PH patients. Univariable analysis using the Cox model showed that severely reduced LV GLS > −14.2%, with good sensitivity (77.8%) and high specificity (93.5%) indicated an increase of the risk of death by 11-fold. LV GLS significantly correlated in PH patients with RV ESVI (r = 0.322, p = 0.035), RV EF (r = 0.444, p < 0.003). Conclusions: LV systolic function and LV global longitudinal strain measurements using CMR-FT correlates with RV dysfunction and is associated with poor clinical outcomes in precapillary PH patients.

scholarly journals Early Right Ventricular Apical Pacing-Induced Gene Expression Alterations Are Associated with Deterioration of Left Ventricular Systolic Function

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Haiyan Xu ◽  
Xiongwei Xie ◽  
Jiangjin Li ◽  
Yuanyuan Zhang ◽  
Changsong Xu ◽  
...  
Keyword(s):  
Energy Metabolism ◽  
Right Ventricular ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Pacemaker Implantation ◽  
Right Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Lv Function ◽  
High Dose ◽  
Mrna Levels

The chronic high-dose right ventricular apical (RVA) pacing may have deleterious effects on left ventricular (LV) systolic function. We hypothesized that the expression changes of genes regulating cardiomyocyte energy metabolism and contractility were associated with deterioration of LV function in patients who underwent chronic RVA pacing. Sixty patients with complete atrioventricular block and preserved ejection fraction (EF) who underwent pacemaker implantation were randomly assigned to either RVA pacing (n=30) group or right ventricular outflow tract (RVOT) pacing (n=30) group. The mRNA levels of OPA1 and SERCA2a were significantly lower in the RVA pacing group at 1 month’s follow-up (both p<0.001). Early changes in the expression of selected genes OPA1 and SERCA2a were associated with deterioration in global longitudinal strain (GLS) that became apparent months later (p=0.002 and p=0.026, resp.) The altered expressions of genes that regulate cardiomyocyte energy metabolism and contractility measured in the peripheral blood at one month following pacemaker implantation were associated with subsequent deterioration in LV dyssynchrony and function in patients with preserved LVEF, who underwent RVA pacing.

scholarly journals Role of global longitudinal strain to identify and monitor left ventricular dysfunction over time in Becker muscular dystrophy

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
T Gegenava ◽  
N Velde ◽  
Z Koeks ◽  
P Spitali ◽  
E Niks ◽  
...  
Keyword(s):  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Reference Value ◽  
Becker Muscular Dystrophy ◽  
Left Ventricular ◽  
Lv Function ◽  
Myocardial Involvement ◽  
Lv Systolic Function ◽  
Over Time

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Myocardial involvement is a frequent manifestation of Becker muscular dystrophy (BMD) representing one of the main causes of death; however, it has been shown that left ventricular (LV) systolic function is not specifically related to the degree of skeletal myopathy and therefore each patient should be screened for myocardial involvement. Advanced echocardiographic measures of LV function, such as global longitudinal strain (GLS), have not been studied in BMD patients and might help in identifying myocardial involvement at an early stage. Aim of this study was therefore to perform a longitudinal assessment of LV function but using LV ejection fraction (EF) and GLS in a relatively large cohort of BMD patients (Fig 1). Methods: A total of 40 BMD patients (39 ± 13 years) were analyzed including standard and advanced echocardiography at the time of their first visit and at 24 months (IQR 23-25) follow-up. A control group consisted of 22 age- and gender-matched healthy subjects. Results: BMD patients showed significantly impaired LV systolic function as compared to controls both by  LVEF (47 ± 11% vs. 61 ± 8%, p &lt; 0.001) and LV GLS (-16% (-17%-12%) vs. -19% (-21%-18%), p &lt; 0.001). However, a total of 32 (80%) BMD patients showed impaired LV GLS (based on a reference value -18%) and only 24 (60%) BMD patients showed reduced LVEF (based on reference value 52%) suggesting at the important role of LV GLS to identify early myocardial involvement. Furthermore at the follow-up assessment (available in n = 29 patients), LV GLS showed significant deterioration in BMD patients (from -15%±3 to -14%±4, p = 0.004), while LVEF and LV volumes did not show significant changes over time. Conclusion: LV GLS is significantly impaired in BMD patients and shows progressive deterioration over time, while LVEF remains unchanged. LV GLS might therefore represents a new tool to improve identification of early myocardial involvement and subclinical changes in these patients. Abstract Figure. LV systolic function in Becker disease

scholarly journals The non-invasive assessment of myocardial work by pressure-strain analysis: clinical applications

2021 ◽  
Author(s):  
Dawud Abawi ◽  
Tommaso Rinaldi ◽  
Alessandro Faragli ◽  
Burkert Pieske ◽  
Daniel A. Morris ◽  
...  
Keyword(s):  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Strain Analysis ◽  
Response Prediction ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Lv Function ◽  
Current Application ◽  
Non Invasive ◽  
Echocardiographic Parameters

AbstractPressure–volume (PV) analysis is the most comprehensive way to describe cardiac function, giving insights into cardiac mechanics and energetics. However, PV analysis still remains a highly invasive and time-consuming method, preventing it from integration into clinical practice. Most of the echocardiographic parameters currently used in the clinical routine to characterize left ventricular (LV) systolic function, such as LV ejection fraction and LV global longitudinal strain, do not take the pressure developed within the LV into account and therefore fall too short in describing LV function as a hydraulic pump. Recently, LV pressure-strain analysis has been introduced as a new technique to assess myocardial work in a non-invasive fashion. This new method showed new insights in comparison to invasive measurements and was validated in different cardiac pathologies, e.g., for the detection of coronary artery disease, cardiac resynchronization therapy (CRT)-response prediction, and different forms of heart failure. Non-invasively assessed myocardial work may play a major role in guiding therapies and estimating prognosis. However, its incremental prognostic validity in comparison to common echocardiographic parameters remains unclear. This review aims to provide an overview of pressure-strain analysis, including its current application in the clinical arena, as well as potential fields of exploitation.

scholarly journals Catecholamines Induce Left Ventricular Subclinical Systolic Dysfunction: A Speckle-Tracking Echocardiography Study

Cancers ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 318 ◽  
Author(s):  
Jan Kvasnička ◽  
Tomáš Zelinka ◽  
Ondřej Petrák ◽  
Ján Rosa ◽  
Branislav Štrauch ◽  
...  
Keyword(s):  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Lv Function ◽  
Echocardiographic Parameters ◽  
Lv Systolic Function ◽  
Lower Magnitude

Background: Pheochromocytomas (PHEO) are tumors arising from chromaffin cells from the adrenal medulla, having the ability to produce, metabolize and secrete catecholamines. The overproduction of catecholamines leads by many mechanisms to the impairment in the left ventricle (LV) function, however, endocardial measurement of systolic function did not find any differences between patients with PHEO and essential hypertension (EH). The aim of the study was to investigate whether global longitudinal strain (GLS) derived from speckle-tracking echocardiography can detect catecholamine-induced subclinical impairments in systolic function. Methods: We analyzed 17 patients (10 females and seven males) with PHEO and 18 patients (nine females and nine males) with EH. The groups did not differ in age or in 24-h blood pressure values. Results: The patients with PHEO did not differ in echocardiographic parameters including LV ejection fraction compared to the EH patients (0.69 ± 0.04 vs. 0.71 ± 0.05; NS), nevertheless, in spackle-tracking analysis, the patients with PHEO displayed significantly lower GLS than the EH patients (−14.8 ± 1.5 vs. −17.8 ± 1.7; p < 0.001). Conclusions: Patients with PHEO have a lower magnitude of GLS than the patients with EH, suggesting that catecholamines induce a subclinical decline in LV systolic function.

scholarly journals 618 Adaptive myocardial mechanics in aortic stenosis patients

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M Alfarih ◽  
A Alfuhied ◽  
P Kumar M ◽  
G Lloyd ◽  
A D Hughes ◽  
...  
Keyword(s):  
Aortic Stenosis ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Intraclass Correlation ◽  
Strain Analysis ◽  
Inverse Correlation ◽  
Left Ventricular ◽  
Lv Function ◽  
Myocardial Mechanics ◽  
And Gender

Abstract Introduction Left ventricular (LV) hypertrophy in aortic stenosis (AS) becomes maladaptive over time, leading first to a reduction in global longitudinal strain (GLS) and in a later stage a reduction in ejection fraction (EF). The myocardial state of impaired GLS but preserved EF is a key remodeling turning point in AS, yet little is known about the coping mechanics of the LV at or around this sensitive juncture. Aim 1) To study the relationship between LV mass index (LVMi) increase and measures of LV function, including strain in AS; 2) To investigate whether augmentation of global myocardial radial and circumferential strain (GRS, GCS) compensates for the GLS reduction in AS patients with preserved EF. Methods One-hundred and eleven patients with varying degrees of AS, and 20 age- and gender-matched healthy volunteers were prospectively enrolled. transthoracic echocardiography with offline strain analysis was performed using TomTec software. Intra- and inter-observer variability of linear LV internal dimensions/thickness, EF and strain indices was tested on 20 randomly selected patients. Results Clinical and demographic characteristics of cases and controls are shown in Figure 1. GLS was impaired in AS patients compared to controls. In AS with preserved EF (&gt;50%), as LVMi increased, GLS progressively improved up to a point, beyond which any further increase in LVMi appeared counter-productive with impairment of GLS (Figure 1). EF preservation in these AS patients was mediated by a compensatory supernormal augmentation of GRS and a smaller augmentation of GCS (Figure 1). We observed a significant inverse correlation between GRS and GLS (r = 0.3, p = 0.002), and a similar trend between GCS and GLS (r = 0.275, p = 0.004). Intraclass correlation coefficient was high for all measurements (0.7-0.9). Conclusion In patients with AS and preserved EF, progressive myocardial hypertrophy improves GLS up to a point beyond which GLS drops and GRS increase to compensate. This plasticity of myocardial mechanics, in particular the supranormal augmentation of GRS is what enables the pathologically hypertrophied AS ventricle to delay the otherwise inexorable decline in its global systolic function. Abstract 618 Figure 1

scholarly journals P1253 A case report of acromegalic cardiomyopathy with severe left ventricular hypertrophy

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
M D Kuklina ◽  
K V Melkozerov ◽  
V Y Kalashnikov
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Ejection Fraction ◽  
Diastolic Dysfunction ◽  
Pituitary Tumor ◽  
Ventricular Hypertrophy ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Lv Function ◽  
Acromegalic Cardiomyopathy

Abstract Introduction Acromegaly is a rare disease, mostly caused by a growth hormone (GH)-secreting benign pituitary tumor, with an increased production of GH and insulin-like growth factor 1 (IGF-1). One hallmark feature of the disease is acromegalic cardiomyopathy, a syndrome of progressive cardiac dysfunction characterized by left ventricular hypertrophy, diastolic dysfunction, and combined systolic and diastolic dysfunction in the very advanced stage. Clinical case A 54-year-old male with history of arterial hypertension and abnormal electrocardiogram (ECG) for more than 10 years was diagnosed with active stage of acromegaly (IGF-1-1711ng/ml, cardiac magnetic resonance (CMR) – pituitary tumor). Surgical treatment was recommended. He was referred for preoperative cardiac evaluation preceding transsphenoidal resection of a pituitary adenoma. He denied syncope or any chest pain. The standard 12-lead ECG demonstrated sinus rhythm, left atrial enlargement and left ventricular (LV) hypertrophy with deep negative T waves in V3-V6 leads. Holter monitor demonstrated episodes of non-sustained ventricular tachycardia. Transthoracic echocardiography revealed severe asymmetric LV hypertrophy without LVOT obstruction at rest and maneuver Valsalva (max. grad. – 19mm. Hg) with mildly abnormal LV ejection fraction (48%, range ≥52%), severe reduced global longitudinal strain (-8,2%, range &lt;-18%) and grade II diastolic dysfunction. CMR imaging was performed. According to CMR suggested hypertrophic cardiomyopathy (HCM) demonstrating area of myocardial fibrosis on extensive late gadolinium enhancement, maximal LV wall thickness of 40 mm, increased myocardial mass (index 277g/m2, range 68–103g/m2) and mildly reduced systolic LV function (LVEF - 54%, range 57-74%). Coronary angiography did not show significant stenosis. After cardiac examination, transsphenoidal adenomectomy was done. There are currently no algorithms sudden cardiac death (SCD) for patients with acromegalic cardiomyopathy, but he was recommended implantation of cardioverter defibrillator devices on a scale for HCM (Risc SCD – 4,17%). Acromegaly-induced cardiomyopathy can mimic HCM. He was also recommended genetic typing for HCM, considering the results of MRI. Conclusion/Discussion: Reduction GLS might be expected to result in a fall in LVEF, however this is often not the case in hypertrophic LV diseases. It is important to note that measures of regional function such as myocardial strain may actually reflect global systolic function better than the ejection fraction. The results may improve our ability to provide a more accurate prognosis and better assessment of actual systolic function. Because cardiomyopathy is an important cause of mortality in acromegaly, diagnosis and appropriate management are critical to improve survival. Abstract P1253 Figure.

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