After myocardial infarction, optimal clinical management depends critically on cardiac imaging. Remodelling and heart failure, presence of inducible ischaemia, presence of dysfunctional viable myocardium, future risk of adverse events including risk of ventricular arrhythmias, need for anticoagulation, and other questions should be addressed by cardiac imaging. Strengths and weaknesses, recent developments, choice, and timing of the different non-invasive techniques are reviewed for this frequent clinical scenario.

Context: Information about the risk and course of coronary artery disease (CAD) in acromegaly is limited. Objective: To evaluate CAD risk in acromegalic patients at diagnosis and after successful treatment during follow-up. Subjects and methods: Twenty-five consecutive patients (age 45.1G10.6 years, 15 women) were studied at the time of diagnosis, and 19 patients were re-evaluated after 4.6G1.1 years. The European Society of Cardiology (ESC) risk score was calculated, and a cardiac computed tomography was performed for detection and quantification (Agatston score (AS)) of coronary artery calcium (CACs). Fifty age-, sex-, and CAD risk-matched subjects and CAC data from the population-based Heinz Nixdorf Recall (HNR) study served as controls. Results: In 21 of the 25 patients, the 10-year risk of developing CAD according to the ESC risk score was low (!10%) and high (O20%) in four patients. The AS was lower than in controls (2.6G7.9 vs 66G182; PZ0.014) and less patients had a positive CAC (ASO0) (20 vs 48%, PZ0.024), which in the acromegalic patients was less than expected from the HNR study. The AS did not correlate with GH excess or disease duration. In 19 acromegalic patients, who were in remission and re-evaluated after 4.6G1.1 years, the ESC risk (PZ0.102) and the AS (PZ0.173) did not change significantly and no symptomatic CAD event occurred. Conclusion: CAD risk in newly diagnosed acromegalic patients was low and remained stable after successful treatment. CAC was lower than in controls suggesting that GH excess per se does not carry an additional CAD risk.

Myocardial function significantly recovers after replacing the stenosed aortic valve. However, there is a considerable difference between the response of longitudinal, radial, and circumferential function. Our data suggest that echocardiographic assessment of regional function is feasible and of potential clinical importance.

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Athletes with an ER pattern had significantly higher E/e' ratios, reflecting higher atrial filling pressures, higher LA volume, and higher IL-6 plasma levels. All these factors may contribute to atrial remodeling over time and thus increase the risk of AF in long-term endurance sports.