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Acromegaly (AKRO) caused the left ventricular hypertrophy (LVH). LV systolic function measured by conventional EF or FS in patients with LVH is almost always normal in spite of adverse prognosis of LVH. Therefore, LV midwall FS (mwFS) should be used in patients with increased wall thickness for the assessment of LV systolic performance. End-systolic stress ESS is a major determinant of overall left ventricular performance. Ultrasonic myocardial tissue characterization by integrated backscatter (IBS) has been successfully used for the differentiation of various myopathies from normal myocardium.The aim of study was evaluation of left ventricular wall stress and midwall mechanics in patient with acromegaly.Objective and methods: Study group: 44 patients with acromegaly (AKRO) (24 female; age 53±15 years). Control group: 44 patients with arterial hypertension (HA) (22 female; age 59±11years) and 44 patients with aortic stenosis (AS) (20 female; age 65±8,7). Standard echocardiographic examination were performed. Cyclic variation of IBS (CVIBS) and end-diastolic IBS (IBSed) intensity were evaluated and averaged (CVIBS mean, IBSed mean).Results: For entire group of 132 patients CVIBS mean directly and significantly correlated with mwFS (r-0,25;p<0,05) and significantly and indirectly with ESS (r=-0,54, p<0,05), There was no significant correlation with conventional EF and FS. IBSed mean directly and significantly correlated with with ESS (r=0,28, p<0,05). There was no significant correlation with conventional EF, FS and mwFS. 61% patients has an elevated ESS. CVIBS mean was significantly lower in this subgroup compare to patients with normal end-systolic wall stress (7,5±2,3dB vs 8,7±1,8dB, p<0,001).Conclusion: 1. Conventional systolic function parameter (EF and FS) and wall stress and midwall function indices were in normal range in patients with acromegaly. 2. Ultrasonic tissue characterization by CVIBS could be reliable parameter of overall left ventricular performance in patients with LVH and acromegaly.