Background: Cardiac resynchronization therapy (CRT) is an established treatment for heart failure with reduced ejection fraction (HfrEF). Etiology may influence the outcome of patients undergoing CRT. Objective: to evaluate whether etiology (ischemic vs non-ischemic) influences the response to CRT and overall outcome. Methods: Our study included HFrEF patients undergoing CRT between January 2017-November 2019. We assessed right ventricle (RV) and left ventricle (LV) function using transthoracic echocardiography at baseline and one year after CRT. The response to CRT was defined by a decrease of more than 15% of left ventricle systolic volume. Patients were divided in two groups: ischemic and non-ischemic based on personal history. Adverse events (HF related hospitalizations and deaths) were tracked for 33± 12.8 months. Results: 52 patients undergoing CRT were included (64±13.5 years, 55.7% male, 70% non-ischemic etiology) The two groups were similar considering LV systolic baseline parameters and volumes. Ischemic etiology was associated with non-LBBB morphology on ECG (p=0.03), a more severe LV diastolic dysfunction using E/e ratio (p<0.05), and a more severe RV dysfunction using TAPSE (p=0.008) and RV fractional area change (FAC) (p<0.05). There was no significant difference in CRT response between ischemic and non-ischemic etiology. 14 (26.9%) patients had events (10 hospitalizations and 4 deaths) with a higher prevalence in the ischemic group (58.33% vs 25%, p=0.01). Univariate Cox regression analysis reported a higher risk of cardiovascular events for ischemic etiology (HR 2.4, 95% CI [0.8-8.1], p <0.05). In our cohort there was no significant difference in use of an implantable cardioverter-defibrillator in addition to CRT between ischemic and non-ischemic group (64.2% respectively 63.3%, p =0.3). Conclusion: Our study shows that ischemic and non-ischemic HF patients had similar response to CRT. However, ischemic etiology was associated with a higher risk of adverse cardiovascular events and a worse RV systolic dysfunction at baseline.

Craniopharyngiomas are rare tumors developed in the area of the sella turcica and especially the suprasellar region. Despite their benign histological nature they are locally aggressive and surgical intervention is a major challenge due to the risk of damaging critical neural and vascular neighbouring structures. Objective: To study the postsurgical evolution of craniopharyngioma in adults after total or partial surgical resection. Material and methods: We performed a retrospective review of adult craniopharyngioma patients evaluated and followed up in the Pituitary Diseases Department of the National Institute of Endocrinology in Bucharest between 1998 and 2018. Results: A total of 60 patients (39.62±15.6 years-old) diagnosed with craniopharyngioma were included. All underwent initial surgery (68.3 % transcranial, 31.7% transsphenoidal approach). Gross total resection (GTR) was achieved in 21 cases (35%), in all the others partial resection was obtained (non-GTR). Immediate non-threatening postsurgical complications were anosmia (in 2 cases), cerebrospinal fluid-CSF leak (3 cases), subdural hematoma (2 cases). After surgery 13 cases (21.66%) had cognitive impairment (2 with GTR, 11 with non-GTR), 14 (23.3%) had hypothalamic syndrome (diurnal sleepiness, appetite and memory dysfunction- present in 1 case with GTR, 13 with non-GTR), 27 cases (45%) reported lethargy (7 GTR, 20 non-GTR), 24 (40%) complained of headaches (6 GTR, 18 nonGTR). All these complications were signifi cantly more frequent in cases with incomplete tumor resection compared to those with GTR: p= 0.000; 0.000; 0.036 and 0.009, respectively. Conclusions: Craniopharyngioma as well as its treatment are associated with very significant morbidity. Aggressive surgical resection with the aim of GTR is possible in a signifi cant percentage of cases and if it is carefully considered in view of the surgically perceived risk of neurologic injury it is associated with lower postsurgical morbidity.

Pituitary adenomas are benign neoplasms originating in the anterior pituitary cells, that represent 15-20% of all intracranial tumors. Pituitary adenomas (PA) can be secreting (producing growth hormone-GH, prolactin-PRL, adrenocor-ticotropic hormone-ACTH or, very rarely gonadotro-pins-FSH and LH or thyrotropic hormone TSH) or non-secreting (NPA). [...]