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Cardiac dysfunction in acromegaly: evidence by pulsed wave tissue Doppler imaging
G Mercuro1, S Zoncu, P Colonna
1Department of Cardiovascular Sciences, Department of Medical Sciences, University of Cagliari, Cagliari, Italy. mercuro@pacs.unica.it
European Journal of Endocrinology
|October 7, 2000
Summary
Pulsed-wave tissue Doppler imaging (PWTDI) reveals early systolic dysfunction in acromegalic cardiomyopathy, challenging previous beliefs about preserved systolic function. This advanced echocardiography technique offers greater sensitivity for detecting regional myocardial abnormalities.
Area of Science:
- Cardiology
- Endocrinology
- Medical Imaging
Background:
- Acromegalic cardiomyopathy is characterized by diastolic dysfunction.
- The natural history and early functional changes in acromegaly require further investigation.
- Conventional echocardiography may not fully capture subtle myocardial impairments.
Purpose of the Study:
- To evaluate the utility of pulsed-wave tissue Doppler imaging (PWTDI) in assessing myocardial function in acromegaly.
- To understand the natural history of acromegalic cardiomyopathy using advanced echocardiographic techniques.
- To investigate early systolic and diastolic dysfunction in patients with active acromegaly.
Main Methods:
- Pulsed-wave tissue Doppler imaging (PWTDI) was performed on 18 patients with active acromegaly and 13 healthy controls.
- Conventional echocardiographic parameters including ejection fraction (EF), E/A ratio, and isovolumic relaxation time (IVRT) were measured.
- PWTDI provided measurements of systolic peak velocity (Sv), early (Ev) and late (Av) diastolic peak velocities, Ev/Av ratio, and regional IVRT (IVRTs).
Main Results:
- Patients with acromegaly exhibited prolonged global IVRT, indicating diastolic dysfunction.
- PWTDI revealed prolonged regional IVRTs and an inverted Ev/Av ratio, consistent with diastolic dysfunction.
- A significant negative correlation was found between the Ev/Av ratio and IVRT, but not the E/A ratio.
- Reduced Sv was observed in the basal lateral wall, correlating with the severity of diastolic dysfunction.
- Impaired regional systolic function was detected by PWTDI despite normal ejection fraction.
Conclusions:
- PWTDI confirms diastolic dysfunction in acromegalic cardiomyopathy with higher sensitivity than global Doppler indices.
- Regional PWTDI is more sensitive in detecting diastolic dysfunction compared to global measures.
- PWTDI identified regional systolic dysfunction in acromegaly patients with normal EF, contradicting the established view of preserved systolic function in early stages.