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Acromegaly: evidence for a direct relation between disease activity and cardiac dysfunction in patients without

Burkhard L Herrmann1, C Bruch, B Saller

  • 1Department of Internal Medicine, Division of Endocrinology, University of Essen, Hufelandstrasse 55, D-45122 Essen, Germany. burkhard.hermann@uni-essen.de

Clinical Endocrinology
|May 29, 2002
PubMed

Insights

Active acromegaly impairs diastolic function in patients with normal left ventricular mass. Tissue Doppler imaging and the Tei-Index can detect this dysfunction, which is linked to disease activity.

Area of Science:

  • Cardiology
  • Endocrinology
  • Echocardiography

Background:

  • Acromegaly frequently causes cardiac abnormalities, including left ventricular (LV) hypertrophy and heart failure.
  • Previous studies noted systolic and diastolic dysfunction in acromegaly, often linked to LV hypertrophy.
  • The effect of active acromegaly on LV performance in patients with normal or mildly increased LV mass was not well-defined.

Purpose of the Study:

  • To investigate the impact of active acromegaly on left ventricular (LV) performance.
  • To assess diastolic function in patients with active acromegaly and normal or slightly elevated LV mass.
  • To evaluate the utility of tissue Doppler imaging (TDI) and the myocardial performance index (Tei-Index) in detecting cardiac dysfunction in acromegaly.

Main Methods:

  • Conventional 2D/Doppler echocardiography and TDI of the mitral annulus were used.
  • 13 patients with active acromegaly (AA), 19 cured/controlled patients (CA), and 21 healthy controls (CON) were studied.
  • The combined myocardial performance index (Tei-Index) was calculated for all participants.

Main Results:

  • Early diastolic annular velocity (ET) and the ET/AT ratio were significantly reduced in the AA group compared to CA and CON.
  • Patients with active acromegaly showed a prolonged deceleration time.
  • The Tei-Index was significantly higher in the AA group than in controls, indicating impaired myocardial performance.

Conclusions:

  • Diastolic dysfunction is detectable by TDI in active acromegaly patients with normal or mildly increased LV mass.
  • This diastolic dysfunction appears directly related to acromegaly disease activity.
  • The Tei-Index is a sensitive tool for assessing both systolic and diastolic LV function in acromegalic patients.
Abstract

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