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Relation of endocrine and cardiac findings in acromegalics
1III, Department of Medicine, Johannes Gutenberg University Hospital, Mainz, FRG.
Insights
Acromegaly patients exhibit increased ventricular arrhythmia and left ventricular hypertrophy compared to healthy individuals. The duration of acromegaly, not hormone levels, correlates with these cardiac changes.
Area of Science:
- Cardiology
- Endocrinology
Background:
- Acromegaly, a condition caused by excess growth hormone, is associated with cardiovascular complications.
- Cardiac involvement is a significant concern in acromegaly patients.
Purpose of the Study:
- To investigate cardiac involvement in acromegaly patients.
- To compare the prevalence and severity of arrhythmias and cardiac structural changes in acromegaly patients versus controls.
Main Methods:
- Evaluated 32 acromegaly patients and 50 healthy controls.
- Utilized stress electrocardiography (ECG), 24-hour Holter monitoring, and echocardiography.
- Assessed endocrine parameters, clinical scores, and disease duration.
Main Results:
- Acromegaly patients showed significantly higher prevalence and severity of ventricular arrhythmia compared to controls (48% vs 12%).
- Repetitive ventricular arrhythmia was more common in acromegaly patients (31% vs 8%).
- Ventricular arrhythmia frequency increased with disease duration and correlated with left ventricular mass and clinical activity score, but not hormone levels. Left ventricular hypertrophy was observed in acromegaly patients.
Conclusions:
- Acromegaly patients exhibit increased frequency and complexity of ventricular arrhythmias and left ventricular hypertrophy.
- Disease duration appears to be a more critical factor than hormone levels in the development of these cardiac abnormalities.
Abstract:
Cardiac involvement in 32 acromegalics was related to endocrine parameters, clinical score and duration of the disease as well as compared to that of 50 controls free of cardiac disease. Stress ECG, 24h Holter monitoring and echocardiography revealed that supraventricular premature complexes did not occur more often in acromegalics than in controls, both prevalence and severity of ventricular arrhythmia, however, were higher in patients compared to controls: 15/32 (48%) acromegalics had complex ventricular arrhythmia as compared with 6/50 (12%) normal subjects (p less than 0.01). Repetitive ventricular arrhythmia was manifest in 10/32 (31%) patients but only in 4/50 (8%) controls (p less than 0.01). Furthermore, frequency of ventricular premature complexes increased with duration of acromegaly (p less than 0.01), the severity of the former being correlated with left ventricular mass and with clinical activity score (p less than 0.01). No correlation, however, was found between the degree of ventricular arrhythmia and hormone levels. Left ventricular muscle mass was increased (p less than 0.02) due to concentric hypertrophy. Thus, compared to controls, acromegalics show more frequent and complex ventricular arrhythmia and left ventricular hypertrophy. Duration of the disease rather than hormone levels seems to be relevant for these pathological changes.