Aortic root ectasia in patients with acromegaly: experience at a single center

Acromegaly is associated with increased cardiovascular mortality, and increased aortic root diameter has been recently described in the literature as a possible feature of acromegalic cardiomyopathy.

To assess the aortic root diameter and the prevalence of aortic ectasia in acromegalic patients.

This paper presents a transversal analysis of 42 acromegalic patients by Doppler echocardiogram and comparison with 42 age, sex, body surface area and hypertension matched controls.

The mean aortic root diameter at the level of the aortic leaflets was increased in acromegalic patients when compared to controls (3·4 ± 0·5 vs 2·9 ± 0·4 cm, respectively, P < 0·0001). The aortic root diameter was significantly greater in men than in women (3·6 ± 0·6 cm vs 3·2 ± 0·4 cm, respectively, P = 0·004), and the left ventricular mass index was positively correlated with the diameter of the aorta (r = 0·37, P = 0·01). Using a cut-off point ≥ 3·8 cm, an aortic ectasia prevalence of 26·1 vs 2·3% was found in acromegalic patients and controls, respectively (P = 0·002). Only acromegaly was associated with aortic ectasia (P = 0·01).

The aortic root diameter was higher, and the prevalence of aortic ectasia was more common in acromegalic patients than in controls. In addition, only acromegalic disease was associated with aortic ectasia, suggesting the direct effects of GH and insulin-like growth factor-I excess on the cardiovascular system.