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Published on: December 11, 2017
Left ventricular synchronicity is impaired in patients with active acromegaly
Abdulkadir Kırış1, Cihangir Erem, Oğuzhan Ekrem Turan
1Department of Cardiology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey. akiris79@yahoo.com
Insights
Acromegaly patients exhibit impaired left ventricular (LV) synchronicity, showing increased LV dyssynchrony. This cardiac dysfunction is linked to disease activity and may worsen cardiovascular complications in acromegaly.
Area of Science:
- Cardiology
- Endocrinology
- Medical Imaging
Background:
- Acromegaly, a disorder caused by excess growth hormone, is linked to cardiovascular issues including hypertension and heart dysfunction.
- Left ventricular (LV) dyssynchrony, a loss of simultaneous contraction in cardiac segments, is a potential contributor to these cardiovascular problems.
Purpose of the Study:
- To investigate the presence and extent of left ventricular dyssynchrony in patients with active acromegaly.
- To compare LV dyssynchrony parameters between acromegalic patients and healthy controls.
Main Methods:
- Tissue Synchronization Imaging (TSI) was used to evaluate dyssynchrony.
- Thirty patients with active acromegaly and 30 controls underwent TSI measurements.
- Four specific TSI parameters quantifying systolic dyssynchrony were computed for the LV.
Main Results:
- Patients with acromegaly demonstrated significantly increased LV dyssynchrony across all measured TSI parameters compared to controls.
- Specific findings include higher standard deviation of time to peak systolic velocity (Ts) in 12 LV segments and basal segments, and greater maximal differences in Ts.
- A significant correlation was observed between growth hormone/IGF-1 levels and LV dyssynchrony (Ts-SD-12).
Conclusions:
- Left ventricular synchronicity is impaired in patients with acromegaly.
- LV dyssynchrony is associated with acromegaly disease activity.
- LV dyssynchrony may play a role in the adverse cardiovascular effects observed in acromegaly.
Abstract:
Acromegaly is associated with a variety of cardiovascular disturbances such as left ventricular hypertrophy, diastolic cardiac dysfunction, and hypertension. Left ventricular (LV) dyssynchrony means the impairment of synchronicity and is defined as the loss of the simultaneous peak contraction of corresponding cardiac segments. The objective of this study was to investigate whether acromegalic patients have left ventricular dyssynchrony. Dyssynchrony was evaluated in 30 patients with active acromegaly and 30 controls. All the patients and controls were subjected to a tissue synchronization imaging. The time to regional peak systolic tissue velocity (Ts) in LV by the six-basal-six-mid-segmental model was measured on ejection phase TSI images and four TSI parameters of systolic dyssynchrony were computed. All TSI parameters of LV dyssynchrony increased in patients with acromegaly compared to the controls: the standard deviation (SD) of the 12 LV segments Ts (43.5 ± 13.5 vs 26.2 ± 12.5, p < 0.001); the maximal difference in Ts between any 2 of the 12 LV segments (133.3 ± 38 vs 84.6 ± 37.6, p < 0.001); the SD of the 6 basal LV segments (41.1 ± 15.9 vs 25.4 ± 14.8, p = 0.001); and the maximal difference in Ts between any 2 of the 6 basal LV segments (102.6 ± 37.5 vs 65.2 ± 36.9, p = 0.001). In addition, there were significant relationships between the levels of growth hormone/insulin-like growth factor-1 and Ts-SD-12. LV synchronicity has been impaired in patients with acromegaly. Left ventricular dyssynchrony is associated with disease activity and it may contribute to the harmful cardiovascular effects of acromegaly.
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