Acromegalic cardiomyopathy. An echocardiographic study.

Area of Science:

• Cardiology
• Endocrinology
• Internal Medicine

Background:

• Acromegaly, a disorder caused by excess growth hormone (GH), can lead to cardiovascular complications.
• Left ventricular hypertrophy (LVH) is a potential consequence, but its prevalence and determinants in acromegaly require further clarification.

Purpose of the Study:

• To investigate the prevalence of left ventricular hypertrophy (LVH) in acromegalic patients.
• To identify potential determinants of LVH in acromegaly, including blood pressure, GH levels, and disease duration.

Main Methods:

• M-mode (2-D derived) echocardiography was used to assess left ventricular mass (LVM) and cardiac function in 18 acromegalic patients and 18 matched controls.
• Patients were stratified based on hypertension status (BP > 160/95 mmHg).
• Correlations between LVM and various clinical parameters (BP, GH, IGF-1/Sm-C, disease duration) were analyzed.

Main Results:

• A significantly higher LVM was observed in acromegalic patients (183.1 g/m2) compared to controls (130 g/m2).
• LVH (LVM > 140 g/m2) was present in 15 out of 18 acromegalic patients, versus 2 out of 18 controls.
• Concentric LVH was the predominant pattern in acromegalic patients.
• No significant correlation was found between LVM and blood pressure, GH, or IGF-1 levels.
• A significant positive correlation was identified between LVM and the duration of acromegaly (r=0.44, p<0.05).

Conclusions:

• LVH is an early and frequent finding in acromegaly.
• Factors such as body size, blood pressure, and cardiac output do not fully explain the prevalence of LVH.
• Long-term exposure to elevated GH levels appears to be the most significant determinant of LVH in acromegaly, suggesting a crucial role for metabolic factors.