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The right atrium in acromegaly-a three-dimensional speckle-tracking echocardiographic analysis from the MAGYAR-Path
Árpád Kormányos1, Anita Kalapos1, Péter Domsik1
12nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.
Insights
Acromegaly significantly impacts right atrial (RA) function, with enhanced RA function observed in patients. These cardiac changes, particularly in active acromegaly, appear partially reversible with treatment.
Area of Science:
- Cardiology
- Endocrinology
- Medical Imaging
Background:
- Acromegaly, a rare hormonal disorder caused by excess human growth hormone (hGH), frequently leads to cardiovascular complications like hypertension and cardiomyopathy.
- Left ventricular hypertrophy and myocardial fibrosis are common in acromegaly, potentially causing severe heart failure.
Purpose of the Study:
- To quantify right atrial (RA) morphology and function in acromegaly patients using three-dimensional speckle-tracking echocardiography (3DSTE).
- To investigate the relationship between RA function and hormonal status in acromegaly.
Main Methods:
- The study included 30 acromegaly patients (22 analyzed) and 44 healthy controls.
- Complete two-dimensional Doppler echocardiography and 3DSTE were performed on all participants.
- RA volumetric parameters and strain analysis were utilized.
Main Results:
- Acromegaly patients exhibited significantly higher RA volumetric parameters (Vmax, Vmin, VpreA) compared to controls.
- RA function appeared enhanced in acromegaly patients, especially those with active disease.
- Significant correlations were found between RA strain parameters and hormonal variables in active acromegaly.
Conclusions:
- Acromegaly significantly affects right atrial function.
- These alterations in RA function seem to be partially reversible with appropriate treatment.
Background:
Acromegaly is a chronic, rare hormonal disease associated with major cardiovascular co-morbidities. The disease, in the majority of the cases, is caused by a benign human growth hormone (hGH) secreting adenoma. Cardiovascular involvement is especially common in acromegalic patients from the most common hypertension to cardiomyopathy. Left ventricular hypertrophy and myocardial fibrosis are considered common findings in acromegalic cardiomyopathy, which might result in severe heart failure at end-stages. It was set out to quantify right atrial (RA) morphology and function in a group of acromegalic patients using three-dimensional (3D) speckle-tracking echocardiography (3DSTE).
Methods:
The study comprised 30 patients from which 8 patients were excluded due to inadequate image quality. Mean age of the remaining acromegaly patients were 53.7±14.5 years (7 males). In the control group 44 healthy adults were enrolled (mean age: 50.7±12.6 years, 15 males). In each case, complete two-dimensional Doppler echocardiography was performed followed by 3DSTE.
Results:
All three RA volumetric parameters (Vmax, Vmin, VpreA) were significantly higher in case of acromegaly compared to the healthy controls. Strain analysis revealed that RA function may be enhanced in acromegalic patients, which is more notable in case of active acromegaly. Numerous independent strain parameters had significant correlations with different hormonal variables in the active acromegaly group. These correlations were not present in the inactive acromegaly subgroup.
Conclusions:
Acromegaly has a profound effect on RA function and with proper treatment these changes partly seem to be reversible.
