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Acromegaly: The Relationship between Hemodynamic Profiles Assessed via Impedance Cardiography and Left Ventricular
Agnieszka Włochacz1, Paweł Krzesiński1, Beata Uziębło-Życzkowska1
1Department of Cardiology and Internal Medicine, Military Institute of Medicine, National Research Institute, 01-982 Warsaw, Poland.
Insights
In acromegaly patients, impaired heart pump function and increased afterload, measured by impedance cardiography, correlate with poorer systolic function detected by echocardiography. This highlights cardiovascular risks associated with growth hormone excess.
Area of Science:
- Cardiology
- Endocrinology
- Medical Imaging
Background:
- Acromegaly involves prolonged exposure to growth hormone and IGF-1, potentially causing cardiovascular complications.
- Assessing cardiovascular effects in acromegaly is crucial for patient management.
Purpose of the Study:
- To investigate the correlation between hemodynamic parameters from impedance cardiography (ICG) and left ventricular systolic function assessed by echocardiography in acromegaly patients.
- To understand the impact of acromegaly on cardiac function and vascular load.
Main Methods:
- An observational cohort study included 33 newly diagnosed acromegaly patients without significant comorbidities.
- Spearman's rank correlation analysis was used to compare ICG-derived indices (cardiac function, afterload, thoracic fluid content) with echocardiography-derived left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS).
Main Results:
- Lower LVEF correlated with reduced stroke volume index (SI) and increased systemic vascular resistance index (SVRI).
- Poorer GLS showed significant associations with lower SI, cardiac index (CI), velocity index (VI), acceleration index (ACI), Heather index (HI), and total arterial compliance index (TACI), alongside higher SVRI.
- No significant correlation was found between LVEF or GLS and thoracic fluid content (TFC).
Conclusions:
- In acromegaly, diminished echocardiographic systolic function parameters are linked to impaired cardiac pump function and elevated afterload, as indicated by ICG.
- ICG provides valuable insights into the hemodynamic alterations associated with acromegaly-induced cardiac dysfunction.
Abstract:
Background/Objectives: Acromegaly-induced prolonged exposure to growth hormone and insulin-like growth factor 1 may have significant cardiovascular effects. The purpose of this study was to assess the relationship between hemodynamic parameters measured via impedance cardiography (ICG) and parameters of systolic left ventricular function measured via echocardiography in patients with acromegaly. Methods: The observational cohort study included 33 patients with newly diagnosed acromegaly, with a mean age of 47 years and without significant comorbidities. Correlation analysis (Spearman's rank correlation coefficient R) was performed on parameters obtained by ICG and left ventricular systolic function parameters obtained by echocardiography. ICG assessment included indices of (1) cardiac function as a pump: stroke volume index (SI), cardiac index (CI), Heather index (HI), velocity index (VI), and acceleration index (ACI); (2) afterload: systemic vascular resistance index (SVRI) and total arterial compliance index (TACI); and (3) thoracic fluid content (TFC). Echocardiographic examinations evaluated left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS). Results: A lower LVEF was associated with a lower SI (R = 0.38; p = 0.03) and a higher SVRI (R = -0.35; p = 0.046), whereas lower GLS was associated with lower SI (R = 0.43; p = 0.02), CI (R = 0.62; p < 0.001), VI (R = 0.59; p < 0.001), ACI (R = 0.38; p = 0.048), HI (R = 0.59; p < 0.001), and TACI (R = 0.50; p = 0.006) and a higher SVRI (R = -0.59; p < 0.001). No significant correlation was observed between either LVEF or GLS and TFC. Conclusions: In patients with acromegaly, poorer echocardiographic parameters of left ventricular systolic function are associated with impaired function of the heart as a pump and higher afterload as assessed via ICG.
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