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.

Journal of Clinical Medicine
|September 28, 2024
PubMed

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.

Related Concept Videos

Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
1
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
3
Mitral Regurgitation I: Introduction01:20

Mitral Regurgitation I: Introduction

Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
4
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
1
Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
2
Imbalances in Cardiac Output01:26

Imbalances in Cardiac Output

The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
1.4K