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[Acromegalic cardiomyopathy: an echocardiographic study]
Insights
Acromegaly patients show increased heart muscle thickness and size, particularly with active disease. Echocardiography effectively detects these cardiac changes in acromegaly.
Area of Science:
- Cardiology
- Endocrinology
- Medical Imaging
Context:
- Acromegaly, a condition caused by excess growth hormone (GH), can lead to significant cardiovascular complications.
- Cardiac involvement in acromegaly is common but requires accurate assessment methods.
Purpose:
- To evaluate cardiac structure and function in acromegalic patients using echocardiography.
- To correlate echocardiographic findings with disease activity and duration.
Summary:
- Acromegalic patients exhibited increased left ventricular (LV) wall thickness, LV mass, and left atrial (LA) dimension compared to controls.
- Left ventricular hypertrophy (LVH) was prevalent (79%), with asymmetric septal hypertrophy (ASH) in 10.5%.
- Active acromegaly (elevated GH) correlated with greater LV wall thickness and mass, and these parameters correlated with disease duration.
Impact:
- Echocardiography is a valuable tool for assessing cardiac involvement in acromegaly.
- Findings highlight the structural cardiac changes associated with acromegaly, emphasizing the need for monitoring.
- Understanding these changes aids in managing acromegaly patients and preventing cardiac complications.
Abstract:
Thirty eight acromegalic patients (A) and a control group (C) of subjects without heart disease, were studied with echocardiography. Acromegalies were divided in two groups, A1 and A2, who had increase or normal serum growth hormone (GH) levels respectively after treatment (pituitary adenectomy and/or bromocriptine), at the time of the study. In acromegalic patients (A) mean left ventricular (LV) dimensions were normal while LV wall and septal thickness, LV mass and left atrial (LA) dimension were increased compared to control subjects. LVH was present in 79% of acromegalic patients. Asymmetric septal hypertrophy (ASH) was found in 10,5% of our patients. In group A1, IVS, LVPW, LVMM/m2 were significantly increased as compared to group A2. Fractional shortening (FS), ejection fraction (EF), mean velocity of circumferential fibre shortening (Vcf), frequency-normalized Vcf (Vcfn), posterior left ventricular wall velocity (PWV), and normalized PWV (PWVn) were normal in both groups. In patients with active acromegaly (Al) IVS and LVMM/m2 correlated well with the total duration of the disease (r=0.550 p less than 0.01 for IVS; r=0.624 p less than 0.01 for LVMM/m2) and with the duration of acromegaly before treatment (r=0.568, p less than 0.01 for IVS; r=0.500 p less than 0.01 for LVMM/m2). Furthermore a positive correlation was found between IVS and GH levels (r=0,550 p less than 0.01). Concomitant coronary artery disease and or hypertension did not seem to play any role in causing the above mentioned echocardiographic changes. Echocardiography is useful in assessing the cardiac involvement in patients with acromegaly.