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Heart failure in 3 patients with acromegaly: echocardiographic assessment
J Aono1, S Nobuoka, J Nagashima
1Second Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa.
Insights
Acromegaly can cause heart failure due to acromegalic cardiomyopathy, presenting echocardiographic findings similar to idiopathic dilated cardiomyopathy in patients without hypertension or coronary artery disease.
Area of Science:
- Cardiology
- Endocrinology
Background:
- Acromegaly, a condition caused by excess growth hormone, can lead to various cardiovascular complications.
- Heart failure is a serious manifestation that requires thorough investigation of its underlying cause.
Observation:
- Three patients with acromegaly presented with heart failure.
- Two patients had heart failure attributed to acromegalic cardiomyopathy.
- One patient possibly had heart failure due to a combination of acromegalic and familial hypertrophic cardiomyopathy.
Findings:
- Common echocardiographic findings included left atrial enlargement, dilated left ventricle with hypokinesis, and reduced systolic function.
- Notably, left ventricular hypertrophy was absent in these cases.
- Echocardiographic features in acromegaly-associated heart failure mimicked idiopathic dilated cardiomyopathy.
Implications:
- These findings highlight the importance of considering acromegalic cardiomyopathy in patients with heart failure, especially in the absence of traditional risk factors.
- Understanding these specific echocardiographic patterns can aid in accurate diagnosis and management of acromegaly-related cardiac dysfunction.
Abstract:
We evaluated 3 patients with acromegaly who developed heart failure. Heart failure appeared to be due to acromegalic cardiomyopathy in 2 patients who did not have hypertension or evidence of coronary artery disease, and it was possibly due to acromegalic cardiomyopathy combined with familiar hypertrophic cardiomyopathy in 1 patient. The common echocardiographic findings in the present three cases were: 1) enlargement of the left atrium, 2) markedly dilated left ventricular cavity with diffuse hypokinesis, 3) decrease of indices of the left ventricular systolic function, and 4) no evidence of left ventricular hypertrophy. Echocardiographic findings in acromegaly with congestive heart failure resemble those of idiopathic dilated cardiomyopathy.