Abstract
Cardiac abnormalities are the most common and deadly comorbidities of acromegaly. Assessments using cardiac magnetic resonance (CMR) imaging in acromegaly patients are rare. We aimed to evaluate the frequencies of left ventricular hypertrophy (LVH), interventricular septum hypertrophy (IVSH), LV systolic dysfunction (LVSD), right ventricular systolic dysfunction (RVSD), and myocardial fibrosis (MCF) and detailed quantitative parameters in acromegaly patients using CMR and analyze their correlations with clinical features. Sixty-one patients were enrolled in this study. The rates of LVH, IVSH, LVSD, RVSD, and MCF were 26.2%, 27.9%, 8.2%, 9.8%, and 14.8%, respectively. The average LV mass, LV mass index, IVS thickness, LV and RV free wall thickness, and LV and RV ejection fractions were 114.4 g, 60.0 g/m2, 9.6 mm, 7.2 mm, 2.9 mm, 59.9%, and 56.6%, respectively. The LV mass index was larger (68.9 ± 26.0 vs. 48.8 ± 10.6 g/m2), the IVS was thicker (10.3 ± 2.8 vs. 8.8 ± 1.8 mm), and the LV (57.6 ± 12.3% vs. 62.8 ± 4.8%) and RV ejection fractions (54.6 ± 8.7% vs. 59.2 ± 5.9%) were lower in male patients than in female patients (all p < 0.05). Age, body mass index (BMI), disease duration, and hypertension were associated with cardiac abnormalities (all p < 0.05). In conclusion, structural and functional cardiac abnormalities can be comprehensively evaluated by CMR in acromegaly patients. Gender greatly affects the presence of cardiac abnormalities. Age, BMI, disease duration, and hypertension but not GH or IGF-1 levels are associated clinical factors.
Highlights
Is a chronic neuroendocrine disease that is usually caused by pituitary adenoma and characterized by elevated growth hormone (GH) and insulin-like growth factor 1 (IGF-1) levels in serum [1]
We aimed to evaluate the frequencies of left ventricular hypertrophy (LVH), interventricular septum hypertrophy (IVSH), LV systolic dysfunction (LVSD), right ventricular systolic dysfunction (RVSD), and myocardial fibrosis (MCF) and detailed quantitative parameters in acromegaly patients using Cardiac magnetic resonance (CMR) and analyze their correlations with clinical features
Five previous studies have used the gold standard, CMR, to evaluate cardiac abnormalities in acromegaly patients (Table 5) [13,14,15,16,17]. e 2010 study by Bogazzi et al [22] is not included in Table 5 because the patient sample was the same as that included in the study conducted by the same authors in 2008 [13]. e CMR results for acromegaly patients varied among different studies. e 2008 study by Bogazzi et al [13] was the first study to demonstrate that the frequency of LVH in acromegaly patients was 72% as evaluated by CMR. is frequency was much higher than 36% as detected by echocardiography in the same group, and the frequencies of MCF and LVSD were both 0% [13]
Summary
Is a chronic neuroendocrine disease that is usually caused by pituitary adenoma and characterized by elevated growth hormone (GH) and insulin-like growth factor 1 (IGF-1) levels in serum [1]. Elevated hormone levels and increased cardiac risk factors, including obesity, hypertension, diabetes, and hyperlipemia, first cause and aggravate heart abnormalities, which are the most common comorbidity observed in acromegaly patients [2,3,4]. Cardiac comorbidities are responsible for approximately 60% of deaths in acromegaly patients, in whom echocardiography is the method most frequently used to assess changes in cardiac structure and function [4, 5]. CMR is considered the “gold standard” for assessing myocardial mass, heart chamber volume, and ventricular systolic function [8,9,10,11]. Cardiac evaluation by CMR has the potential to detect some secluded or deadly heart diseases that are difficult to detect using echocardiography in acromegaly patients
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