DOPPLER-ECHOCARDIOGRAPHIC PATTERNS IN PATIENTS WITH ACROMEGALY

Cardiovascular problems have long been recognized as responsible for a n increased morbidity and mortality in patients with acromegaly. The a im of the present study was to evaluate echocardiographically the prev alence of cardiomyopathy in a cohort of acromegalic patients and to an alyze the results in relation to demographic, clinical and hormonal da ta. This study, a retrospective controlled clinical trial, was perform ed in 25 acromegalic patients, 12 men and 13 women aged 26-66 years (m ean: 52.6). Fifteen patients had an active disease, 10 were cured by p revious pituitary surgery. The same echocardiographic parameters were analyzed in 50 healthy subjects aged 30-70 years (mean: 51.4). Serum G H was determined on at least 4 samples drawn over 24 hours and plasma IGF-1 on a single point. Standardized parameters of diastolic and syst olic function were evaluated by real-time Doppler echocardiography. Tw elve patients with active acromegaly underwent also 48-hour ECG regist ering. Left ventricular (LV) hypertrophy was found in 14/25 patients ( 56%). No difference was found between patients with active disease (53 %) and patients with cured acromegaly (60%). LV mass index was signifi cantly increased in acromegalics in comparison with healthy subjects ( 137 +/- 43 g/m(2) vs 96 +/- 16 g/m(2), p< 0.01) and also the indices o f LV diastolic function were significantly impaired. Asymmetric septal hypertrophy was found only in one patient. Hypertension was detected in 9/25 patients (36%) without difference between patients with active or cured disease (40% vs 30%, NS). No significant correlation was fou nd between hormonal or clinical data and echocardiographic findings. D uring Hotter monitoring, heart rate of acromegalics was not significan tly different from that of controls (78 +/- 12 bpm vs 72 +/- 10 bpm, N S) and only isolated supraventricular or ventricular premature complex es (Lown class 1) were detected. In conclusion, this study provides ev idence of subclinical LV dysfunction in acromegaly in the absence of o ther known causes of heart disease and no significant difference in ec hocardiographic pattern was apparent between active or cured acromegal ics.