IMPAIRED CARDIAC-PERFORMANCE IS A DISTINCT FEATURE OF UNCOMPLICATED ACROMEGALY

This study was designed to assess right and left ventricular function in patients with active acromegaly. To this end, 26 acromegalic patien ts (9 of whom had arterial hypertension) and 15 normal subjects of com parable age and sex distribution were studied by radionuclide angiogra phy at rest and during supine bicycle-ergometer exercise and echocardi ography. At rest, the filling rates of left (-19%; P < 0.005) and righ t ventricle (-32%; P < 0.001) were significantly reduced in acromegali c patients, whereas right and left ventricle ejection fractions (EFs) were normal. During physical exercise, EF was considerably lower in th e acromegalic patients than in controls. This was true for both left, (61 +/- 11% us. 75 +/- 8%; P < 0.001) and right ventricle (45 +/- 13 v s. 58 +/- 11%; < 0.002). In as many as 73% of patients, EF increased l ess than 5%, thus fulfilling the criteria for impaired cardiac perform ance. Left ventricular mass index was 60% greater in acromegalics than in controls (P < 0.001). A significant difference in left ventricular mass index was also present when normotensive acromegalic patients we re compared with controls (P < 0.001). No significant difference in th e indices of systolic and diastolic function was observed between the subgroups of normotensive and hypertensive acromegalics, either at res t or during exercise. The data demonstrate that in uncomplicated acrom egaly, besides cardiac hypertrophy, there are also important alteratio ns of systolic and diastolic function of both ventricles, leading to a significant impairment of cardiac performance.