ECHOCARDIOGRAPHIC EVIDENCE FOR A DIRECT EFFECT OF GH IGF-I HYPERSECRETION ON CARDIAC MASS AND FUNCTION IN YOUNG ACROMEGALICS/

OBJECTIVE The interpretation of echocardiographic abnormalities in acr omegalic patients is complicated by non-specific age-related diseases, many of which are commoner in acromegaly, We have therefore investiga ted the cause-effect relationship between GWIGF-I hypersecretion and p recocious cardiovascular abnormalities in a series of young acromegali c patients. DESIGN An open prospective study. PATIENTS 20 acromegalic patients aged under 30 years, with normal blood pressure and glucose t olerance, and 20 age-matched control subjects, MEASUREMENTS Cardiac mo rphological parameters and indices of systolic and diastolic function at rest were studied by Doppler echocardiography, RESULTS Left ventric ular mass (LVM) and LVM index (LVMI) were higher in acromegalics than in control subjects (215.0 +/- 154g vs 140.8 +/- 8.5g, P = 0.0002 and 109 8 +/- 5.9g/m(2) vs 82.1 +/-:3.7g/m(2), P = 0.0008, respectively), reaching values of left ventricular hypertrophy in 4 patients (20%), B oth ejection fraction and fractional shortening were normal(66.4 +/- 2 .1% vs 62.2 +/-1.9% and 37.5 +/- 5% vs 35.8 +/-1.3%, respectively), in dicating normal left ventricular systolic function, Abnormalities of l eft and right diastolic ventricular filling were found, which consiste d of an increased isovolumic relaxation time (99.2 +/- 2.7 ms vs 89.0 +/- 2.7ms, P = 0.01) and impaired mitral and tricuspidal flow velocity curves, CONCLUSIONS An increase in cardiac mass and subclinical biven tricular diastolic dysfunction were observed in young acromegalic pati ents, These findings argue for a direct cause-effect relationship betw een GH/IGF-I hypersecretion and myocardial abnormalities, and indicate that careful cardiological evaluation is mandatory in all acromegalic s, whatever their age.