Picó Alfonso A A M, Martínez Martínez J G, Domínguez Escribano J R, Climent Payá V E, Pineda Rocamora J, Soborg Garri F
Servicio de Cardiología. Hospital General de Alicante. Sección de Endocrinología. Hospital General de Alicante y Hospital Clínico de San Juan de Alicante.
Rev Esp Cardiol. 2001 Jan;54(1):37-42. doi: 10.1016/s0300-8932(01)76262-8.
Left ventricle impairment is very common in acromegaly. Concentric hypertrophy and diastolic dysfunction are observed at an early stage. Late left ventricle dilatation with systolic dysfunction may appear. Few reports have studied right ventricle diastolic function.
Twenty-seven acromegalic patients were included. Biventricular diastolic function was assessed using Doppler-echocardiography. Possible associations with hormonal activity, evolution time of illness, hypertension, left ventricular hypertrophy and systolic impairment on echocardiography were studied.
Fifteen patients showed left ventricular diastolic dysfunction, whereas thirteen patients showed right ventricular diastolic dysfunction. A good correlation was observed between E/A relation of both ventricles (r = 0.70; p < 0.01) and isovolumetric relaxation time (r = -0.60; p < 0.01). The right ventricular E/A relation correlated with left ventricular mass index and significance was almost achieved with the presence of hypertension. There was no statistical correlations between the right ventricular E/A relation and hormone values or evolution time of illness. The left ventricular E/A relation showed a significant association with left ventricular mass index, isovolumetric time index and evolution time of illness. There were no statistical association with hormone values.
The high prevalence of right ventricular diastolic dysfunction observed in acromegaly suggests the presence of acromegalic myocardiopathy.
左心室功能损害在肢端肥大症中非常常见。早期可观察到向心性肥厚和舒张功能障碍。后期可能出现左心室扩张伴收缩功能障碍。很少有报告研究右心室舒张功能。
纳入27例肢端肥大症患者。使用多普勒超声心动图评估双心室舒张功能。研究了与激素活性、病程、高血压、左心室肥厚以及超声心动图上的收缩功能损害之间可能存在的关联。
15例患者出现左心室舒张功能障碍，而13例患者出现右心室舒张功能障碍。观察到两个心室的E/A比值之间存在良好的相关性（r = 0.70；p < 0.01）以及等容舒张时间之间存在良好的相关性（r = -0.60；p < 0.01）。右心室E/A比值与左心室质量指数相关，并且在存在高血压时几乎达到显著水平。右心室E/A比值与激素值或病程之间无统计学相关性。左心室E/A比值与左心室质量指数、等容时间指数和病程之间存在显著关联。与激素值无统计学关联。
在肢端肥大症中观察到的右心室舒张功能障碍的高患病率提示存在肢端肥大性心肌病。
