van der Klaauw Agatha A, Bax Jeroen J, Smit Johannes W A, Holman Eduard R, Delgado Victoria, Bleeker Gabe B, Biermasz Nienke R, Roelfsema Ferdinand, Romijn Johannes A, Pereira Alberto M
Departments of Endocrinology, C4-R, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands.
Eur J Endocrinol. 2008 Aug;159(2):97-103. doi: 10.1530/EJE-08-0138. Epub 2008 May 21.
The clinical manifestations of acromegalic cardiomyopathy include arrhythmias, valvular regurgitation, concentric left ventricular (LV) hypertrophy, and LV systolic and diastolic dysfunction. At present, it is unknown whether acromegaly also affects the aortic root.
Aortic root diameters were prospectively assessed in 37 acromegalic patients (18 patients with active disease and 19 with controlled disease) by conventional two-dimensional and Doppler echocardiography before, and after, an observation period of 1.9 years (range 1.5-3.0 years). Baseline parameters were compared with healthy controls.
The diameters of the aortic root at the sino-tubular junction and the ascending aorta were increased in patients with acromegaly: 30+/-4 vs 26+/-3 mm (P=0.0001) and 33+/-5 vs 30+/-4 mm (P=0.006) respectively. The diameter of the aortic root at the aortic annulus and aortic sinus were not different from controls. During follow-up, the aortic root diameters increased at the levels of the annulus and the sinotubular junction (P=0.025 and P=0.024 respectively), whereas there was no change in the diameters at the levels of the sinus and the ascending aorta during follow-up. Baseline aortic root diameters were not influenced by disease duration, current disease activity, or blood pressure. When patients with active and inactive disease were analyzed separately, only the diameter of the sinotubular junction increased in patients with inactive acromegaly during follow-up (P=0.031).
Aortic root diameters are increased in patients with acromegaly compared with healthy controls.
肢端肥大症性心肌病的临床表现包括心律失常、瓣膜反流、左心室（LV）向心性肥厚以及LV收缩和舒张功能障碍。目前，尚不清楚肢端肥大症是否也会影响主动脉根部。
通过传统二维和多普勒超声心动图，对37例肢端肥大症患者（18例疾病活动期患者和19例疾病控制期患者）在1.9年（范围1.5 - 3.0年）的观察期前后进行主动脉根部直径的前瞻性评估。将基线参数与健康对照进行比较。
肢端肥大症患者的窦管交界处和升主动脉的主动脉根部直径增加：分别为30±4 vs 26±3 mm（P = 0.0001）和33±5 vs 30±4 mm（P = 0.006）。主动脉瓣环和主动脉窦处的主动脉根部直径与对照组无差异。随访期间，主动脉瓣环和窦管交界处的主动脉根部直径增加（分别为P = 0.025和P = 0.024），而随访期间窦部和升主动脉水平的直径无变化。基线主动脉根部直径不受疾病持续时间、当前疾病活动度或血压的影响。当分别分析疾病活动期和非活动期患者时，仅非活动期肢端肥大症患者在随访期间窦管交界处的直径增加（P = 0.031）。
与健康对照相比，肢端肥大症患者的主动脉根部直径增加。
