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肢端肥大症患者的主动脉根部扩张:单中心经验。

Aortic root ectasia in patients with acromegaly: experience at a single center.

机构信息

Endocrinology Unit, Hospital Universitário Clementino Fraga Filho/Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.

出版信息

Clin Endocrinol (Oxf). 2011 Oct;75(4):495-500. doi: 10.1111/j.1365-2265.2011.04067.x.

DOI:10.1111/j.1365-2265.2011.04067.x
PMID:21521335
Abstract

BACKGROUND

Acromegaly is associated with increased cardiovascular mortality, and increased aortic root diameter has been recently described in the literature as a possible feature of acromegalic cardiomyopathy.

OBJECTIVE

To assess the aortic root diameter and the prevalence of aortic ectasia in acromegalic patients.

PATIENTS AND METHODS

This paper presents a transversal analysis of 42 acromegalic patients by Doppler echocardiogram and comparison with 42 age, sex, body surface area and hypertension matched controls.

RESULTS

The mean aortic root diameter at the level of the aortic leaflets was increased in acromegalic patients when compared to controls (3·4 ± 0·5 vs 2·9 ± 0·4 cm, respectively, P < 0·0001). The aortic root diameter was significantly greater in men than in women (3·6 ± 0·6 cm vs 3·2 ± 0·4 cm, respectively, P = 0·004), and the left ventricular mass index was positively correlated with the diameter of the aorta (r = 0·37, P = 0·01). Using a cut-off point ≥ 3·8 cm, an aortic ectasia prevalence of 26·1 vs 2·3% was found in acromegalic patients and controls, respectively (P = 0·002). Only acromegaly was associated with aortic ectasia (P = 0·01).

CONCLUSION

The aortic root diameter was higher, and the prevalence of aortic ectasia was more common in acromegalic patients than in controls. In addition, only acromegalic disease was associated with aortic ectasia, suggesting the direct effects of GH and insulin-like growth factor-I excess on the cardiovascular system.

摘要

背景

肢端肥大症与心血管死亡率增加有关,最近的文献中描述了主动脉根部直径增大是肢端肥大性心肌病的一个可能特征。

目的

评估肢端肥大症患者的主动脉根部直径和主动脉扩张的发生率。

患者和方法

本文通过多普勒超声心动图对 42 例肢端肥大症患者进行了横断面分析,并与 42 例年龄、性别、体表面积和高血压相匹配的对照组进行了比较。

结果

与对照组相比,肢端肥大症患者的主动脉瓣叶水平主动脉根部直径增加(分别为 3.4 ± 0.5 cm 和 2.9 ± 0.4 cm,P < 0.0001)。男性的主动脉根部直径明显大于女性(分别为 3.6 ± 0.6 cm 和 3.2 ± 0.4 cm,P = 0.004),左心室质量指数与主动脉直径呈正相关(r = 0.37,P = 0.01)。使用截点≥3.8 cm,肢端肥大症患者和对照组的主动脉扩张发生率分别为 26.1%和 2.3%(P = 0.002)。只有肢端肥大症与主动脉扩张有关(P = 0.01)。

结论

与对照组相比,肢端肥大症患者的主动脉根部直径较高,主动脉扩张的发生率更高。此外,只有肢端肥大症与主动脉扩张有关,提示 GH 和 IGF-1 过多对心血管系统有直接影响。

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