Department of Cardiology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
Endocrine. 2013 Aug;44(1):200-6. doi: 10.1007/s12020-012-9859-9. Epub 2012 Dec 20.
Acromegaly is associated with a variety of cardiovascular disturbances such as left ventricular hypertrophy, diastolic cardiac dysfunction, and hypertension. Left ventricular (LV) dyssynchrony means the impairment of synchronicity and is defined as the loss of the simultaneous peak contraction of corresponding cardiac segments. The objective of this study was to investigate whether acromegalic patients have left ventricular dyssynchrony. Dyssynchrony was evaluated in 30 patients with active acromegaly and 30 controls. All the patients and controls were subjected to a tissue synchronization imaging. The time to regional peak systolic tissue velocity (Ts) in LV by the six-basal-six-mid-segmental model was measured on ejection phase TSI images and four TSI parameters of systolic dyssynchrony were computed. All TSI parameters of LV dyssynchrony increased in patients with acromegaly compared to the controls: the standard deviation (SD) of the 12 LV segments Ts (43.5 ± 13.5 vs 26.2 ± 12.5, p < 0.001); the maximal difference in Ts between any 2 of the 12 LV segments (133.3 ± 38 vs 84.6 ± 37.6, p < 0.001); the SD of the 6 basal LV segments (41.1 ± 15.9 vs 25.4 ± 14.8, p = 0.001); and the maximal difference in Ts between any 2 of the 6 basal LV segments (102.6 ± 37.5 vs 65.2 ± 36.9, p = 0.001). In addition, there were significant relationships between the levels of growth hormone/insulin-like growth factor-1 and Ts-SD-12. LV synchronicity has been impaired in patients with acromegaly. Left ventricular dyssynchrony is associated with disease activity and it may contribute to the harmful cardiovascular effects of acromegaly.
肢端肥大症与多种心血管紊乱有关,如左心室肥厚、舒张性心脏功能障碍和高血压。左心室(LV)不同步是指同步性受损,定义为相应心段同时收缩峰值的丧失。本研究旨在探讨肢端肥大症患者是否存在左心室不同步。在 30 例活动性肢端肥大症患者和 30 例对照者中评估不同步。所有患者和对照者均接受组织同步成像检查。在射血期 TSI 图像上测量 LV 六基底六中段模型局部收缩期组织速度(Ts)的达峰时间,并计算 4 个收缩期不同步参数。与对照组相比,肢端肥大症患者的 LV 不同步所有 TSI 参数均增加:12 个 LV 节段 Ts 的标准差(SD)(43.5 ± 13.5 比 26.2 ± 12.5,p < 0.001);12 个 LV 节段中任意 2 个节段之间 Ts 的最大差值(133.3 ± 38 比 84.6 ± 37.6,p < 0.001);6 个基底 LV 节段的 SD(41.1 ± 15.9 比 25.4 ± 14.8,p = 0.001);6 个基底 LV 节段中任意 2 个节段之间 Ts 的最大差值(102.6 ± 37.5 比 65.2 ± 36.9,p = 0.001)。此外,生长激素/胰岛素样生长因子-1 水平与 Ts-SD-12 呈显著相关。肢端肥大症患者的 LV 同步性受损。左心室不同步与疾病活动有关,可能导致肢端肥大症的有害心血管影响。