Thomas Julia D J, Dattani Abhishek, Zemrak Filip, Burchell Thomas, Akker Scott A, Kaplan Felicity J L, Khoo Bernard, Aylwin Simon, Grossman Ashley B, Davies L Ceri, Korbonits Márta
Centre for Endocrinology, WHRI, Barts & the London School of Medicine and Dentistry, Queen Mary University of London.
NIHR Cardiovascular Biomedical Research Unit, St Bartholomew's Hospital, London.
Exp Clin Endocrinol Diabetes. 2017 Jun;125(6):365-367. doi: 10.1055/s-0042-123710. Epub 2017 Feb 6.
Blockade of the angiotensin-renin system, with angiotensin converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARBs), has been shown to improve cardiac outcomes following myocardial infarction and delay progression of heart failure. Acromegaly is associated with a disease-specific cardiomyopathy, the pathogenesis of which is poorly understood.The cardiac indices of patients with active acromegaly with no hypertension (Group A, n=4), established hypertension not taking ACEi/ARBs (Group B, n=4) and established hypertension taking ACEi/ARBs (Group C, n=4) were compared using cardiac magnetic imaging.Patients taking ACEi/ARBs had lower end diastolic volume index (EDVi) and end systolic volume index (ESVi) than the other 2 groups ([C] 73.24 vs. [A] 97.92 vs. [B] 101.03 ml/m, ANOVA p=0.034, B vs. C p<0.01). Groups A and B had EDVi and ESVi values at the top of published reference range values; Group C had values in the middle of the range.Acromegaly patients on ACEi/ARBs for hypertension demonstrate improved cardiac indices compared to acromegaly patients with hypertension not taking these medications. Further studies are needed to determine if these drugs have a beneficial cardiac effect in acromegaly in the absence of demonstrable hypertension.
血管紧张素转换酶抑制剂（ACEi）和血管紧张素受体阻滞剂（ARBs）对血管紧张素-肾素系统的阻断作用已被证明可改善心肌梗死后的心脏预后，并延缓心力衰竭的进展。肢端肥大症与一种特定疾病的心肌病有关，其发病机制尚不清楚。使用心脏磁共振成像比较了无高血压的活动性肢端肥大症患者（A组，n = 4）、未服用ACEi/ARBs的已确诊高血压患者（B组，n = 4）和服用ACEi/ARBs的已确诊高血压患者（C组，n = 4）的心脏指标。服用ACEi/ARBs的患者的舒张末期容积指数（EDVi）和收缩末期容积指数（ESVi）低于其他两组（[C] 73.24 vs. [A] 97.92 vs. [B] 101.03 ml/m，方差分析p = 0.034，B组与C组比较p < 0.01）。A组和B组的EDVi和ESVi值处于已发表参考范围值的上限；C组的值处于范围中间。与未服用这些药物的高血压肢端肥大症患者相比，服用ACEi/ARBs治疗高血压的肢端肥大症患者的心脏指标有所改善。需要进一步研究以确定这些药物在无明显高血压的肢端肥大症中是否具有有益的心脏作用。
