Kormányos Árpád, Domsik Péter, Kalapos Anita, Valkusz Zsuzsanna, Lengyel Csaba, Forster Tamás, Nemes Attila
2nd Department of Medicine and Cardiology Centre, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.
1st Department of Medicine, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.
Echocardiography. 2018 Jul;35(7):975-984. doi: 10.1111/echo.13860. Epub 2018 Mar 22.
Acromegaly is a chronic and disfiguring hormonal disease caused by a benign growth hormone-secreting pituitary adenoma in most of the cases. The objective of this study was to investigate three-dimensional (3D) speckle tracking echocardiography (3DSTE)-derived left atrial (LA) volumetric and functional properties in patients with acromegaly. It was also examined whether the activity of acromegaly is associated with further alterations in these LA parameters.
A total of 23 patients with acromegaly were involved in this study. Due to inadequate image quality, 4 patients were excluded from the 3DSTE analysis. The mean age of the remaining acromegalic subjects was 58.5 ± 13.1 years (7 males). The control group consisted of 21 age- and gender-matched healthy subjects (mean age 51.8 ± 10.3 years, 10 males).
Maximum (44.8 ± 12.7 mL vs 78.7 ± 25.4 mL, P < .05), minimum (24.1 ± 9.0 mL vs 44.5 ± 15.5 mL, P < .05), and preatrial contraction (35.5 ± 11.2 mL vs 66.0 ± 22.8 mL, P < .05) LA volumes were significantly different between all acromegaly patients compared with controls. Increased peak global and mean segmental radial and 3D strains and decreased LA circumferential strain (CS) could be detected in all acromegaly patients as compared to healthy subjects. Significant correlation could be detected between insulin-like growth factor 1 (IGF-1) index and peak superior LA-CS (r = .49, P = .05) in acromegaly.
Acromegaly is associated with increased LA volumes and changes in LA functional properties.
肢端肥大症是一种慢性且毁容性的激素疾病，大多数情况下由分泌生长激素的垂体良性腺瘤引起。本研究的目的是调查三维（3D）斑点追踪超声心动图（3DSTE）得出的肢端肥大症患者左心房（LA）容积和功能特性。同时还研究了肢端肥大症的活动是否与这些左心房参数的进一步改变有关。
本研究共纳入23例肢端肥大症患者。由于图像质量不佳，4例患者被排除在3DSTE分析之外。其余肢端肥大症患者的平均年龄为58.5±13.1岁（7例男性）。对照组由21例年龄和性别匹配的健康受试者组成（平均年龄51.8±10.3岁，10例男性）。
与对照组相比，所有肢端肥大症患者的左心房最大容积（44.8±12.7 mL对78.7±25.4 mL，P<.05）、最小容积（24.1±9.0 mL对44.5±15.5 mL，P<.05）和心房收缩前容积（35.5±11.2 mL对66.0±22.8 mL，P<.05）均有显著差异。与健康受试者相比，所有肢端肥大症患者均可检测到整体峰值和平均节段径向应变及三维应变增加，左心房圆周应变（CS）降低。在肢端肥大症患者中，胰岛素样生长因子1（IGF-1）指数与左心房上壁峰值CS之间存在显著相关性（r =.49，P =.05）。
肢端肥大症与左心房容积增加和左心房功能特性改变有关。
