Popielarz-Grygalewicz Agata, Gąsior Jakub S, Konwicka Aleksandra, Grygalewicz Paweł, Stelmachowska-Banaś Maria, Zgliczyński Wojciech, Dąbrowski Marek
Cardiology Clinic of Physiotherapy Division of the 2nd Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland.
Faculty of Health Sciences and Physical Education, Kazimierz Pulaski University of Technology and Humanities in Radom, Radom, Poland.
Int J Endocrinol. 2018 Jul 11;2018:6935054. doi: 10.1155/2018/6935054. eCollection 2018.
To determine whether the echocardiographic presentation allows for diagnosis of acromegalic cardiomyopathy. 140 patients with acromegaly underwent echocardiography as part of routine diagnostics. The results were compared with the control group comprising of 52 age- and sex-matched healthy volunteers. Patients with acromegaly presented with higher BMI, prevalence of arterial hypertension, and glucose metabolism disorders (i.e., diabetes and/or prediabetes). In patients with acromegaly, the following findings were detected: increased left atrial volume index, increased interventricular septum thickness, increased posterior wall thickness, and increased left ventricular mass index, accompanied by reduced diastolic function measured by the following parameters: E'med., E/E', and E/A. Additionally, they presented with abnormal right ventricular systolic pressure. All patients had normal systolic function measured by ejection fraction. However, the values of global longitudinal strain were slightly lower in patients than in the control group; the difference was statistically significant. There were no statistically significant differences in the size of the right and left ventricle, thickness of the right ventricular free wall, and indexed diameter of the ascending aorta between patients with acromegaly and healthy volunteers. None of 140 patients presented systolic dysfunction, which is the last phase of the so-called acromegalic cardiomyopathy. Some abnormal echocardiographic parameters found in acromegalic patients may be caused by concomitant diseases and not elevated levels of GH or IGF-1 alone. The potential role of demographic parameters like age, sex, and/or BMI requires further research.
为了确定超声心动图表现是否有助于诊断肢端肥大症性心肌病。140例肢端肥大症患者接受了超声心动图检查作为常规诊断的一部分。将结果与由52名年龄和性别匹配的健康志愿者组成的对照组进行比较。肢端肥大症患者的体重指数、动脉高血压患病率和糖代谢紊乱(即糖尿病和/或糖尿病前期)较高。在肢端肥大症患者中,检测到以下结果:左心房容积指数增加、室间隔厚度增加、后壁厚度增加和左心室质量指数增加,同时通过以下参数测量的舒张功能降低:E'med.、E/E'和E/A。此外,他们还出现了异常的右心室收缩压。所有患者通过射血分数测量的收缩功能均正常。然而,患者的整体纵向应变值略低于对照组;差异具有统计学意义。肢端肥大症患者与健康志愿者之间在右心室和左心室大小、右心室游离壁厚度以及升主动脉内径方面没有统计学显著差异。140例患者中无一例出现收缩功能障碍,而收缩功能障碍是所谓肢端肥大症性心肌病的最后阶段。肢端肥大症患者中发现的一些异常超声心动图参数可能是由合并疾病引起的,而不仅仅是生长激素或胰岛素样生长因子-1水平升高所致。年龄、性别和/或体重指数等人口统计学参数的潜在作用需要进一步研究。