Guo Xiaopeng, Cao Jian, Liu Peijun, Cao Yihan, Li Xiao, Gao Lu, Wang Zihao, Fang Ligang, Jin Zhengyu, Wang Yining, Xing Bing
Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Int J Endocrinol. 2020 Feb 14;2020:2018464. doi: 10.1155/2020/2018464. eCollection 2020.
Cardiac abnormalities are the most common and deadly comorbidities of acromegaly. Assessments using cardiac magnetic resonance (CMR) imaging in acromegaly patients are rare. We aimed to evaluate the frequencies of left ventricular hypertrophy (LVH), interventricular septum hypertrophy (IVSH), LV systolic dysfunction (LVSD), right ventricular systolic dysfunction (RVSD), and myocardial fibrosis (MCF) and detailed quantitative parameters in acromegaly patients using CMR and analyze their correlations with clinical features. Sixty-one patients were enrolled in this study. The rates of LVH, IVSH, LVSD, RVSD, and MCF were 26.2%, 27.9%, 8.2%, 9.8%, and 14.8%, respectively. The average LV mass, LV mass index, IVS thickness, LV and RV free wall thickness, and LV and RV ejection fractions were 114.4 g, 60.0 g/m, 9.6 mm, 7.2 mm, 2.9 mm, 59.9%, and 56.6%, respectively. The LV mass index was larger (68.9 ± 26.0 vs. 48.8 ± 10.6 g/m), the IVS was thicker (10.3 ± 2.8 vs. 8.8 ± 1.8 mm), and the LV (57.6 ± 12.3% vs. 62.8 ± 4.8%) and RV ejection fractions (54.6 ± 8.7% vs. 59.2 ± 5.9%) were lower in male patients than in female patients (all < 0.05). Age, body mass index (BMI), disease duration, and hypertension were associated with cardiac abnormalities (all < 0.05). In conclusion, structural and functional cardiac abnormalities can be comprehensively evaluated by CMR in acromegaly patients. Gender greatly affects the presence of cardiac abnormalities. Age, BMI, disease duration, and hypertension but not GH or IGF-1 levels are associated clinical factors.
心脏异常是肢端肥大症最常见且致命的合并症。在肢端肥大症患者中，使用心脏磁共振（CMR）成像进行评估的情况很少见。我们旨在评估肢端肥大症患者左心室肥厚（LVH）、室间隔肥厚（IVSH）、左心室收缩功能障碍（LVSD）、右心室收缩功能障碍（RVSD）和心肌纤维化（MCF）的发生率以及详细的定量参数，并分析它们与临床特征的相关性。本研究纳入了61例患者。LVH、IVSH、LVSD、RVSD和MCF的发生率分别为26.2%、27.9%、8.2%、9.8%和14.8%。左心室质量、左心室质量指数、室间隔厚度、左心室和右心室游离壁厚度以及左心室和右心室射血分数的平均值分别为114.4 g、60.0 g/m、9.6 mm、7.2 mm、2.9 mm、59.9%和56.6%。男性患者的左心室质量指数更大（68.9±26.0 vs. 48.8±10.6 g/m），室间隔更厚（10.3±2.8 vs. 8.8±1.8 mm），左心室（57.6±12.3% vs. 62.8±4.8%）和右心室射血分数（54.6±8.7% vs. 59.2±5.9%）低于女性患者（均P<0.05）。年龄、体重指数（BMI）、病程和高血压与心脏异常相关（均P<0.05）。总之，CMR可全面评估肢端肥大症患者的心脏结构和功能异常。性别对心脏异常的存在有很大影响。年龄、BMI、病程和高血压而非生长激素（GH）或胰岛素样生长因子-1（IGF-1）水平是相关临床因素。
