Department of Endocrinology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Department of Medical Ultrasonics, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Front Endocrinol (Lausanne). 2023 Oct 20;14:1260842. doi: 10.3389/fendo.2023.1260842. eCollection 2023.
In recent years, cardiovascular disease has garnered increasing attention as the second leading cause of death in individuals with acromegaly, following malignancy. Identifying cardiac dysfunction early in acromegaly patients for timely intervention has become a focal point of clinical research. Speckle tracking echocardiography, a well-established ultrasound technique, surpasses conventional Doppler ultrasound in its sensitivity to assess both local and global cardiac mechanics. It can accurately detect subclinical and clinical myocardial dysfunction, including myocardial ischemia, ventricular hypertrophy, and valvular changes. Over the past five years, the use of speckle tracking echocardiography in acromegaly patients has emerged as a novel approach. Throughout the cardiac cycle, speckle tracking echocardiography offers a sensitive evaluation of the global and regional myocardial condition by quantifying the motion of myocardial fibres in distinct segments. It achieves this independently of variations in ultrasound angle and distance, effectively simulating the deformation of individual ventricles across different spatial planes. This approach provides a more accurate description of changes in cardiac strain parameters. Importantly, even in the subclinical stage when ejection fraction remains normal, the strain parameters assessed by speckle tracking echocardiography hold a good predictive value for the risk of cardiovascular death and hospitalization in acromegaly patients with concomitant cardiovascular disease. This information aids in determining the optimal timing for interventional therapy, offering important insights for cardiac risk stratification and prognosis. In the present study, we comprehensively reviewed the research progress of speckle tracking echocardiography in evaluating of cardiac dysfunction in acromegaly patients, to pave the way for early diagnosis of acromegaly cardiomyopathy.
近年来，心血管疾病作为肢端肥大症患者的第二大死亡原因（仅次于恶性肿瘤），受到了越来越多的关注。早期识别肢端肥大症患者的心脏功能障碍并及时进行干预已成为临床研究的重点。斑点追踪超声心动图是一种成熟的超声技术，其敏感性超过传统的多普勒超声，可用于评估局部和整体心脏力学。它可以准确检测亚临床和临床心肌功能障碍，包括心肌缺血、心室肥厚和瓣膜变化。在过去五年中，斑点追踪超声心动图在肢端肥大症患者中的应用已成为一种新方法。在整个心动周期中，斑点追踪超声心动图通过量化不同节段心肌纤维的运动，对整体和局部心肌状况进行敏感评估。它独立于超声角度和距离的变化，有效地模拟了不同空间平面上单个心室的变形。这种方法提供了对心脏应变参数变化的更准确描述。重要的是，即使射血分数保持正常的亚临床阶段，斑点追踪超声心动图评估的应变参数对伴有心血管疾病的肢端肥大症患者心血管死亡和住院风险具有良好的预测价值。这些信息有助于确定介入治疗的最佳时机，为心脏风险分层和预后提供重要的见解。在本研究中，我们全面回顾了斑点追踪超声心动图在评估肢端肥大症患者心脏功能障碍方面的研究进展，为肢端肥大症心肌病的早期诊断铺平了道路。
