Nemes Attila, Rácz Gergely, Kormányos Árpád, Gyenes Nándor, Ambrus Nóra, Lengyel Csaba, Valkusz Zsuzsanna
Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Semmelweis Street 8, P.O. Box 427, H-6725 Szeged, Hungary.
Biomedicines. 2024 Jul 2;12(7):1464. doi: 10.3390/biomedicines12071464.
Acromegaly is an endocrine pathology characterized by the overproduction of human growth hormone. The present study aimed to analyze three-dimensional speckle-tracking echocardiography (3DSTE)-derived tricuspid annular (TA) properties in detail in patients with acromegaly and to compare the findings to those of matched healthy controls.
The present study consisted of 29 patients with acromegaly (mean age: 55.9 ± 14.5 years, 21 males), of which 13 had an active disease. The control population comprised 57 healthy subjects (mean age: 53.2 ± 8.4 years, 38 males).
In the presence of acromegaly, left atrial and end-diastolic left ventricular (LV) sizes were dilated, and LV ejection fraction was increased, which was accompanied by thickened interventricular septum and LV posterior wall as compared with matched healthy controls. The presence of grade 1 mitral (MR) and tricuspid (TR) regurgitations were more frequent in acromegaly than in controls, regardless of disease activity. Higher than grade 1 MR/TR was uncommon in acromegaly. The 3DSTE-derived all end-diastolic (2.47 ± 0.27 cm vs. 2.23 ± 0.27 cm; 8.73 ± 1.77 cm vs. 6.67 ± 1.40 cm; 11.56 ± 1.34 cm vs. 10.20 ± 1.10 cm, < 0.001 for all) and end-systolic (1.97 ± 0.27 cm vs. 1.77 ± 0.28 cm; 6.24 ± 1.61 cm vs. 5.01 ± 1.42 cm; 9.80 ± 1.35 cm vs. 8.72 ± 1.10 cm, < 0.001 for all) TA diameters, areas, and perimeters proved to be dilated, while TA functional parameters including TA fractional area change (28.77 ± 9.80% vs. 27.64 ± 15.34%, = 0.720) and fractional shortening (20.60 ± 9.08% vs. 20.51 ± 8.81%, = 0.822) were normal in acromegaly regardless of whether acromegaly was active or not. RA volumes respecting the cardiac cycle were dilated in acromegaly as compared with those of healthy controls regardless of disease activity and were associated with respective changes in TA dimensions.
In the presented acromegaly patients, significant TA dilation with preserved function could be detected regardless of disease activity. RA volumes and TA dimensions are correlated in acromegaly.
肢端肥大症是一种内分泌疾病,其特征是人体生长激素分泌过多。本研究旨在详细分析三维斑点追踪超声心动图(3DSTE)得出的肢端肥大症患者三尖瓣环(TA)特性,并将结果与匹配的健康对照者进行比较。
本研究纳入29例肢端肥大症患者(平均年龄:55.9±14.5岁,男性21例),其中13例为活动期疾病。对照组包括57名健康受试者(平均年龄:53.2±8.4岁,男性38例)。
与匹配的健康对照者相比,肢端肥大症患者存在左心房及舒张末期左心室(LV)大小扩张,LV射血分数增加,同时伴有室间隔和LV后壁增厚。无论疾病活动状态如何,1级二尖瓣反流(MR)和三尖瓣反流(TR)在肢端肥大症患者中比对照组更常见。高于1级的MR/TR在肢端肥大症中并不常见。3DSTE得出的所有舒张末期(2.47±0.27 cm对2.23±0.27 cm;8.73±1.77 cm对6.67±1.40 cm;11.56±1.34 cm对10.20±1.10 cm,均P<0.001)和收缩末期(1.97±0.27 cm对1.77±0.28 cm;6.24±1.61 cm对5.01±1.42 cm;9.80±1.35 cm对8.72±1.10 cm,均P<0.001)TA直径、面积和周长均扩张,而TA功能参数包括TA面积变化分数(28.77±9.80%对27.64±15.34%,P=0.720)和缩短分数(20.6±9.08%对20.51±8.81%,P=0.822)在肢端肥大症患者中正常,无论肢端肥大症是否处于活动期。无论疾病活动状态如何,与健康对照者相比,肢端肥大症患者整个心动周期的右心房容积均扩张,且与TA尺寸的相应变化相关。
在本研究的肢端肥大症患者中,无论疾病活动状态如何,均可检测到TA显著扩张且功能保留。肢端肥大症患者右心房容积与TA尺寸相关。