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肢端肥大症:通过阻抗心动图评估的血流动力学特征与通过超声心动图评估的左心室收缩功能之间的关系。

Acromegaly: The Relationship between Hemodynamic Profiles Assessed via Impedance Cardiography and Left Ventricular Systolic Function Assessed via Echocardiography.

作者信息

Włochacz Agnieszka, Krzesiński Paweł, Uziębło-Życzkowska Beata, Witek Przemysław, Zieliński Grzegorz, Kazimierczak Anna, Wierzbowski Robert, Banak Małgorzata, Gielerak Grzegorz

机构信息

Department of Cardiology and Internal Medicine, Military Institute of Medicine, National Research Institute, 01-982 Warsaw, Poland.

Department of Internal Medicine, Endocrinology, and Diabetes, Medical University of Warsaw, 02-106 Warsaw, Poland.

出版信息

J Clin Med. 2024 Sep 23;13(18):5630. doi: 10.3390/jcm13185630.

Abstract

: Acromegaly-induced prolonged exposure to growth hormone and insulin-like growth factor 1 may have significant cardiovascular effects. The purpose of this study was to assess the relationship between hemodynamic parameters measured via impedance cardiography (ICG) and parameters of systolic left ventricular function measured via echocardiography in patients with acromegaly. : The observational cohort study included 33 patients with newly diagnosed acromegaly, with a mean age of 47 years and without significant comorbidities. Correlation analysis (Spearman's rank correlation coefficient R) was performed on parameters obtained by ICG and left ventricular systolic function parameters obtained by echocardiography. ICG assessment included indices of (1) cardiac function as a pump: stroke volume index (SI), cardiac index (CI), Heather index (HI), velocity index (VI), and acceleration index (ACI); (2) afterload: systemic vascular resistance index (SVRI) and total arterial compliance index (TACI); and (3) thoracic fluid content (TFC). Echocardiographic examinations evaluated left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS). : A lower LVEF was associated with a lower SI (R = 0.38; = 0.03) and a higher SVRI (R = -0.35; = 0.046), whereas lower GLS was associated with lower SI (R = 0.43; = 0.02), CI (R = 0.62; < 0.001), VI (R = 0.59; < 0.001), ACI (R = 0.38; = 0.048), HI (R = 0.59; < 0.001), and TACI (R = 0.50; = 0.006) and a higher SVRI (R = -0.59; < 0.001). No significant correlation was observed between either LVEF or GLS and TFC. : In patients with acromegaly, poorer echocardiographic parameters of left ventricular systolic function are associated with impaired function of the heart as a pump and higher afterload as assessed via ICG.

摘要

肢端肥大症导致长期暴露于生长激素和胰岛素样生长因子1可能会产生显著的心血管影响。本研究的目的是评估肢端肥大症患者通过阻抗心动图(ICG)测量的血流动力学参数与通过超声心动图测量的左心室收缩功能参数之间的关系。

这项观察性队列研究纳入了33例新诊断的肢端肥大症患者,平均年龄47岁,无显著合并症。对ICG获得的参数和超声心动图获得的左心室收缩功能参数进行相关性分析(Spearman等级相关系数R)。ICG评估包括:(1)作为泵的心脏功能指标:每搏量指数(SI)、心指数(CI)、希瑟指数(HI)、速度指数(VI)和加速度指数(ACI);(2)后负荷:全身血管阻力指数(SVRI)和总动脉顺应性指数(TACI);以及(3)胸液含量(TFC)。超声心动图检查评估左心室射血分数(LVEF)和整体纵向应变(GLS)。

较低的LVEF与较低的SI(R = 0.38;P = 0.03)和较高的SVRI(R = -0.35;P = 0.046)相关,而较低的GLS与较低的SI(R = 0.43;P = 0.02)、CI(R = 0.62;P < 0.001)、VI(R = 0.59;P < 0.001)、ACI(R = 0.38;P = 0.048)、HI(R = 0.59;P < 0.001)和TACI(R = 0.50;P = 0.006)以及较高的SVRI(R = -0.59;P < 0.001)相关。未观察到LVEF或GLS与TFC之间存在显著相关性。

在肢端肥大症患者中,超声心动图显示的左心室收缩功能较差的参数与ICG评估的作为泵的心脏功能受损和较高的后负荷相关。

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