Bertoni P D, Di Michele R, Canziani R, Morandi G
G Ital Cardiol. 1983;13(3):152-62.
Thirty eight acromegalic patients (A) and a control group (C) of subjects without heart disease, were studied with echocardiography. Acromegalies were divided in two groups, A1 and A2, who had increase or normal serum growth hormone (GH) levels respectively after treatment (pituitary adenectomy and/or bromocriptine), at the time of the study. In acromegalic patients (A) mean left ventricular (LV) dimensions were normal while LV wall and septal thickness, LV mass and left atrial (LA) dimension were increased compared to control subjects. LVH was present in 79% of acromegalic patients. Asymmetric septal hypertrophy (ASH) was found in 10,5% of our patients. In group A1, IVS, LVPW, LVMM/m2 were significantly increased as compared to group A2. Fractional shortening (FS), ejection fraction (EF), mean velocity of circumferential fibre shortening (Vcf), frequency-normalized Vcf (Vcfn), posterior left ventricular wall velocity (PWV), and normalized PWV (PWVn) were normal in both groups. In patients with active acromegaly (Al) IVS and LVMM/m2 correlated well with the total duration of the disease (r=0.550 p less than 0.01 for IVS; r=0.624 p less than 0.01 for LVMM/m2) and with the duration of acromegaly before treatment (r=0.568, p less than 0.01 for IVS; r=0.500 p less than 0.01 for LVMM/m2). Furthermore a positive correlation was found between IVS and GH levels (r=0,550 p less than 0.01). Concomitant coronary artery disease and or hypertension did not seem to play any role in causing the above mentioned echocardiographic changes. Echocardiography is useful in assessing the cardiac involvement in patients with acromegaly.
对38例肢端肥大症患者(A组)和一组无心脏病的对照组(C组)进行了超声心动图研究。肢端肥大症患者分为A1和A2两组,在研究时,分别在治疗(垂体腺瘤切除术和/或溴隐亭)后血清生长激素(GH)水平升高或正常。在肢端肥大症患者(A组)中,左心室(LV)平均内径正常,但与对照组相比,左心室壁和室间隔厚度、左心室质量和左心房(LA)内径增加。79%的肢端肥大症患者存在左心室肥厚(LVH)。10.5%的患者发现有不对称性室间隔肥厚(ASH)。与A2组相比,A1组的室间隔厚度(IVS)、左心室后壁厚度(LVPW)、左心室质量指数(LVMM/m2)显著增加。两组的缩短分数(FS)、射血分数(EF)、圆周纤维缩短平均速度(Vcf)、频率归一化Vcf(Vcfn)、左心室后壁速度(PWV)和归一化PWV(PWVn)均正常。在活动性肢端肥大症患者(A1组)中,IVS和LVMM/m2与疾病总病程密切相关(IVS:r = 0.550,p < 0.01;LVMM/m2:r = 0.624,p < 0.01),与治疗前肢端肥大症病程也密切相关(IVS:r = 0.568,p < 0.01;LVMM/m2:r = 0.500,p < 0.01)。此外,IVS与GH水平之间存在正相关(r = 0.550,p < 0.01)。合并冠状动脉疾病和/或高血压似乎在引起上述超声心动图改变中不起任何作用。超声心动图有助于评估肢端肥大症患者的心脏受累情况。