Ozbey N, Oncül A, Buğra Z, Vural A, Erzengin F, Orhan Y, Büyüköztürk K, Sencer E, Molvalilar S
Department of Internal Medicine, Istanbul Faculty of Medicine, Capa, Turkiye.
J Endocrinol Invest. 1997 Jun;20(6):305-11. doi: 10.1007/BF03350308.
It is recently shown that the majority of acromegalic patients without concomitant heart disease have diastolic dysfunction at rest. The aim of this study is to evaluate left ventricular diastolic function in normotensive acromegalic patients without any evidence of heart disease. Eleven acromegalic patients and 16 normal subjects of comparable age and sex distribution were studied by echocardiography. Left ventricular end-diastolic diameter, interventricular septal thickness, left ventricular posterior wall thickness, left ventricular end-diastolic volume and stroke volume were found to be significantly higher in acromegalic patients. Left ventricular mass and left ventricular mass index increased significantly in acromegalics in comparison with controls (229.16 +/- 46.11 g versus 167.17 +/- 24.57 g and 124.99 +/- 26.91 g/m2 versus 95.09 +/- 13.29 g/m2 respectively, p < 0.001). Mitral A wave desceleration rate and isovolumetric relaxation time (IVRT)-two of the studied parameters of left ventricular diastolic filling- were significantly prolonged in patients as compared with controls (p = 0.03 and p < 0.001 respectively). Four (36%) of the acromegalic patients had peak early/late diastolic mitral velocity ratio lower than 1, indicating diastolic dysfunction. All of the patients had IVRT longer than 90 ms (mean + 2 standart deviations of normals). It is concluded that in acromegalic patients without any other evidence of heart disease left ventricular diastolic function is impaired. This indicates a specific cardiomyopathy exists in the subclinical stage. IVRT is found to be more sensitive than other studied parameters for detecting diastolic dysfunction at this stage.
最近的研究表明，大多数无合并心脏病的肢端肥大症患者静息时存在舒张功能障碍。本研究的目的是评估无任何心脏病证据的血压正常的肢端肥大症患者的左心室舒张功能。通过超声心动图对11例肢端肥大症患者和16例年龄和性别分布相当的正常受试者进行了研究。发现肢端肥大症患者的左心室舒张末期直径、室间隔厚度、左心室后壁厚度、左心室舒张末期容积和每搏输出量均显著更高。与对照组相比，肢端肥大症患者的左心室质量和左心室质量指数显著增加（分别为229.16±46.11 g对167.17±24.57 g和124.99±26.91 g/m²对95.09±13.29 g/m²，p<0.001）。与对照组相比，患者的二尖瓣A波减速速率和等容舒张时间（IVRT）——左心室舒张期充盈的两个研究参数——显著延长（分别为p = 0.03和p<0.001）。4例（36%）肢端肥大症患者的舒张早期/晚期二尖瓣峰值速度比低于1，提示舒张功能障碍。所有患者的IVRT均超过90 ms（正常均值+2标准差）。结论是，在无任何其他心脏病证据的肢端肥大症患者中，左心室舒张功能受损。这表明在亚临床阶段存在一种特定的心肌病。发现IVRT在检测该阶段舒张功能障碍方面比其他研究参数更敏感。
