Copyright © 1993 by the European Society of Cardiology.
© 1993 The European Society of Cardiology
Evidence for biventricular involvement in acromegaly: a Doppler echocardiographic study
Department of Internal Medicine Federico II University Naples, Italy
*Department of Endocrinology, Federico II University Naples, Italy
Received 28 April 1992; revised 17 July 1992; .
Correspondence: Serafino Fazio, MD, IV Medicina Interna, II Facoltá di Medicina. via Pansini 5, 80131 Napoli, Italy
Abstract
To investigate left and right ventricular involvement in acromegaly, 20 patients were studied by Doppler echocardiography. Nine of them had systemic hypertension. Right ventricular free wall thickness was significantly increased in acromegalic patients (8 ± 2 vs 4 ± 1 mm; P <0.001). Left ventricular mass index was augmented both in the whole group and in the subgroup of normotensive acromegalics, as compared with normals (134 ± 33 and 115 ± 20 vs 80 ± 18 g.m–2,. P <0.01). Ejection phase indices were normal in the patient group, while impaired left and right ventricular diastolic filling was found. In fact, isovolumic relaxation time was prolonged (118 ± 21 vs 78 ± 12 ms; P <0.001), ratio of early to late mitral (0. ± 0.3 vs 1.8±0.5 P<0.001) and tricuspid (1.0±0.2 vs 1.4±0.3 P<0.001 flow velocities were significantly decreased as compared with controls. Superior vena cava flowmetry was also abnormal showing a marked decrease of diastolic filling wave and, consequently, of the ratio between peak diastolic and peak systolic flow velocity. No significant differences observed between normotensive and hypertensive acromegalics, except for left ventricular mass index (115 ± 20 vs 156 ± 31 g.m–2; P <0.01). These findings indicate that abnormal diastolic filling patterns of transmitral, transtricuspid, and superior vena cava flowmetry suggesting ‘impaired relaxation’ associated with increased left and right ventricular mass, frequently occur in acromegaly.
Key Words: Acromegaly • Doppler echocardiography • left and right ventricular diastolic filling • superior vena cava
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