engleski

Early detection of heart affection in acromegaly assesed by color doppler myocardial imaging

In acromegaly, left ventricular hypertrophy (LVH) and diastolic dysfunction can be revealed by echocardiography. Using new method Color Doppler Myocardial Imaging (CDMI) and by measuring myocardial velocities we can detect changes in myocardial function earlier than conventional echocardiography (PWE). We sought to analyze myocardial relaxation using CDMI in acromegalic patients with and without diastolic dysfunction according to PWE parameters. 26 patients with acromegaly (50.27± ; 11.25 yrs) with normal systolic function and initial LVH present in 23% of pts were distributed in 2 groups according to disease activity. Group A: 14 patients in remission ; group B: 12 patients with active disease. All patients and 11 healthy age matched normals underwent CDMI (E’ , A’ , AtA’ , DtA’ ) at the lateral mitral annulus and PWE (IVRT, PFVE, PFVA, DtE, Adur, PVA, PVAdur). The Student’ s T-test was used for statistical analysis. P value <0.05  vs. control group and  vs. group A was considered significant. Results: Group A: parameters measured by PWE revealed diastolic dysfunction in 21% of patients, while CDMI revealed mean E’ /A’ =1, 03± ; 0, 33*, E’ = -7, 17± ; 1, 96 cm/s*, A’ = -7, 22± ; 1, 62 cm/s*, AtA’ = 0, 07± ; 0, 02 s*, DtA’ = 0, 08± ; 0, 01s*. Diastolic dysfunction (E’ /A’ <1) was noticed in 43% patients. Group B: PWE parameters showed diastolic dysfunction in 25% of patients. CDMI values indicated diastolic dysfunction in majority of patients (92%). Mean: E’ /A’ = 0.76 0.23* , E’ = -6, 38± ; 2, 09 cm/s*, A’ = -9, 07± ; 2, 11 cm/s* , AtA’ = 0, 06± ; 0, 02 s* , DtA’ = 0, 08± ; 0, 02s*. Using CDMI in patients with active disease we revealed diastolic dysfunction in the majority of patients, while in patients in remission we found significantly less diastolic dysfunction. CDMI is much more sensitive in detecting diastolic dysfunction in both groups compared to PWE. Therefore, it seems that data obtained by CDMI are the earliest evidence of acromegalic heart disease as there was no hypertrophy in majority of patients. These data might have significant clinical value in diagnosis of subclinical disease and follow up of the treatment.

acromegaly; myocardium; tissue Doppler

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