title: Blood pressure-independent cardiac hypertrophy in acromegalic patients.
abstract: OBJECTIVE
  Acromegaly is frequently associated with an increase in left ventricular mass, even in the absence of systemic hypertension. Pathological studies on acromegalic hearts have shown an extensive interstitial fibrosis, suggesting the existence of a specific acromegalic cardiomyopathy. The aim of this study was to assess left ventricular wall structure in acromegaly by ultrasonic tissue characterization.
  
  
  METHODS
  We studied 10 untreated acromegalic patients and 10 age-matched healthy control subjects. The echo patterns of two-dimensional long-axis end-diastolic echocardiograms were assessed by colour-scale analysis of the interventricular septum, with estimates of the mean colour scale value, the broad band (Bb) and the derived collagen volume fraction (dCVF). We also measured electrocardiographic QT interval dispersion (QTd) as a marker of dyshomogeneous ventricular repolarization.
  
  
  RESULTS
  Seven patients had left ventricular hypertrophy according to the sex-independent criteria; of these, two had arterial hypertension. None of our patients had echocardiographic evidence of diastolic or systolic dysfunction. All patients showed significantly increased myocardial echoreflectivity (Bb = 106.4+/-12.1 versus 79.3+/-6.5; dCVF% = 2.78+/-0.53 versus 1.58+/-0.29; P < 0.0001) and QTd (66+/-13 ms versus 54+/-8 ms, P < 0.05). A significant correlation was found between dCVF and the duration of acromegaly (r = 0.80; P = 0.005).
  
  
  CONCLUSIONS
  Left ventricular remodelling observed in acromegaly is not related to the presence of arterial hypertension; we hypothesize that the increased echoreflectivity and QTd are long-term consequences of cardiac hypertrophy and prolonged exposure to high levels of growth hormone and insulin-like growth factor-I.
authors.affiliation: Istituto di Clinica Medica Generale e Terapia Medica, Centro di Fisiologia Clinica e Ipertensione, Università di Milano, Italy. img.lab@mailserver.unimi.it
authors.forename: M
authors.initials: M
authors.lastname: Ciulla
authors.forename: M
authors.initials: M
authors.lastname: Arosio
authors.forename: M V
authors.initials: MV
authors.lastname: Barelli
authors.forename: R
authors.initials: R
authors.lastname: Paliotti
authors.forename: S
authors.initials: S
authors.lastname: Porretti
authors.forename: P
authors.initials: P
authors.lastname: Valentini
authors.forename: G
authors.initials: G
authors.lastname: Tortora
authors.forename: V
authors.initials: V
authors.lastname: Buonamici
authors.forename: A
authors.initials: A
authors.lastname: Moraschi
authors.forename: V
authors.initials: V
authors.lastname: Capiello
authors.forename: F
authors.initials: F
authors.lastname: Magrini
mesh_terms: D000172:Acromegaly / Q000150:complications* / Q000503:physiopathology*; D000328:Adult; D001794:Blood Pressure; D003094:Collagen / Q000378:metabolism; D003720:Densitometry; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism; D015203:Reproducibility of Results; D013690:Television; D013997:Time Factors
chemical_list: D003094:Collagen