title: High prevalence of cardiac valve disease in acromegaly: an observational, analytical, case-control study.
abstract: To characterize mitral and aortic valve abnormalities we performed M-mode, two-dimensional, and pulsed Doppler echocardiography in 42 patients with active acromegaly, 22 patients cured of acromegaly, and 64 controls pair-matched with the patients for sex and age. The overall prevalence of valve abnormalities was higher in both the active patients (86% vs. 24%; P < 0.0001) and the cured patients (73% vs. 9%; P < 0.0001) than in controls. Left ventricular hypertrophy was higher in active (81% vs. 29%; P < 0.0001), but not in cured (41% vs. 14%; P = 0.09) patients than in controls. Cardiac valve abnormalities were associated with left ventricular hypertrophy in both patients and controls, without any difference between them. Conversely, among subjects without left ventricular hypertrophy, mitral and aortic abnormalities were only present in the patients (75% of active and 54% of cured), but not in controls (3% of active controls and 0% of cured controls). In conclusion, patients with active acromegaly and those cured of the disease have a high prevalence of mitral and aortic abnormalities. The persistence of valve disease in patients with cured acromegaly is likely to be correlated with the persistence of left ventricular hypertrophy, which should be carefully and continuously monitored as an aspect of the risk of cardiac dysfunction in these patients.
authors.affiliation: Department of Molecular and Clinical Endocrinology and Oncology, Federico II University of Naples, 80123 Naples, Italy. calao@unina.it
authors.forename: Annamaria
authors.initials: A
authors.lastname: Colao
authors.forename: Letizia
authors.initials: L
authors.lastname: Spinelli
authors.forename: Paolo
authors.initials: P
authors.lastname: Marzullo
authors.forename: Rosario
authors.initials: R
authors.lastname: Pivonello
authors.forename: Mario
authors.initials: M
authors.lastname: Petretta
authors.forename: Carolina
authors.initials: C
authors.lastname: Di Somma
authors.forename: Giovanni
authors.initials: G
authors.lastname: Vitale
authors.forename: Domenico
authors.initials: D
authors.lastname: Bonaduce
authors.forename: Gaetano
authors.initials: G
authors.lastname: Lombardi
mesh_terms: D000172:Acromegaly / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D001024:Aortic Valve Stenosis / Q000453:epidemiology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D017379:Hypertrophy, Left Ventricular / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000453:epidemiology*; D015995:Prevalence