title: Left ventricular diastolic function and cardiac performance during exercise in patients with acromegaly.
abstract: Exercise-induced impairment of left ventricular (LV) ejection fraction is common in patients with acromegaly and normal resting systolic function. This study aimed to clarify whether diastolic dysfunction plays a role in the abnormal adaptation to exercise in these patients. Forty-eight patients with active acromegaly underwent LV radionuclide angiography at rest and during exercise. Doppler echocardiography was also performed to assess LV mass index and diastolic function by combined analysis of mitral and pulmonary flow velocity curves. LV ejection fraction at peak exercise was related to rest ejection fraction (r = 0.78; P < 0.001), peak filling rate (r = 0.55; P < 0.01), LV mass index (r = -0.56; P < 0.001), and the difference between duration of diastolic reverse pulmonary vein flow and mitral flow at atrial contraction (Delta duration) (r = -0.54; P < 0.01). At stepwise regression analysis, rest ejection fraction and Delta duration were the only variables that independently influenced (P < 0.001) ejection fraction at peak exercise. Diastolic dysfunction is important in determining cardiac performance during exercise in patients with acromegaly and normal resting systolic function. Combined analysis of pulmonary vein and mitral flow velocity curves allows the identification of impaired LV diastolic function in such patients.
authors.affiliation: Department of Internal Medicine, Federico II University, 80131 Naples, Italy.
authors.forename: Letizia
authors.initials: L
authors.lastname: Spinelli
authors.forename: Mario
authors.initials: M
authors.lastname: Petretta
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Verderame
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Carbone
authors.forename: Angela Assunta
authors.initials: AA
authors.lastname: Venetucci
authors.forename: Andrea
authors.initials: A
authors.lastname: Petretta
authors.forename: Wanda
authors.initials: W
authors.lastname: Acampa
authors.forename: Domenico
authors.initials: D
authors.lastname: Bonaduce
authors.forename: Annamaria
authors.initials: A
authors.lastname: Colao
authors.forename: Alberto
authors.initials: A
authors.lastname: Cuocolo
mesh_terms: D000172:Acromegaly / Q000000981:diagnostic imaging / Q000503:physiopathology*; D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology; D004452:Echocardiography; D015150:Echocardiography, Doppler; D015444:Exercise / Q000502:physiology*; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006334:Heart Function Tests; D006728:Hormones / Q000097:blood; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011875:Radionuclide Angiography; D012044:Regression Analysis; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D006728:Hormones; D019382:Human Growth Hormone