Increased prevalence of regurgitant valvular heart disease in acromegaly.
Cardiac involvement is common in acromegaly, but the prevalence of valvular abnormalities in patients with acromegaly has not been documented and is the topic of this study. In a prospective study design, 40 consecutive patients with acromegaly and 120 control subjects (matched for age, sex, hypertension, and left ventricular systolic function) were studied. All patients and controls were evaluated using conventional two-dimensional and Doppler echocardiography. Significant valve disease was more prevalent in acromegalics compared with controls (22% vs. 6.7%, respectively; P = 0.005). Aortic valve regurgitation (>/=>trace severity) was present in 30% of patients vs. 7% of controls (P < 0.001), and mitral regurgitation (>/=moderate severity) was absent in controls but present in 5% of acromegalics (P = 0.014 vs. controls). Binary logistic regression analysis showed a significant impact only for disease duration on valvular disease, with an odds ratio of 1.19 (95% confidence interval, 1.028-1.376; P = 0.019). Acromegaly is associated with an increased prevalence of regurgitant valvular heart disease. This is dependent on the duration of exposure to increased GH concentrations, with a 19% increase in odds per year. This increased prevalence of occult valvular disease indicates that these patients require appropriate follow-up care and monitoring, especially patients with inadequate control of GH overproduction.
Pereira
Alberto M
AM
Department of Endocrinology and Metabolism, Leiden University Medical Center, 2300 RC Leiden, The Netherlands. a.m.pereira@lumc.nl
van Thiel
Sjoerd W
SW
Lindner
Jonathan R
JR
Roelfsema
Ferdinand
F
van der Wall
Ernst E
EE
Morreau
Hans
H
Smit
Jan W A
JW
Romijn
Johannes A
JA
Bax
Jeroen J
JJ
D000172:Acromegaly / Q000150:complications*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001022:Aortic Valve Insufficiency / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology; D011446:Prospective Studies; D014262:Tricuspid Valve Insufficiency / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology; D014463:Ultrasonography; D016277:Ventricular Function, Left