Evaluation of the impact of treatment on endothelial function and cardiac performance in acromegaly.
OBJECTIVE
To evaluate the effects of treatment on left ventricular (LV) performance and endothelial function in patients with acromegaly.


METHODS
Nineteen patients with active acromegaly (AA), 18 patients with cured/well-controlled acromegaly (CA), and 25 healthy control subjects were studied. LV performance was evaluated by two-dimensional/Doppler echocardiography and Doppler tissue imaging (TDI). Flow-mediated dilatation (FMD) was measured by B-mode ultrasound. Endothelial cell markers; thrombomodulin (TM), and P-selectin were also measured.


RESULTS
Tei index was higher than the control subjects in both acromegaly groups. The ratio of early and late diastolic annular velocities (Em'/Am') was significantly lower in the AA group than the other groups (P < 0.05). FMD in both acromegaly groups was significantly lower than the controls (P < 0.001) but difference between acromegaly groups was not significant (P > 0.05). In the CA group, P-selectin was higher than the controls and was even higher in the AA (P < 0.05). TM was significantly higher in the active group (P < 0.05) and not different than the controls in the CA group.


CONCLUSIONS
TDI determine LV performance changes in acromegaly earlier than conventional echocardiographic methods. Endothelial function both in the form of FMD and endothelial cell markers is impaired in acromegaly. While in cured acromegaly endothelial cell injury, as evidenced by TM levels, is decreased, endothelial dysfunction still persists.
Akgul
Ebru
E
Department of Cardiology, Ufuk University School of Medicine, Ankara, Turkey. eakgul2004@yahoo.com
Tokgozoglu
S Lale
SL
Erbas
Tomris
T
Kabakci
Giray
G
Aytemir
Kudret
K
Haznedaroglu
Ibrahim
I
Oto
Ali
A
Kes
S Sirri
SS
D000172:Acromegaly / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000601:surgery*