Acromegalic cardiomyopathy in an extensively admixed population: is there a role for GH/IGF-I axis?
BACKGROUND
A specific acromegaly-related cardiomyopathy has been described in the literature, largely in Caucasians, which is independent of other risk factors, mainly hypertension.


OBJECTIVE
This study assessed the cardiac changes in acromegalics of significant ethnic diversity and also the relevance of the aetiopathogenic factors involved, such as disease activity and hypertension.


METHODS
It is a cross-sectional study with a comparative control group.


METHODS
In this study, 37 acromegalic patients (20 Intermediate-skinned (IS), 14 Dark-skinned (DS) and three Light-skinned (LS) individuals) and 74 controls matched by age, gender and hypertension were evaluated. Cardiac morphology and function were addressed using echocardiography parameters.


RESULTS
The mean age of patients was 46.9 ± 12.8 years, with 67.6% being women and 43.2% hypertensive. The prevalence of left ventricular hypertrophy (LVH) between acromegalics was 56.8% vs 10.8% in the controls (P < 0.001). About 86% of patients with LVH had active disease (P = 0.023). Logistic regression revealed that disease activity presented a stronger association (OR = 5.925; CI = 1.085-32.351; P = 0.040) with LVH than hypertension (OR = 3.237; CI = 0.702-14.924; P = 0.132). When DS acromegalics were compared with IS ones, no statistically significant differences were observed.


CONCLUSIONS
Chronically hyperactive somatotropic axis remains as an independent and determining factor in the development of left ventricular hypertrophy, as it is more associated with this condition than hypertension in a largely admixed population with a high degree of African ancestry.
Endocrinology Unit, Hospital Universitário Presidente Dutra, Universidade Federal do Maranhão, Rua Barão de Itapary, São Luís, Brazil. gilvancortes@uol.com.br
Gilvan Cortês
GC
Nascimento
Marina Torres
MT
de Oliveira
Viviane Chaves
VC
Carvalho
Maria Honorina Cordeiro
MH
Lopes
Adriana Maria Guimarães
AM
Sá
Marinilde Teles
MT
Souza
Adalgisa de Souza Paiva
Ade S
Ferreira
Pedro Antônio Muniz
PA
Ferreira
Manuel dos Santos
Mdos S
Faria
D000172:Acromegaly / Q000150:complications / Q000453:epidemiology* / Q000378:metabolism; D000328:Adult; D009202:Cardiomyopathies / Q000453:epidemiology* / Q000209:etiology; D003430:Cross-Sectional Studies; D005260:Female; D019382:Human Growth Hormone / Q000378:metabolism; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D008875:Middle Aged
D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I