title: Quantifying subtle changes in cardiovascular mechanics in acromegaly: a Doppler myocardial imaging study.
abstract: OBJECTIVE
  To describe morphological and functional cardiovascular changes in acromegaly (ACM) patients, as well as to investigate the ability of Doppler-based myocardial deformation imaging (DMI) to characterize subtle dysfunction in ACM.
  
  
  METHODS
  69 patients (pts) with ACM (mean age 47 ± 10 years, 27 men) and 31 controls (mean age 43 ± 16 years, matched for age and gender) were recruited. Standard echocardiography and DMI data were obtained for all patients. Peak systolic longitudinal strain values (S) were determined for the left and right ventricles. Radial S was measured at the level of the mid inferolateral segment. Using a high-resolution echo-tracking system, the main indices of arterial stiffness were measured.
  
  
  RESULTS
  Of the ACM subjects, 57 had active disease (group A), and 12 controlled ACM (group B). All pts with ACM presented structural changes: a higher LV indexed mass (112 ± 36, 118 ± 23 vs 74 ± 18 g/m(2), p < 0.001) and a higher relative wall thickness (0.45 ± 0.09, 0.50 ± 0.07 vs 0.40 ± 0.07, p = 0.003) compared to controls. Also, ACM pts had functional changes: reduced LV ejection fraction (57 ± 5, 55 ± 5 vs 64 ± 4%, p < 0.001) and altered diastolic function (E/A 1.0 ± 0.4, 1.1 ± 0.1 vs 1.3 ± 0.3, p = 0.005) compared to controls. Both longitudinal and radial LV S values were lower in ACM compared to controls: -16.5 ± 3.5, -16.8 ± 4.3 vs -21.5 ± 3.8%, p < 0.001 for longitudinal and 38.3 ± 12.3, 35.6 ± 11.8 vs 52.2 ± 11.7%, p = 0.002 for radial strain.
  
  
  CONCLUSIONS
  ACM pts present LV concentric hypertrophy and LV systolic and diastolic dysfunction, even in controlled disease. Altered global LV systolic function appears to be due both to longitudinal and radial dysfunction.
authors.affiliation: University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania, rjurcut@gmail.com.
authors.forename: R
authors.initials: R
authors.lastname: Jurcut
authors.forename: S
authors.initials: S
authors.lastname: Găloiu
authors.forename: A
authors.initials: A
authors.lastname: Florian
authors.forename: A
authors.initials: A
authors.lastname: Vlădaia
authors.forename: O R
authors.initials: OR
authors.lastname: Ioniţă
authors.forename: M S
authors.initials: MS
authors.lastname: Amzulescu
authors.forename: I
authors.initials: I
authors.lastname: Baciu
authors.forename: B A
authors.initials: BA
authors.lastname: Popescu
authors.forename: M
authors.initials: M
authors.lastname: Coculescu
authors.forename: C
authors.initials: C
authors.lastname: Ginghina
mesh_terms: D000172:Acromegaly / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D000328:Adult; D009202:Cardiomyopathies / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology