title: Severe sleep apnea-hypopnea syndrome is related to left ventricle dysfunction and hypertrophy in acromegalic patients.
abstract: OBJECTIVE
  To assess whether sleep apnea-hypopnea syndrome (SAHS) is a risk factor for development of acromegalic cardiomyopathy.
  
  
  METHODS
  A descriptive, cross-sectional study of 32 patients with acromegaly (15 categorized as non-controlled-NCA and 17 as controlled-CA) compared to 20 matched controls (by sex, age, and BMI) referred to the pulmonology department for suspected SAHS. Polysomnography, echocardiography (M-mode, 2-dimensional, and Doppler), and 12-lead electrocardiography were performed in all participants. Development of cardiac morbidity (ischemia heart disease or heart failure) was evaluated after 7 years.
  
  
  RESULTS
  SAHS was diagnosed in 81.3% of patients with acromegaly and 85% of controls. Mild SAHS was more common in CA than in NCA patients (31.3% vs. 0%, p=0.048). There was a trend to greater prevalence of left ventricular diastolic dysfunction (LVDD) in acromegalic patients as compared to controls (58.1% vs. 30%, p=0.05). Presence of severe SAHS in patients with acromegaly was related to greater risk of LVDD (90.9% vs. 40%, p=0.008; OR 2.3 [1.3-4.0]), LV hypertrophy (55.6% vs. 10.5%, p=0.02; OR 5.3 [1.3-22.2]), and cardiac events (87.5% vs. 35.6%; p=0.01; OR 7.53 [1.07-53.24]).
  
  
  CONCLUSIONS
  SAHS is highly prevalent in patients with acromegaly. Only in these patients was severe SAHS associated to hypertrophy, LV diastolic dysfunction, and cardiac events.
authors.affiliation: Endocrine Department, Hospital General Universitario Alicante, Alicante, Spain. Electronic address: ruthsanchez@coma.es.
authors.forename: Ruth
authors.initials: R
authors.lastname: Sanchez-Ortiga
authors.affiliation: Cardiology Department, Hospital General Universitario Alicante, Alicante, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Climent
authors.affiliation: Endocrine Department, Hospital General Universitario Alicante, Alicante, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Sanchez-Tejada
authors.affiliation: Pneumology Department, Hospital General Universitario Alicante, Alicante, Spain.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Candela
authors.affiliation: Endocrine Department, Hospital General Universitario Alicante, Alicante, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pico
mesh_terms: D000172:Acromegaly / Q000453:epidemiology* / Q000503:physiopathology; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D017379:Hypertrophy, Left Ventricular / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology; D017286:Polysomnography; D015995:Prevalence; D011446:Prospective Studies; D012306:Risk; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology* / Q000503:physiopathology; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology
keywords: Acromegalia; Acromegaly; Cardiomiopatía; Cardiomyopathy; Sleep apnea–hypopnea syndrome; Sleep-disordered breathing; Síndrome de apnea-hipopnea del sueño; Transtorno respiratorio del sueño