title: Low Frequency of Cardiomyopathy Using Cardiac Magnetic Resonance Imaging in an Acromegaly Contemporary Cohort.
abstract: BACKGROUND
  Left ventricular hypertrophy (LVH) and myocardial fibrosis are considered common findings of the acromegaly cardiomyopathy in echocardiography studies.
  
  
  OBJECTIVE
  To evaluate the frequency of LVH, systolic dysfunction and myocardial fibrosis was undertaken in patients with acromegaly using cardiac magnetic resonance imaging (CMRi) before and after 12 months of octreotide long-acting repeatable treatment.
  
  
  METHODS
  Consecutive patients with active acromegaly submitted to biochemical analysis and CMRi before and after 12 months of treatment. Additionally, echocardiography was performed before treatment.
  
  
  RESULTS
  Forty consecutive patients were evaluated using CMRi at baseline and 30 patients were reevaluated after 12 months of treatment. Additionally, 29 of these patients were submitted to echocardiography. Using CMRi, the frequency of LVH was 5%. The mean left ventricular mass index (LVMi) was 61.73 ± 18.8 g/m(2). The mean left ventricular ejection fraction (LVEF) was 61.85 ± 9.2%, and all patients had normal systolic function. Late gadolinium enhancement was present in five patients (13.5%), and one patient (3.5%) had an increased extracellular volume. After treatment, 12 patients (40%) had criteria for disease control. No clinically relevant differences in cardiac variables before and after treatment were observed. Additionally, there was no difference in LVMi and LVEF among patients with and without disease control. Using echocardiography, 31% of the patients had LVH, mean LVMi was 117.8 ± 46.3 g/m(2) and mean LVEF was 67.3 ± 4.4%. All patients had normal systolic function.
  
  
  CONCLUSIONS
  We demonstrated by CMRi, the gold-standard method, that patients with active acromegaly might have a lower prevalence of cardiac abnormalities than previously reported.
authors.affiliation: Neuroendocrinology Research Center/Endocrine Section (C.M.d.S.S., L.K., L.V.N., M.R.G.) and Cardiology Section (I.V., S.S.X., R.C.P.), Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Clínica de Diagnóstico por Imagem/Multi-Imagem (I.G.), Rio de Janeiro, Brazil; Radiology Department (I.G.), Casa de Saude São Jose, Rio de Janeiro, Brazil; Endocrine Section (L.K.), Hospital Federal de Bonsucesso, Rio de Janeiro, Brazil; Endocrine Section (L.W.), Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione, IEDE, Rio de Janeiro, Brazil; Endocrine Section (G.A.B.L.), Medical School and Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, Brazil; Endocrine Section (L.V.N.), Hospital Federal da Lagoa, Rio de Janeiro, Brazil.
authors.forename: Cintia Marques
authors.initials: CM
authors.lastname: dos Santos Silva
authors.affiliation: Neuroendocrinology Research Center/Endocrine Section (C.M.d.S.S., L.K., L.V.N., M.R.G.) and Cardiology Section (I.V., S.S.X., R.C.P.), Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Clínica de Diagnóstico por Imagem/Multi-Imagem (I.G.), Rio de Janeiro, Brazil; Radiology Department (I.G.), Casa de Saude São Jose, Rio de Janeiro, Brazil; Endocrine Section (L.K.), Hospital Federal de Bonsucesso, Rio de Janeiro, Brazil; Endocrine Section (L.W.), Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione, IEDE, Rio de Janeiro, Brazil; Endocrine Section (G.A.B.L.), Medical School and Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, Brazil; Endocrine Section (L.V.N.), Hospital Federal da Lagoa, Rio de Janeiro, Brazil.
authors.forename: Ilan
authors.initials: I
authors.lastname: Gottlieb
authors.affiliation: Neuroendocrinology Research Center/Endocrine Section (C.M.d.S.S., L.K., L.V.N., M.R.G.) and Cardiology Section (I.V., S.S.X., R.C.P.), Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Clínica de Diagnóstico por Imagem/Multi-Imagem (I.G.), Rio de Janeiro, Brazil; Radiology Department (I.G.), Casa de Saude São Jose, Rio de Janeiro, Brazil; Endocrine Section (L.K.), Hospital Federal de Bonsucesso, Rio de Janeiro, Brazil; Endocrine Section (L.W.), Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione, IEDE, Rio de Janeiro, Brazil; Endocrine Section (G.A.B.L.), Medical School and Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, Brazil; Endocrine Section (L.V.N.), Hospital Federal da Lagoa, Rio de Janeiro, Brazil.
authors.forename: Isabela
authors.initials: I
authors.lastname: Volschan
authors.affiliation: Neuroendocrinology Research Center/Endocrine Section (C.M.d.S.S., L.K., L.V.N., M.R.G.) and Cardiology Section (I.V., S.S.X., R.C.P.), Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Clínica de Diagnóstico por Imagem/Multi-Imagem (I.G.), Rio de Janeiro, Brazil; Radiology Department (I.G.), Casa de Saude São Jose, Rio de Janeiro, Brazil; Endocrine Section (L.K.), Hospital Federal de Bonsucesso, Rio de Janeiro, Brazil; Endocrine Section (L.W.), Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione, IEDE, Rio de Janeiro, Brazil; Endocrine Section (G.A.B.L.), Medical School and Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, Brazil; Endocrine Section (L.V.N.), Hospital Federal da Lagoa, Rio de Janeiro, Brazil.
authors.forename: Leandro
authors.initials: L
authors.lastname: Kasuki
authors.affiliation: Neuroendocrinology Research Center/Endocrine Section (C.M.d.S.S., L.K., L.V.N., M.R.G.) and Cardiology Section (I.V., S.S.X., R.C.P.), Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Clínica de Diagnóstico por Imagem/Multi-Imagem (I.G.), Rio de Janeiro, Brazil; Radiology Department (I.G.), Casa de Saude São Jose, Rio de Janeiro, Brazil; Endocrine Section (L.K.), Hospital Federal de Bonsucesso, Rio de Janeiro, Brazil; Endocrine Section (L.W.), Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione, IEDE, Rio de Janeiro, Brazil; Endocrine Section (G.A.B.L.), Medical School and Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, Brazil; Endocrine Section (L.V.N.), Hospital Federal da Lagoa, Rio de Janeiro, Brazil.
authors.forename: Leila
authors.initials: L
authors.lastname: Warszawski
authors.affiliation: Neuroendocrinology Research Center/Endocrine Section (C.M.d.S.S., L.K., L.V.N., M.R.G.) and Cardiology Section (I.V., S.S.X., R.C.P.), Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Clínica de Diagnóstico por Imagem/Multi-Imagem (I.G.), Rio de Janeiro, Brazil; Radiology Department (I.G.), Casa de Saude São Jose, Rio de Janeiro, Brazil; Endocrine Section (L.K.), Hospital Federal de Bonsucesso, Rio de Janeiro, Brazil; Endocrine Section (L.W.), Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione, IEDE, Rio de Janeiro, Brazil; Endocrine Section (G.A.B.L.), Medical School and Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, Brazil; Endocrine Section (L.V.N.), Hospital Federal da Lagoa, Rio de Janeiro, Brazil.
authors.forename: Giovanna Aparecida
authors.initials: GA
authors.lastname: Balarini Lima
authors.affiliation: Neuroendocrinology Research Center/Endocrine Section (C.M.d.S.S., L.K., L.V.N., M.R.G.) and Cardiology Section (I.V., S.S.X., R.C.P.), Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Clínica de Diagnóstico por Imagem/Multi-Imagem (I.G.), Rio de Janeiro, Brazil; Radiology Department (I.G.), Casa de Saude São Jose, Rio de Janeiro, Brazil; Endocrine Section (L.K.), Hospital Federal de Bonsucesso, Rio de Janeiro, Brazil; Endocrine Section (L.W.), Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione, IEDE, Rio de Janeiro, Brazil; Endocrine Section (G.A.B.L.), Medical School and Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, Brazil; Endocrine Section (L.V.N.), Hospital Federal da Lagoa, Rio de Janeiro, Brazil.
authors.forename: Sergio Salles
authors.initials: SS
authors.lastname: Xavier
authors.affiliation: Neuroendocrinology Research Center/Endocrine Section (C.M.d.S.S., L.K., L.V.N., M.R.G.) and Cardiology Section (I.V., S.S.X., R.C.P.), Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Clínica de Diagnóstico por Imagem/Multi-Imagem (I.G.), Rio de Janeiro, Brazil; Radiology Department (I.G.), Casa de Saude São Jose, Rio de Janeiro, Brazil; Endocrine Section (L.K.), Hospital Federal de Bonsucesso, Rio de Janeiro, Brazil; Endocrine Section (L.W.), Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione, IEDE, Rio de Janeiro, Brazil; Endocrine Section (G.A.B.L.), Medical School and Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, Brazil; Endocrine Section (L.V.N.), Hospital Federal da Lagoa, Rio de Janeiro, Brazil.
authors.forename: Roberto Coury
authors.initials: RC
authors.lastname: Pedrosa
authors.affiliation: Neuroendocrinology Research Center/Endocrine Section (C.M.d.S.S., L.K., L.V.N., M.R.G.) and Cardiology Section (I.V., S.S.X., R.C.P.), Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Clínica de Diagnóstico por Imagem/Multi-Imagem (I.G.), Rio de Janeiro, Brazil; Radiology Department (I.G.), Casa de Saude São Jose, Rio de Janeiro, Brazil; Endocrine Section (L.K.), Hospital Federal de Bonsucesso, Rio de Janeiro, Brazil; Endocrine Section (L.W.), Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione, IEDE, Rio de Janeiro, Brazil; Endocrine Section (G.A.B.L.), Medical School and Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, Brazil; Endocrine Section (L.V.N.), Hospital Federal da Lagoa, Rio de Janeiro, Brazil.
authors.forename: Leonardo Vieira
authors.initials: LV
authors.lastname: Neto
authors.affiliation: Neuroendocrinology Research Center/Endocrine Section (C.M.d.S.S., L.K., L.V.N., M.R.G.) and Cardiology Section (I.V., S.S.X., R.C.P.), Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Clínica de Diagnóstico por Imagem/Multi-Imagem (I.G.), Rio de Janeiro, Brazil; Radiology Department (I.G.), Casa de Saude São Jose, Rio de Janeiro, Brazil; Endocrine Section (L.K.), Hospital Federal de Bonsucesso, Rio de Janeiro, Brazil; Endocrine Section (L.W.), Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione, IEDE, Rio de Janeiro, Brazil; Endocrine Section (G.A.B.L.), Medical School and Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, Brazil; Endocrine Section (L.V.N.), Hospital Federal da Lagoa, Rio de Janeiro, Brazil.
authors.forename: Mônica R
authors.initials: MR
authors.lastname: Gadelha
mesh_terms: D000172:Acromegaly / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D000328:Adult; D009202:Cardiomyopathies / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D015331:Cohort Studies; D004719:Endomyocardial Fibrosis / Q000150:complications / Q000473:pathology; D005110:Extracellular Space / Q000000981:diagnostic imaging; D005260:Female; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000473:pathology; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000008:administration & dosage / Q000627:therapeutic use; D011859:Radiography; D013318:Stroke Volume; D014463:Ultrasonography; D016277:Ventricular Function, Left
chemical_list: D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D015282:Octreotide