title: Acromegaly-induced cardiomyopathy with dobutamine-induced outflow tract obstruction.
abstract: A 50-year-old man with a history of acromegaly was referred for preoperative cardiac evaluation preceding trans-sphenoidal resection of a pituitary macroadenoma. Dobutamine stress echocardiography was negative for myocardial ischaemia. Resting left ventricular (LV) LV ejection fraction (LVEF) was 64% and there was hypertrophy of ventricular septum (18 mm) without resting LV outflow tract obstruction. With 40 µg/kg/min of dobutamine, the LVEF became hyperdynamic at 80%, and there was a maximal instantaneous LV outflow tract gradient of 77 mm Hg. There was no delayed myocardial enhancement on cardiac MRI and the pattern of hypertrophy was concentric. Acromegaly-induced cardiomyopathy can mimic hypertrophic cardiomyopathy in the setting of dobutamine provocation. Because cardiomyopathy is an important cause of mortality in acromegaly, diagnosis and appropriate management are critical to improve survival.
authors.affiliation: Department of Cardiology, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Mahmoud A
authors.initials: MA
authors.lastname: Abdelsalam
authors.affiliation: Department of Endocrinology, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Todd B
authors.initials: TB
authors.lastname: Nippoldt
authors.affiliation: Department of Cardiology, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Geske
mesh_terms: D000172:Acromegaly / Q000150:complications*; D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000209:etiology*; D004280:Dobutamine; D025401:Echocardiography, Stress; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016277:Ventricular Function, Left; D014694:Ventricular Outflow Obstruction / Q000209:etiology*
chemical_list: D004280:Dobutamine