Abstract
Introduction
Acromegaly is a chronic, rare hormonal disease associated with major cardiovascular comorbidities. The disease, in the majority of the cases, is caused by a benign human growth hormone secreting adenoma. Cardiovascular involvement is especially common in acromegaly patients from the most common hypertension to cardiomyopathy. It was set out to quantify right atrial (RA) morphology and function in a group of acromegaly patients using three-dimensional (3D) speckle-tracking echocardiography (3DSTE).
Methods
The study comprised 30 patients from which 8 patients were excluded due to inadequate image quality. Mean age of the remaining acromegaly patients were 53.7 ± 14.5 years (7 males). Ten patients were in active phase, while 12 subjects had inactive acromegaly. In the control group 40 healthy adults were enrolled (mean age: 52.3 ± 8.2 years, 15 males). In each case, complete two-dimensional Doppler echocardiography was performed followed by 3DSTE.
Results
Maximum (54.5 ± 14.4 ml vs. 47.2 ± 11.6 ml, p <0.05) and minimum (35.5 ± 10.2 ml vs. 29.2 ± 9.1 ml, p <0.05) RA volumes and RA volume before atrial contraction (45.1 ± 11.1 ml vs. 38.2 ± 10.3 ml, p <0.05) were significantly higher in case of acromegaly compared to the healthy controls. Both global and mean segmental peak 3D strain (-11.94 ± 7.52% vs. -8.07 ± 5.03%, p <0.05 and -17.16 ± 6.13% vs. -13.78 ± 5.35%, p <0.05) were higher in the acromegaly group compared to the controls. At atrial contraction, mean segmental radial strain (-13.22 ± 6.45% vs. -9.74 ± 4.58%, p <0.05) was significantly higher and mean segmental 3D strain (-9.78 ± 5.44% vs. -13.78 ± 5.35%, p <0.05) was significantly lower in the acromegaly group compared to the controls. Between the active and inactive group of acromegaly patients, mean segmental longitudinal strain (28.17 ± 4.89% vs. 35.34 ± 9.75%, p <0.05) was significantly different. Numerous independent strain parameters had significant correlations with different hormonal variables in the active acromegaly group. These correlations were not present in the inactive acromegaly subgroup.
Conclusion
Acromegaly is associated with significant RA volumetric and functional abnormalities.
Noninvasive Localization of Accessory Pathways in Wolff–Parkinson–White Syndrome by Three-Dimensional Speckle Tracking Echocardiography
