Cardiac Structural Alterations of Acromegalic, Without Alteration in Cardiac Function, Evaluated by Doppler Echocardiography with Speckle Tracking

BACKGROUND: Acromegaly is most commonly caused by growth hormone secreting pituitary (GH) macroadenoma. Cardiovascular events are the leading cause of death in this population.

OBJECTIVE: To analyze the cardiac structural and functional changes in patients with acromegaly and to correlate the findings with the concentrations of GH and IGF-1 post treatment and with the presumed time of disease.

METHOD: A quantitative study involving 19 individuals with acromegaly, 10 with inactive disease and 9 with active disease and 16 healthy individuals, matched by sex and age. Age ranged from 19 to 78 years. Two-dimensional echocardiogram and speckle tracking were performed.

RESULTS: Mean left ventricular mass index (LVMI) were significantly higher in acromegalic patients (89.1 ± 27.9) compared to the control group (66.9 ± 15.7) (p = 0.015). There was a direct correlation between IGF-1 mean concentration and left ventricular systolic volume (LVSV) in acromegalic patients (r = 0.64; p = 0.004) even when the disease was inactive (n=10; r = 0.9; p = 0.002) and between IGF1 mean concentration and left ventricular diastolic volume (LVDV). The left ventricular ejection fraction (EF) and the global longitudinal strain (GLS) did not differ between groups (p> 0.05).

CONCLUSION: Although patients with acromegaly had higher LVMI, they did not show difference in GLS indicating a small chance of progression to systolic disfunction. Direct correlation between IGF-1 and LDVD and LVSV demonstrates the relevance of a good hormonal control to reduce cardiac changes.