Assessment of right ventricular functions in acromegaly: comparison of active disease with remission

Abstract

Aim Cardiac involvement in acromegaly is defined as acromegalic cardiomyopathy, an insidious and chronic disease. Previous research on acromegalic cardiomyopathy was largely focused on morphological and functional assessment of the left heart. Since the literature data regarding right heart function in acromegalic patients are limited, we aimed to evaluate the structure and function of the right heart in such patients.Material and Methods We included 43 adult participants as the acromegaly group and 42 individuals as the control group. All patients underwent echocardiographic evaluation. The results were compared between acromegaly and control groups and between active and controlled acromegaly groups.Results The acromegaly group had increased interventricular septum thickness, right ventricular (RV) free wall thickness, right atrium (RA) minor diameter, RV basal and longitudinal diameters, RV end-diastolic and end-systolic areas, E / E’ ratio, isovolumetric relaxation time, and RV ejection time. The E / A ratio and E’ velocity were reduced. GH and IGF-1 were positively correlated with RV longitudinal diameter, indexed RA minor-axis dimension, and indexed RV end-diastolic area. Patients with active acromegaly had increased RV index of myocardial performance (RVIMP) and isovolumetric contraction time and shortened RV ejection time compared to patients in remission. A RVIMP value of 0.435 predicted active acromegaly with a sensitivity and specificity of 0.83 and 0.64, respectively (p=0.002).Conclusions Increases in the size and diameters of the right heart chambers along with RV free wall thickness may be attributed to acromegalic cardiomyopathy. RVIMP, isovolumetric contraction time, and ejection time are parameters that can be used in the evaluation of active acromegaly disease.

Myocardial, Valvular, and Vascular Structural and Functional Properties in Acromegaly

“…Increased RA minor diameter could be detected in acromegaly, which correlated with hGH and IGF-1 levels [93]. Profound RA remodeling could be demonstrated, including RA dilation in all phases of RA function without changes in any RA-SV and RA-EmF values, especially in acromegaly patients with active disease in the MAGYAR-Path Study.…”

“…hGH and IGF-1 positively correlated with RV longitudinal diameter and indexed RV end-diastolic area. Patients with active acromegaly had increased RV index of myocardial performance, isovolumetric contraction time, and shortened RV ejection time compared to patients in remission [93]. In another study, increased deceleration time and decreased E/A were found [94].…”