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Acromegaly tied to worsening heart structure, function
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Adults with acromegaly are more likely to have subclinical atherosclerosis and structural and functional damage to the heart compared with healthy adults, according to findings published in Endocrine Practice.
Güven Bari Cansu, MD, of Yunus Emre State Hospital in Eskiehir, Turkey, and colleagues evaluated 53 adults with acromegaly and 22 age- and sex-matched healthy controls to determine markers of subclinical atherosclerosis and evaluate heart structure and functioning. Researchers compared carotid intima-media thickness, pulse wave velocity and echocardiographic data between participants with and without acromegaly.
Overall, 52.8% of participants with acromegaly had active disease (mean age, 45 years; mean duration of disease, 6.7 years), and 47.2% had biochemically controlled acromegaly (mean age, 43 years; mean duration of disease, 6.6 years).
Compared with participants with biochemically controlled acromegaly and controls, participants with active disease had higher glucose (P = .001) and triglyceride levels (P = .026). Participants with acromegaly had higher carotid intima-media thickness (P = .008) and pulse wave velocity (P = .02) compared with controls.
Carotid intima-media thickness (P < .001) and pulse wave velocity (P < .001) were higher in participants with acromegaly and atherosclerotic risk factors (at least one risk factor, including diabetes, hypertension or hyperlipidemia) compared with controls.
Participants with acromegaly had higher left ventricular mass (P = .004) and left ventricular mass index (P = .016). More participants with acromegaly had left ventricular hypertrophy (50.1%) compared with controls (13.6%; P < .001). Left ventricular diastolic dysfunction was not present in any of the controls, but was present in 11.3% of participants with acromegaly.
“It has been demonstrated that achieving biochemical control over the disease may not suffice to reduce the risk of subclinical atherosclerosis nor to improve cardiac structure or functioning,” the researchers wrote. “These results may point out the likelihood that the structural and functional damage caused by the long-term exposure to excess amounts of [growth hormone]/[insulin-like growth factor I] may tend to be permanent. In addition, in reference to [left ventricular diastolic dysfunction] determination, the relevant criteria had been modified and the recommendation of conducting [left atrial volume index] assessment as an initial step has gained more importance. When [left atrial volume index] is included in the studies focusing on [left ventricular diastolic dysfunction] assessment, the high prevalence rates quantified in previous studies would, in our opinion, turn out to be lower.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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