Cintia Marques dos Santos Silva1, Ilan Gottlieb1, Isabela Volschan1, Leandro Kasuki1, Leila Warszawski1, Giovanna Aparecida Balarini Lima1, Sergio Salles Xavier1, Roberto Coury Pedrosa1, Leonardo Vieira Neto1, Mônica R Gadelha1. 1. Neuroendocrinology Research Center/Endocrine Section (C.M.d.S.S., L.K., L.V.N., M.R.G.) and Cardiology Section (I.V., S.S.X., R.C.P.), Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Clínica de Diagnóstico por Imagem/Multi-Imagem (I.G.), Rio de Janeiro, Brazil; Radiology Department (I.G.), Casa de Saude São Jose, Rio de Janeiro, Brazil; Endocrine Section (L.K.), Hospital Federal de Bonsucesso, Rio de Janeiro, Brazil; Endocrine Section (L.W.), Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione, IEDE, Rio de Janeiro, Brazil; Endocrine Section (G.A.B.L.), Medical School and Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, Brazil; Endocrine Section (L.V.N.), Hospital Federal da Lagoa, Rio de Janeiro, Brazil.
Abstract
CONTEXT: Left ventricular hypertrophy (LVH) and myocardial fibrosis are considered common findings of the acromegaly cardiomyopathy in echocardiography studies. OBJECTIVE: To evaluate the frequency of LVH, systolic dysfunction and myocardial fibrosis was undertaken in patients with acromegaly using cardiac magnetic resonance imaging (CMRi) before and after 12 months of octreotide long-acting repeatable treatment. PATIENTS AND METHODS: Consecutive patients with active acromegaly submitted to biochemical analysis and CMRi before and after 12 months of treatment. Additionally, echocardiography was performed before treatment. RESULTS: Forty consecutive patients were evaluated using CMRi at baseline and 30 patients were reevaluated after 12 months of treatment. Additionally, 29 of these patients were submitted to echocardiography. Using CMRi, the frequency of LVH was 5%. The mean left ventricular mass index (LVMi) was 61.73 ± 18.8 g/m(2). The mean left ventricular ejection fraction (LVEF) was 61.85 ± 9.2%, and all patients had normal systolic function. Late gadolinium enhancement was present in five patients (13.5%), and one patient (3.5%) had an increased extracellular volume. After treatment, 12 patients (40%) had criteria for disease control. No clinically relevant differences in cardiac variables before and after treatment were observed. Additionally, there was no difference in LVMi and LVEF among patients with and without disease control. Using echocardiography, 31% of the patients had LVH, mean LVMi was 117.8 ± 46.3 g/m(2) and mean LVEF was 67.3 ± 4.4%. All patients had normal systolic function. CONCLUSIONS: We demonstrated by CMRi, the gold-standard method, that patients with active acromegaly might have a lower prevalence of cardiac abnormalities than previously reported.
CONTEXT: Left ventricular hypertrophy (LVH) and myocardial fibrosis are considered common findings of the acromegaly cardiomyopathy in echocardiography studies. OBJECTIVE: To evaluate the frequency of LVH, systolic dysfunction and myocardial fibrosis was undertaken in patients with acromegaly using cardiac magnetic resonance imaging (CMRi) before and after 12 months of octreotide long-acting repeatable treatment. PATIENTS AND METHODS: Consecutive patients with active acromegaly submitted to biochemical analysis and CMRi before and after 12 months of treatment. Additionally, echocardiography was performed before treatment. RESULTS: Forty consecutive patients were evaluated using CMRi at baseline and 30 patients were reevaluated after 12 months of treatment. Additionally, 29 of these patients were submitted to echocardiography. Using CMRi, the frequency of LVH was 5%. The mean left ventricular mass index (LVMi) was 61.73 ± 18.8 g/m(2). The mean left ventricular ejection fraction (LVEF) was 61.85 ± 9.2%, and all patients had normal systolic function. Late gadolinium enhancement was present in five patients (13.5%), and one patient (3.5%) had an increased extracellular volume. After treatment, 12 patients (40%) had criteria for disease control. No clinically relevant differences in cardiac variables before and after treatment were observed. Additionally, there was no difference in LVMi and LVEF among patients with and without disease control. Using echocardiography, 31% of the patients had LVH, mean LVMi was 117.8 ± 46.3 g/m(2) and mean LVEF was 67.3 ± 4.4%. All patients had normal systolic function. CONCLUSIONS: We demonstrated by CMRi, the gold-standard method, that patients with active acromegaly might have a lower prevalence of cardiac abnormalities than previously reported.
Authors: I C M Volschan; L Kasuki; C M S Silva; M L Alcantara; R M Saraiva; S S Xavier; M R Gadelha Journal: Pituitary Date: 2017-06 Impact factor: 4.107
Authors: Árpád Kormányos; Anita Kalapos; Péter Domsik; Nándor Gyenes; Nóra Ambrus; Zsuzsanna Valkusz; Csaba Lengyel; Attila Nemes Journal: Quant Imaging Med Surg Date: 2020-03