Left ventricular synchronicity is impaired in patients with active acromegaly
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ORIGINAL ARTICLE
Left ventricular synchronicity is impaired in patients with active acromegaly Abdulkadir Kırıs¸ • Cihangir Erem • Og˘uzhan Ekrem Turan • Nadim Civan • Gu¨lhanım Kırıs¸ • I˙rfan Nuhog˘lu • Abdulselam I˙lter ¨ nder Erso¨z • Merih Kutlu Halil O
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Received: 9 October 2012 / Accepted: 10 December 2012 / Published online: 20 December 2012 Ó Springer Science+Business Media New York 2012
Abstract Acromegaly is associated with a variety of cardiovascular disturbances such as left ventricular hypertrophy, diastolic cardiac dysfunction, and hypertension. Left ventricular (LV) dyssynchrony means the impairment of synchronicity and is defined as the loss of the simultaneous peak contraction of corresponding cardiac segments. The objective of this study was to investigate whether acromegalic patients have left ventricular dyssynchrony. Dyssynchrony was evaluated in 30 patients with active acromegaly and 30 controls. All the patients and controls were subjected to a tissue synchronization imaging. The time to regional peak systolic tissue velocity (Ts) in LV by the six-basal-six-mid-segmental model was measured on ejection phase TSI images and four TSI parameters of systolic dyssynchrony were computed. All TSI parameters of LV dyssynchrony increased in patients with acromegaly compared to the controls: the standard deviation (SD) of the 12 LV segments Ts (43.5 ± 13.5 vs 26.2 ± 12.5, p \ 0.001); the maximal difference in Ts between any 2 of the 12 LV segments (133.3 ± 38 vs 84.6 ± 37.6, p \ 0.001); the SD of the 6 basal LV segments (41.1 ± 15.9 vs 25.4 ± 14.8, p = 0.001); and the maximal A. Kırıs¸ (&) O. E. Turan A. ˙Ilter M. Kutlu Department of Cardiology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey e-mail: [email protected] ¨ . Erso¨z C. Erem N. Civan I˙. Nuhog˘lu H. O Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey G. Kırıs¸ Department of Cardiology, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Trabzon, Turkey
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difference in Ts between any 2 of the 6 basal LV segments (102.6 ± 37.5 vs 65.2 ± 36.9, p = 0.001). In addition, there were significant relationships between the levels of growth hormone/insulin-like growth factor-1 and Ts-SD-12. LV synchronicity has been impaired in patients with acromegaly. Left ventricular dyssynchrony is associated with disease activity and it may contribute to the harmful cardiovascular effects of acromegaly. Keywords Acromegaly Growth hormone Left ventricular dyssynchrony Tissue synchronization imaging
Introduction Acromegaly is an endocrine disease which leads to different cardiovascular disturbances such as left ventricular hypertrophy [1–4], diastolic cardiac dysfunction [5], cardiomyopathy [6, 7], hypertension [8], vascular dysfunction [9], and impaired exercise performance [10]. Morbidity and mortality were increased two- to threefold in acromegaly because of cardiovascular disturbances [6]. Some my
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