Endocrine Abstracts

Introduction: Sleep disordered breathing (SDB) promotes structural myocardial changes and can trigger cardiac arrhythmias. Acromegalic patients have high prevalence of SDB and GH–IGF1 excess is related to a specific cardiomyopathy characterized by concentric cardiac hypertrophy and diastolic dysfunction. The aim of this study was to assess the relationship between SDB and cardiac dysfunction on acromegalic patients.

Material and methods: Observational descriptive study of 32 acromegalic patients (14 men, 50.3±11.4 years, 21 treated with somatostatin analogues (SSA)) and 20 patients referred to the respiratory department for SDB study paired with acromegalic patients in sex, age and BMI (10 men, 53.2±12.7 years). Polysomnography, echocardiography and electrocardiography (ECG) were performed in all patients. Patients were defined having sleep-apnea (SA) if they had more than ten apneas or hypopnoeas per hour. Pearson, t-Student and χ² tests were used for statistical analysis.

Results: 24 (75%) acromegalic patients and 15 (78.9%) controls had SA, all of them due to obstructive cause. 18 (58.1%) acromegalic patients and 6 (30%) controls had diastolic dysfunction of left ventricle (P=0.05). Patients with/without SSA did not have different prevalence of SA or cardiac dysfunction. Only acromegalic patients, but not controls, with SA compared with those without SA had higher diastolic LV diameter (49.7±6.9 vs 44.7±3.7, P=0.02) and higher pulmonary artery systolic pressure (35.3±4.5 vs 22.0±7.6, P=0.01). Moreover, they had a trend toward less cardiac frequency (72.6±7.7 vs 78.1±9.1, P=0.08), less ejection fraction (62.6±12.7 vs 71.4±10.4, P=0.09) and more alterations on ECG (50 vs 12.5%, P 0.09).

Conclusions: SDB is a risk factor to cardiac abnormalities in acromegalic and non acromegalic people. The prevalence of cardiac abnormalities in acromegaly is higher when SA is present, independent of the cure or control of acromegaly.