Endocrine Abstracts

Introduction: Cardiac disease called acromegalic cardiomyopathy may be present in patients with acromegaly at diagnosis, however most echocardiographic studies showed that systolic function in these patients is normal. Speckle tracking echocardiography (STE) is a novel method that allows for the study of global longitudinal strain (GLS), a marker of early and subclinical left ventricular (LV) systolic dysfunction.

Objective: To evaluate left ventricular GLS in patients with naive acromegaly with normal LV systolic function.

Patients and methods: Fifty-one consecutive patients with naive acromegaly with normal systolic LV function measured by ejection fraction (EF), and a control group were matched for age and gender underwent 2D-STE.

Results: The mean GLS was significantly lower in acromegaly group than in the controls (in%, −17.28±4.9 vs. −20.9±3.2, P<0.01). Majority of acromegalic patients (60.7%) had abnormal GLS. Patients with impairment in GLS had statistically significant longer duration of acromegaly symptoms compared to those with normal GLS values (years, 10.0 vs. 5.0, P<0.05). Acromegalics with lower GLS had also statistically significant increase in parameters of LV thickness i.e. intraventicular septum (IVS) [in mm, 13 (8–19) vs. 11.5 (8–14), P<0.05] and posterior wall (PW) [in mm, 13 (8–17) vs. 12 (9–13) P<0.05] compared to those with normal GLS values. Mean left ventricular mass index (LVMi) was increased in the acromegaly group compared to controls (in g/m², 138.8±36.5 vs. 99.4±24.0, P<0.01). There was a statistically significant negative correlation between LVMi and GLS (R=−0.38, P< 0.01)

Conclusions: Naive acromegalic patients presented with lower GLS compared to the control group. This finding indicates subclinical systolic dysfunction in the untreated acromegalic patients. It cannot be ruled out that the LV function measured with GLS improves as an effect of treatment; it requires further studies. We found longer disease duration in a group of acromegalic patients with impairment in GLS compared to those with normal values. Increased efforts should be made to diagnose acromegaly at early stage to prevent cardiac systolic dysfunction.