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Two-dimensional speckle tracking echocardiography demonstrates no effect of active acromegaly on left ventricular strain

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Abstract

Background

Speckle tracking echocardiography (STE) allows for the study of myocardial strain (ε), a marker of early and subclinical ventricular systolic dysfunction. Cardiac disease may be present in patients with acromegaly; however, STE has never been used to evaluate these patients.

Objective

To evaluate left ventricular (LV) global longitudinal strain in patients with active acromegaly with normal LV systolic function.

Design

Cross-sectional clinical study.

Methods

Patients with active acromegaly with no detectable heart disease and a control group were matched for age, gender, arterial hypertension and diabetes mellitus underwent STE. Global LV longitudinal ε (GLS), left ventricular mass index (LVMi), left ventricular ejection fraction (LVEF) and relative wall thickness (RWT) were obtained via two-dimensional (2D) echocardiography using STE.

Results

Thirty-seven patients with active acromegaly (mean age 45.6 ± 13.8; 48.6% were males) and 48 controls were included. The mean GLS was not significantly different between the acromegaly group and the control group (in %, −20.1 ± 3.1 vs. −19.4 ± 2.2, p = 0.256). Mean LVMi was increased in the acromegaly group (in g/m2, 101.6 ± 27.1 vs. 73.2 ± 18.6, p < 0.01). There was a negative correlation between LVMi and GLS (r = −0.39, p = 0.01).

Conclusions

Acromegaly patients, despite presenting with a higher LVMi when analyzed by 2D echocardiography, did not present with impairment in the strain when compared to a control group; this finding indicates a low chance of evolution to systolic dysfunction and agrees with recent studies that show a lower frequency of cardiac disease in these patients.

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Funding

The research has not received funding from any organization or company and was sponsored by the authors themselves.

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Authors and Affiliations

  1. Cardiology Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rodolpho Paulo Rocco, 255, 9th floor, Ilha do Fundão, Rio de Janeiro, 21941-913, Brazil

    I. C. M. Volschan & S. S. Xavier

  2. Neuroendocrinology Research Center/ Endocrinology Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil

    L. Kasuki, C. M. S. Silva & M. R. Gadelha

  3. Neuroendocrine Unit, Instituto Estadual do Cérebro Paulo Niemeyer, Secretaria Estadual de Saúde do Rio de Janeiro, Rio de Janeiro, Brazil

    L. Kasuki & M. R. Gadelha

  4. Endocrine Section, Hospital Federal de Bonsucesso, Rio de Janeiro, Brazil

    L. Kasuki

  5. Echocardiographic Section, Hospital Samaritano e Americas Medical City, Rio de Janeiro, Brazil

    M. L. Alcantara

  6. Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil

    R. M. Saraiva

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  1. I. C. M. Volschan
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  2. L. Kasuki
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  3. C. M. S. Silva
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Correspondence to I. C. M. Volschan.

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Conflict of interest

MRG has received unrestricted research grants and lecture fees from Novartis, Ipsen and Pfizer, has participated on advisory boards of Novartis and Ionis, and is a principal investigator in clinical trials by Novartis and Ipsen. The other authors have no conflicts of interest.

Ethical approval

All procedures performed were in accordance with the ethical standards of the HUCFF/UFRJ ethical committee and with the 1964 Helsinki declaration and its later amendments. Informed consent was obtained from all individual participants included in the study.

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Volschan, I.C.M., Kasuki, L., Silva, C.M.S. et al. Two-dimensional speckle tracking echocardiography demonstrates no effect of active acromegaly on left ventricular strain. Pituitary 20, 349–357 (2017). https://doi.org/10.1007/s11102-017-0795-9

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