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Pulsed tissue Doppler identifies subclinical myocardial biventricular dysfunction in active acromegaly
Author(s) -
Galderisi Maurizio,
Vitale Giovanni,
Bianco Antonio,
Pivonello Rosario,
Lombardi Gaetano,
Divitiis Oreste de,
Colao Annamaria
Publication year - 2006
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.2006.02475.x
Subject(s) - acromegaly , medicine , subclinical infection , cardiology , endocrinology , doppler effect , doppler echocardiography , diastole , hormone , growth hormone , blood pressure , physics , astronomy
Summary Objective The aim of this study was to assess the role of pulsed tissue Doppler (TD) to identify left (LV) and right ventricular (RV) myocardial regional involvement in acromegaly. Patients and measurements Thirty active acromegaly patients, free of diabetes mellitus, thyroid dysfunction, valvular and coronary heart disease, clinically overt heart failure, and 30 sex‐ and age‐matched healthy controls underwent standard Doppler echocardiography and pulsed TD, by placing the sample volume at the level of basal posterior septum, LV lateral mitral annulus and RV lateral tricuspid annulus. Myocardial systolic (S m ) and diastolic velocities (E m /A m ratio) and time‐intervals of relaxation (RT m ), precontraction (PCT m ) and contraction (CT m ) and the PCT m /CT m ratio were measured at each level. Results The two groups had similar heart rate, whereas acromegaly patients had higher body mass index, systolic and diastolic blood pressure, LV mass and impaired Doppler indexes of LV and RV diastolic function, without any difference in the global systolic function. At TD, acromegaly patients showed significantly delayed RT m and PCT m, reduced E m /A m , S m and increased PCT m /CT m of posterior septum, mitral annulus and tricuspid annulus in comparison with controls. By separate multilinear regression analyses, after adjusting for body mass index, heart rate, diastolic blood pressure and LV mass index, age was the main independent determinant of tissue Doppler diastolic but not of systolic indexes. Conclusions In active acromegaly, pulsed TD confirms LV and RV diastolic abnormalities detectable by standard Doppler, additionally identifying subclinical biventricular impairment of systolic function.