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Acromegalic cardiomyopathy in an extensively admixed population: is there a role for GH / IGF ‐ I axis?
Author(s) -
Nascimento Gilvan Cortês,
de Oliveira Marina Torres,
Carvalho Viviane Chaves,
Lopes Maria Honorina Cordeiro,
Guimarães Sá Adriana Maria,
Souza Marinilde Teles,
de Souza Paiva Ferreira Adalgisa,
Ferreira Pedro Antônio Muniz,
Faria Manuel dos Santos
Publication year - 2013
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.1365-2265.2012.04472.x
Subject(s) - acromegaly , medicine , left ventricular hypertrophy , endocrinology , cardiomyopathy , cardiology , population , muscle hypertrophy , disease , risk factor , blood pressure , hormone , heart failure , growth hormone , environmental health
Summary Background A specific acromegaly‐related cardiomyopathy has been described in the literature, largely in Caucasians, which is independent of other risk factors, mainly hypertension. Objective This study assessed the cardiac changes in acromegalics of significant ethnic diversity and also the relevance of the aetiopathogenic factors involved, such as disease activity and hypertension. Design It is a cross‐sectional study with a comparative control group. Patients and methods In this study, 37 acromegalic patients (20 Intermediate‐skinned (IS), 14 Dark‐skinned (DS) and three Light‐skinned (LS) individuals) and 74 controls matched by age, gender and hypertension were evaluated. Cardiac morphology and function were addressed using echocardiography parameters. Results The mean age of patients was 46·9 ± 12·8 years, with 67·6% being women and 43·2% hypertensive. The prevalence of left ventricular hypertrophy (LVH) between acromegalics was 56·8% vs 10·8% in the controls ( P < 0·001). About 86% of patients with LVH had active disease ( P = 0·023). Logistic regression revealed that disease activity presented a stronger association (OR = 5·925; CI = 1·085–32·351; P = 0·040) with LVH than hypertension (OR = 3·237; CI = 0·702–14·924; P = 0·132). When DS acromegalics were compared with IS ones, no statistically significant differences were observed. Conclusion Chronically hyperactive somatotropic axis remains as an independent and determining factor in the development of left ventricular hypertrophy, as it is more associated with this condition than hypertension in a largely admixed population with a high degree of African ancestry.