Cardiac hypertrophy and function in asymptomatic acromegaly.
Cardiac hypertrophy and function in asymptomatic acromegaly.
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无症状肢端肥大症的心脏肥大和功能。
DOI：
10.1093/eurheartj/12.6.666
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发表时间：
1991
影响因子：
39.3
通讯作者：
G. Turpin
中科院分区：
文献类型：
--
作者：
D. Morvan;M. Komajda;Y. Grosgogeat;A. Grímaldi;G. Turpin
心脏病常发生在肢端肥大症晚期。为了在没有明显心脏病的情况下研究肢端肥大症患者的心脏质量和功能，我们对 15 名无症状肢端肥大症患者（其中 6 名患有全身性高血压）进行了多普勒超声心动图检查。这些数据与一组 10 名年龄匹配的对照组的数据进行了比较。肢端肥大症患者的左心室质量指数 (LVMI) 增加（110 +/- 32 vs 32 +/- 12 g m-2，P = 0.02），但缩短分数和收缩时间间隔没有差异。二尖瓣 EF 斜率降低（80 +/- 21 vs 101 +/- 30 mms-1，P 小于 0.02），而等容舒张期 (IRP) 持续时间增加（92 +/- 13 vs 69 +/- 16 ms，P 小于 0.01）。高血压肢端肥大症患者 (n = 6) 的 LVMI 高于正常血压肢端肥大症患者 (n = 9) (133 +/- 27 vs 94 +/- 24 g m-2, P = 0.02)，这一点通过文献中数据的荟萃分析得到证实：存在高血压时肥厚患病率为 76%，而不存在高血压时肥厚患病率为 50%，P 小于 0.002。与正常对照组相比，血压正常的肢端肥大症患者的 IRP 延长（90 +/- 11 vs 69 +/- 16 ms，P 小于 0.01）。总之，在没有明显心脏病的情况下，肢端肥大症经常出现亚临床心脏异常，而无症状高血压肢端肥大症则可见肥厚。此外，舒张异常见于无症状肢端肥大症，可能是由多种心脏相关因素引起的。
Heart disease frequently occurs in advanced acromegaly. In order to investigate cardiac mass and function in acromegaly in the absence of obvious cardiac disease, we performed Doppler echocardiography in 15 asymptomatic acromegalic patients (six of them had systemic hypertension). The data were compared with those of a group of 10 age-matched controls. Left ventricular mass index (LVMI) was increased in acromegaly (110 +/- 32 vs 32 +/- 12 g m-2, P = 0.02), but shortening fraction and systolic time intervals did not differ. Mitral EF slope was decreased (80 +/- 21 vs 101 +/- 30 mms-1, P less than 0.02), while the duration of the isovolumic relaxation period (IRP) was increased (92 +/- 13 vs 69 +/- 16 ms, P less than 0.01). Hypertensive acromegalic patients (n = 6) had a higher LVMI than normotensive acromegalic patients (n = 9) (133 +/- 27 vs 94 +/- 24 g m-2, P = 0.02) and this was confirmed by a meta-analysis of data in the literature: the prevalence of hypertrophy was 76% in the presence of hypertension vs 50% in its absence, P less than 0.002. IRP was prolonged in normotensive acromegalic patients vs normal controls (90 +/- 11 vs 69 +/- 16 ms, P less than 0.01). In conclusion, subclinical cardiac abnormalities occur frequently in acromegaly in the absence of obvious heart disease, and hypertrophy is observed in asymptomatic hypertensive acromegaly. Moreover, diastolic abnormalities are found in asymptomatic acromegaly and could be caused by several heart-related factors.