Abstract
The aim of this study was to evaluate atrial electromechanical delay (EMD), P wave dispersion (Pwd), and left atrial (LA) mechanical functions in patients with active acromegaly. Twenty-three patients with active acromegaly and 27 age- and sex-matched controls were included in this study. All atrial electromechanical interval parameters (PA lateral, PA septum, PA tricuspid, interatrial EMD, intra-LA EMD, and intra-right atrial EMD) were measured from mitral lateral annulus, mitral septal annulus, and right ventricular tricuspid annulus by tissue Doppler imaging. LA volumes were measured by the disk method in the apical four-chamber view and were indexed to the body surface area. Mechanical function parameters of LA were calculated. Pwd was performed by 12-lead electrocardiograms. Atrial electromechanical intervals (PA lateral, PA septum, PA tricuspid, interatrial EMD, intra-LA EMD, and intra-right atrial EMD) and Pwd were similar between patients with acromegaly and control subjects (all p > 0.05). LA volumes (maximum, minimum, and presystolic) and LA mechanical functions were not significantly different between the groups (all p > 0.05). Additionally, serum levels of growth hormone and insulin-like growth factor-1 were not correlated with atrial electromechanical parameters and LA mechanical functions. Atrial electrical conduction times were not prolonged and LA mechanical functions were not impaired in patients with active acromegaly compared with controls. And the prevalence of supraventricular arrhythmia risk may not increase in this population.
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J.T. Lie, Pathology of the heart in acromegaly: anatomic findings in 27 autopsied patients. Am. Heart J. 100, 41–52 (1980)
D. Morvan, M. Komajda, A. Grimaldi, G. Turpin, Y. Grosgogeat, Cardiac hypertrophy and function in asymptomatic acromegaly. Eur. Heart J. 12, 666–672 (1991)
G. Minniti, M.L. Jaffrain-Rea, C. Moroni, R. Baldelli, E. Ferretti, R. Cassone, A. Gulino, G. Tamburrano, Echocardiographic evidence for a direct effect of GH/IGF-I hypersecretion on cardiac mass and function in young acromegalics. Clin. Endocrinol. (Oxf) 49, 101–106 (1998)
G. Vitale, M. Galderisi, R. Pivonello, L. Spinelli, A. Ciccarelli, O. de Divitiis, G. Lombardi, A. Colao, Prevalence and determinants of left ventricular hypertrophy in acromegaly: impact of different methods of indexing left ventricular mass. Clin. Endocrinol. (Oxf) 60, 343–349 (2004)
M. Baykan, C. Erem, O. Gedikli, A. Hacihasanoglu, T. Erdogan, M. Kocak, S. Kaplan, A. Kırıs, S. Celik, Assessment of the Tei index by tissue doppler imaging in patients with acromegaly:serum growth hormone level is associated with the Tei index. Echocardiography 25, 374–380 (2008)
G. Vitale, R. Pivonello, R.S. Auriemma, E. Guerra, F. Milone, S. Savastano, G. Lombardi, A. Colao, Hypertension in acromegaly and in the normal population: prevalence and determinants. Clin. Endocrinol. (Oxf) 63, 470–476 (2005)
R.N. Clayton, Cardiovascular function in acromegaly. Endocr. Rev. 24, 272–277 (2003)
A. Colao, P. Marzullo, A. Cuocolo, L. Spinelli, R. Pivonello, D. Bonaduce, M. Salvatore, G. Lombardi, Reversal acromegalic cardiomyopathy in young but not in middle-aged patients after 12 months of treatment with the depot long-acting somatostatin analogue octreotide. Clin. Endocrinol. (Oxf) 58, 169–176 (2003)
G. Kahaly, K.V. Olshausen, S. Mohr-Kahaly, R. Erbel, S. Boor, J. Beyer, J. Meyer, Arrhythmia profile in acromegaly. Eur. Heart J. 13, 51–56 (1992)
S. Melmed, Acromegaly. N. Engl. J. Med. 322, 966–977 (1990)
A. Colao, D. Ferone, P. Marzullo, G. Lombardi, Systemic complications of acromegaly: epidemiology, pathogenesis and management. Endocr. Rev. 25, 102–152 (2004)
J.D.N. Nabarro, Acromegaly. Clin. Endocrinol. 26, 481–512 (1987)
A. Colao, P. Marzullo, C. Di Somma, G. Lombardi, Growth hormone and the heart. Clin. Endocrinol. (Oxf) 54, 137–154 (2001)
S.S. Damjanovics, A.N. Neskovic, M.S. Petakov, V. Popovic, B. Vujisic, M. Petrovic, M. Nikolic-Djurovic, M. Simic, S. Pekic, J. Marinkovic, High output heart failure in patients with newly diagnosed acromegaly. Am. J. Med. 112, 610–616 (2002)
A. Kırıs, C. Erem, O.E. Turan, N. Civan, G. Kırıs, I. Nuhoglu, A. Ilter, H.O. Ersoz, M. Kutlu, Left ventricular synchronicity is impaired in patients with active acromegaly. Endocrine 44, 200–206 (2013)
J. Abecasis, R. Dourado, A. Ferreira, C. Saraiva, D. Cavaco, K.R. Santos, F.B. Morgado, P. Adragão, A. Silva, Left atrial volume calculated by multi-detector computed tomography may predict successful pulmonary vein isolation in catheter ablation of atrial fibrillation. Europace 11, 1289–1294 (2009)
I. Hof, K. Chilukuri, A. Arbab-Zadeh, D. Scherr, D. Dalal, S. Nazarian, C. Henrikson, D. Spragg, R. Berger, J. Marine, H. Calkins, Does left atrial volume and pulmonary venous anatomy predict the outcome of catheter ablation of atrial fibrillation? J. Cardiovasc. Electrophysiol. 20, 1005–1010 (2009)
A. Prioli, P. Marino, L. Lanzoni, P. Zardini, Increasing degrees of left ventricular filling impairment modulate left atrial function in humans. Am. J. Cardiol. 82, 756–761 (1998)
G. Acar, M. Sayarlioğlu, A. Akçay, A. Sökmen, G. Sökmen, S. Yalçintraş, A.B. Nacar, M. Gündüz, C. Tuncer, Evaluation of atrial electromechanical delay and left atrial mechanical functions in patient with rheumatoid arthritis. Turk. Kardiyol. Dern. Ars. 37, 447–453 (2009)
J. Am, G. Acar, A. Akcay, A. Sokmen, M. Ozkaya, E. Guler, H. Kaya, A.B. Nacar, C. Tuncer, Assessment of atrial electromechanical delay, diastolic functions, and left atrial mechanical functions in patients with type 1 diabetes mellitus. Soc. Echocardiogr. 22, 732–738 (2009)
Q.Q. Cui, W. Zhang, H. Wang, X. Sun, R. Wang, H.Y. Yang, X.Q. Meng, Y. Zhang, H. Wang, Assessment of atrial electromechanical coupling and influential factors in non-rheumatic paroxysmal atrial fibrillation. Clin. Cardiol. 31, 74–78 (2008)
O. Dogdu, M. Yarlioglues, M.G. Kaya, I. Ardic, Y. Kilinc, D. Elcik, S. Kelesoglu, M. Akpek, O. Sahin, S. Cosgun, N. Oguzhan, A. Oguzhan, Assessment of atrial conduction time in patients with systemic lupus erythematosus. J. Investig. Med. 59, 281–286 (2011)
D.R. Clemmons, Clinical laboratory indices in the treatment of the acromegaly. Clin.Chim. Acta. 412, 403–409 (2011)
S. Melmed, F.F. Casanueva, A. Klibanski, M.D. Bronstein, P. Chanson, S.W. Lamberts, C.J. Strasburger, A.H. Wass, A. Giustina, A consensus on the diagnosis and treatment of acromegaly. Pituitary 16, 294–302 (2013)
M.W. Elmlinger, W. Kuhnel, M.M. Weber, M.B. Ranke, Reference ranges for two automated chemiluminescent assays for serum insulin-like growth factor I (IGF-I) and IGF-binding protein 3 (IGFBP-3). Clin. Chem. Lab. Med. 42, 654–664 (2004)
P.E. Dilaveris, E.J. Gialafos, S.K. Sideris, A.M. Theopistou, G.K. Andrikopoulos, M. Kyriakidis, J.E. Gialafos, P.K. Toutouzas, Simple electrocardiographic markers for the prediction of paroxysmal idiopathic atrial fibrillation. Am. Heart J. 135, 733–738 (1998)
R.M. Lang, M. Bierig, R.B. Devereux, F.A. Flachskampf, E. Foster, P.A. Pellikka, M.H. Picard, M.J. Roman, J. Seward, J.S. Shanewise, S.D. Solomon, K.T. Spencer, M.S. Sutton, W.J. Stewart, Chamber Quantification Writing Group; American Society of Echocardiography’s Guidelines and Standards Committee; European Association of Echocardiography. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J. Am. Soc. Echocardiogr. 18, 1440–1463 (2005)
R.B. Devereux, N. Reichek, Echocardiographic assessment of left ventricular hypertrophy:comparison to necropsy findings. Am. J. Cardiol. 57, 450–458 (1986)
J.A. Haffajee, Y. Lee, A.A. Alsheikh-Ali, J.T. Kuvin, N.G. Pandian, A.R. Patel, Pre-operative left atrial mechanical function predicts risk of atrial fibrillation following cardiac surgery. JACC Cardiovasc. Imaging. 4, 833–840 (2011)
S. Cannavo, B. Almoto, G. Cavalli, S. Squadrito, G. Romanello, M.T. Vigo, F. Fiumara, S. Benvenga, F. Trimarchi, Acromegaly and coronary disease: an integrated evaluation of conventional coronary risk factors and coronary calcifications detected by computed tomography. J. Clin. Endocrinol. Metab. 91, 3766–3772 (2006)
A. Giustina, F.F. Casanueva, F. Cavagnini, P. Chanson, D. Clemmons, L.A. Frohman, R. Gaillard, K. Ho, P. Jaquet, D.L. Kleinberg, S.W. Lamberts, G. Lombardi, M. Sheppard, C.J. Strasburger, M.L. Vance, J.A. Wass, S. Melmed, Diagnosis and treatment of acromegaly complications. J. Endocrinol. Invest. 26, 1242–1247 (2003)
P. Maison, A.I. Tropeano, I. Macquin-Mavier, A. Giustina, P. Chanson, Impact of somatostatin analogs on the heart in acromegaly: a metaanalysis. J. Clin. Endocrinol. Metab. 92, 1743–1747 (2007)
C.B. De Vos, B. Weijs, H.J. Crijns, E.C. Cheriex, A. Palmans, J. Habets, M.H. Prins, R. Pisters, R. Nieuwlaat, R.G. Tieleman, Atrial tissue doppler imaging for prediction of new-onset atrial fibrillation. Heart 95, 835–840 (2009)
S.M. Park, Y.H. Kim, J.I. Choi, H.N. Pak, Y.H. Kim, W.J. Shim, Left atrial electromechanical conduction time can predict six-month maintenance of sinus rhythm after electrical cardioversion in persistent atrial fibrillation by doppler tissue echocardiography. J. Am. Soc. Echocardiogr. 23, 309–314 (2010)
S. Ayhan, S. Ozturk, O. Dikbas, A. Erdem, M.F. Ozlu, D. Baltaci, A. Alçelik, M. Tosun, M. Ozyasar, M. Yazici, Detection of subclinical atrial dysfunction by two-dimensional echocardiography in patients with overt hyperthyroidism. Arch. Cardiovasc. Dis. 105, 631–638 (2012)
S. Ozturk, O. Dikbas, M. Ozyasar, S. Ayhan, M.F. Ozlu, D. Baltaci, A. Erdem, A. Alcelik, M. Tosun, M. Yazici, Evaluation of left atrial mechanical functions and atrial conduction abnormalities in patients with clinical hypothyroid. Cardiol. J. 19, 287–294 (2012)
B. Surawicz, M.L. Mangiardi, Electrocardiogram in endocrine and metabolic disorders. Cardiovasc. Clin. 8, 243–266 (1977)
A. Colao, B. Merola, D. Ferone, G. Lombardi, Acromegaly. J. Clin. Endocrinol. Metab. 82, 2777–2781 (1997)
G. Lombardi, A. Colao, P. Marzullo, B. Biondi, E. Palmieri, S. Fazio, Multicenter Italian Study Group on Lanreotide: improvement of left ventricular hypertrophy and arrhythmias after lanreotide-induced GH and IGF-I decrease in acromegaly. A prospective multi-center study. J. Endocrinol. Invest. 25, 971–976 (2002)
A. Frustaci, C. Chimenti, M. Setoguchi, S. Guerra, S. Corsello, F. Crea, A. Leri, J. Kajstura, P. Anversa, A. Maseri, Cell death in acromegalic cardiomyopathy. Circulation 99, 1426–1434 (1999)
L. Sacca, A. Cittadini, S. Fazio, Growth hormone and the heart. Endocr. Rev. 15, 555–573 (1994)
R. Fahlbush, J. Honegger, M. Buchfelder, Acromegaly—the place of the neurosurgeon. Metabolism 45, 65–66 (1996)
A. Giustina, E. Boni, G. Romanelli, V. Grassi, G. Giustina, Cardiopulmonary performance during exercise in acromegaly, and the effects of acute suppression of growth hormone hypersecretion with octreotide. Am. J. Cardiol. 15, 1042–1047 (1995)
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Ilter, A., Kırış, A., Kaplan, Ş. et al. Atrial conduction times and left atrium mechanical functions in patients with active acromegaly. Endocrine 48, 653–660 (2015). https://doi.org/10.1007/s12020-014-0348-1
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DOI: https://doi.org/10.1007/s12020-014-0348-1