Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2012) 29 P1402

ICEECE2012 Poster Presentations Pituitary Clinical (183 abstracts)

Cardiac magnetic resonance imaging detects myocardial fibrosis in patients with active acromegaly

J Feldkamp 1 , J Reinhardt 1 , S Gottschalk 1 , T Rommel 1 , H Gehl 1 , D Buschsieweke 2 & C Stellbrink 1


1Klinikum Bielefeld, Bielefeld, Germany; 2Endocrine Practice, Guetersloh, Germany.


Background: Acromegaly affects almost all organs, including the cardiovascular system. Long-term exposure to high levels of IGH and insulin-like-growth-factor 1 (IGF1) may lead to cardiomyopathy.

Study design: Aim of our investigation was to study cardiac function in patients with active acromegaly using magnetic resonance imaging of the heart (cardiac-MRI) and echocardiography. Eleven patients with active acromegaly could be evaluated within a period of 6 months.

Results: Mean age of the patients (six woman, five men) was 51.5 years (range 23–78). As IGF1 levels have age-related normal ranges, Z-scores were used to compare the endocrine tumor activity. Mean IGF1 value was 416.2 ng/ml ± 228.9 with a mean Z-score for all patients with 2.7.

Echocardiographic evaluation revealed a hypertrophic left ventricle in five patients (45.5%) with an enlarged left atrium in six patients (54.5%). Interventicular septal thickness was enlarged in seven acromegalic patients (63.6%). Mean septal thickness was 12.5 mm (24)±2.3 in men and 12.3 mm±3.0 in women. Diastolic dysfunction measured by early (E) to late (A) atrial peak velocities (E/A ratio) could be seen in three patients (27.8%). Systolic left ventricular ejection fraction (LVEF) was within the low normal range (mean 57.2%±3.6) in all but one patient.

Cardiac MRI confirmed left ventricular hypertrophy in five patients. In four patients (36.4%) a late enhancement could be found in MRI imaging as a sign of myocardial fibrosis. Intramyocardial oedema coud nor be detected. All but one patient with pathologic findings in cardio-MRI or in echocardiography had Z-scores for IGF1 levels above 2.2.

Conclusion: Cardio-MRI gives additional information to standard echocardiographic examinations in the cardiovascular work-up of patients with acromegaly. For the first time cardiac fibrosis could be detected in a relevant proportion of patients with acromegaly by MRI.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

Volume 29

15th International & 14th European Congress of Endocrinology

European Society of Endocrinology 

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