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Endocrine Abstracts (2016) 41 EP903 | DOI: 10.1530/endoabs.41.EP903

1Department of Medicine, University of Padua, Padua, Italy; 2Department of Cardiac, Thoracic and Vascular Sciences, University of PAdua, Padua, Italy; 3Cardiac magnetic resonance unit, Albignasego, Italy.


Introduction: Acromegalic cardiomyopathy is characterized by myocardial hypertrophy and interstitial myocardial fibrosis at biopsy. We studied left ventricular hypertrophy -LVH- through echocardiography (-ECHO- 2-D standard echocardiography and Doppler analysis) and cardiac magnetic resonance (CMR) analysis. Myocardial fibrosis was studied with late enhancement technique (LE) and extracellular volume technique (ECV) at CMR.

Methods: 25 patients -pts- (13 males) with an average age of 49.24±11.96 yy, mean IGF-1 324(186-626) ug/L, 17pts with active disease, 9 pts had a newly diagnosed disease. Results of the CMR (on 24 pts) were compared with those of 20 controls -CTR- matched for sex and age.

Results: On ECHO: 10pts reported LVH (mean left ventricular mass index LVMi=118.83±26.32 g/m2), 17 pts had first grade diastolic dysfunction (E/A=0.81±0.3). There was no correlation between the echocardiography data and IGF-1. On CMR: 5pts had LVH (median LVMi=64.2g/m2). Pts with LVH had higher IGF-1 levels than pts without LVH (Median=801 μg/l vs 267 μg/l; P=0.01); pts with active disease had higher LVMi values than non-active pts (Median=70.2 g/m2 vs 61g/m2; P=0.007); there was a significant correlation between IGF-1 and LVMi (r=0.63; P<0.05). LE was found in 9 pts. Pts’s ECV was significantly elevated in comparison to CTR (pts=24.05±3.2% vs CTR=19.99±1.58% P<0.0001). LVMi at CMR had a significant correlation with LVMi at echocardiography (r=0.5, P<0.05).

Conclusions: This study confirms that LVH and diastolic dysfunction are key features of acromegalic cardiomyopathy. Both macroscopic (LE) and interstitial fibrosis (ECV) are common findings in acromegaly.

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