• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of brheartjLink to Publisher's site
Br Heart J. Sep 1989; 62(3): 185–194.
PMCID: PMC1216761

Subclinical cardiac dysfunction in acromegaly: evidence for a specific disease of heart muscle.

Abstract

Acromegaly is associated with an increased cardiac morbidity and mortality, but it is not clear whether this is the result of increased incidence of hypertension and coronary heart disease or of a specific disease of heart muscle. Thirty four acromegalic patients were studied by non-invasive techniques. Seven of these patients had raised plasma concentrations of growth hormone at the time of study; three were newly diagnosed and had not received any treatment. Hypertension was present in nine (26%) but only three (9%) had electrocardiographic left ventricular hypertrophy. Echocardiography showed ventricular hypertrophy in 12 (48%) and increased left ventricular mass in 17 (68%) patients. Holter monitoring detected important ventricular arrhythmias in 14 patients. Thallium-201 scanning showed evidence for coronary heart disease in eight patients. Systolic time intervals were normal except when there was coexistent ischaemic heart disease. A comparison between 19 acromegalic patients with no other detectable cause of heart disease and 22 age matched controls showed appreciably abnormal left ventricular diastolic function in the group with acromegaly. The abnormalities shown did not correlate with left ventricular mass or wall thickness. There was no difference in diastolic function between patients with active acromegaly and those with treated acromegaly. Hypertensive acromegalic patients had worse diastolic function than hypertensive controls, suggesting that hypertension may further impair the left ventricular diastolic abnormality in acromegaly. This is the first study to find evidence of subclinical cardiac diastolic dysfunction in acromegaly and it supports the suggestion that there is a specific disease of heart muscle in acromegaly.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.4M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Pepine CJ, Aloia J. Heart muscle disease in acromegaly. Am J Med. 1970 Apr;48(4):530–534. [PubMed]
  • HEJTMANCIK MR, BRADFIELD JY, Jr, HERRMAN GR. Acromegaly and the heart: a clinical and pathologic study. Ann Intern Med. 1951 Jun;34(6):1445–1456. [PubMed]
  • McGuffin WL, Jr, Sherman BM, Roth F, Gorden P, Kahn CR, Roberts WC, Frommer PL. Acromegaly and cardiovascular disorders. A prospective study. Ann Intern Med. 1974 Jul;81(1):11–18. [PubMed]
  • Rossi L, Thiene G, Caragaro L, Giordano R, Lauro S. Dysrhythmias and sudden death in acromegalic heart disease. A clinicopathologic study. Chest. 1977 Oct;72(4):495–498. [PubMed]
  • Lie JT. Pathology of the heart in acromegaly: anatomic findings in 27 autopsied patients. Am Heart J. 1980 Jul;100(1):41–52. [PubMed]
  • Jonas EA, Aloia JF, Lane FJ. Evidence of subclinical heart muscle dysfunction in acromegaly. Chest. 1975 Feb;67(2):190–194. [PubMed]
  • Martins JB, Kerber RE, Sherman BM, Marcus ML, Ehrhardt JC. Cardiac size and function in acromegaly. Circulation. 1977 Nov;56(5):863–869. [PubMed]
  • O'Keefe JC, Grant SJ, Wiseman JC, Stiel JN, Wilmshurst EG, Cooper RA, Edwards AC. Acromegaly and the heart--echocardiographic and nuclear imaging studies. Aust N Z J Med. 1982 Dec;12(6):603–607. [PubMed]
  • Bonow RO, Bacharach SL, Green MV, Kent KM, Rosing DR, Lipson LC, Leon MB, Epstein SE. Impaired left ventricular diastolic filling in patients with coronary artery disease: assessment with radionuclide angiography. Circulation. 1981 Aug;64(2):315–323. [PubMed]
  • Qureshi S, Wagner HN, Jr, Alderson PO, Housholder DF, Douglass KH, Lotter MG, Nickoloff EL, Tanabe M, Knowles LG. Evaluation of left-ventricular function in normal persons and patients with heart disease. J Nucl Med. 1978 Feb;19(2):135–141. [PubMed]
  • Inouye I, Massie B, Loge D, Topic N, Silverstein D, Simpson P, Tubau J. Abnormal left ventricular filling: an early finding in mild to moderate systemic hypertension. Am J Cardiol. 1984 Jan 1;53(1):120–126. [PubMed]
  • Bonow RO, Rosing DR, Bacharach SL, Green MV, Kent KM, Lipson LC, Maron BJ, Leon MB, Epstein SE. Effects of verapamil on left ventricular systolic function and diastolic filling in patients with hypertrophic cardiomyopathy. Circulation. 1981 Oct;64(4):787–796. [PubMed]
  • Magorien DJ, Shaffer P, Bush C, Magorien RD, Kolibash AJ, Unverferth DV, Bashore TM. Hemodynamic correlates for timing intervals, ejection rate and filling rate derived from the radionuclide angiographic volume curve. Am J Cardiol. 1984 Feb 1;53(4):567–571. [PubMed]
  • Rodrigues EA, Lahiri A, Hughes LO, Kohli RS, Whittington JR, Raftery EB. Antianginal efficacy of carvedilol, a beta-blocking drug with vasodilating activity. Am J Cardiol. 1986 Nov 1;58(10):916–921. [PubMed]
  • Weissler AM, Garrard CL., Jr Systolic time intervals in cardiac disease (II). Mod Concepts Cardiovasc Dis. 1971 Feb;40(2):5–8. [PubMed]
  • O'Hara MJ, Lahiri A, Whittington JR, Crawley JC, Raftery EB. Detection of high risk coronary artery disease by thallium imaging. Br Heart J. 1985 Jun;53(6):616–623. [PMC free article] [PubMed]
  • Lahiri A, Zanelli GD, O'Hara MJ, Bowles MJ, Jones RI, Cave AP, Raftery EB. Simultaneous measurement of left ventricular function and myocardial perfusion during a single exercise test: dual isotope imaging with gold-195 m and thallium-201. Eur Heart J. 1986 Jun;7(6):493–500. [PubMed]
  • Lahiri A, O'Hara MJ, Bowles MJ, Crawley JC, Raftery EB. Influence of left ventricular function and severity of coronary artery disease on exercise-induced pulmonary thallium-201 uptake. Int J Cardiol. 1984 Apr;5(4):475–490. [PubMed]
  • Devereux RB, Reichek N. Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method. Circulation. 1977 Apr;55(4):613–618. [PubMed]
  • Adam WE, Tarkowska A, Bitter F, Stauch M, Geffers H. Equilibrium (gated) radionuclide ventriculography. Cardiovasc Radiol. 1979 Sep;2(3):161–173. [PubMed]
  • Rodrigues EA, Lahiri A, Raftery EB. Improvement in left ventricular diastolic function in patients with stable angina after chronic treatment with verapamil and nicardipine. Eur Heart J. 1987 Jun;8(6):624–629. [PubMed]
  • Lahiri A, Rodrigues EA, Al-Khawaja I, Raftery EB. Effects of a new vasodilating beta-blocking drug, carvedilol, on left ventricular function in stable angina pectoris. Am J Cardiol. 1987 Apr 1;59(8):769–774. [PubMed]
  • Hains AD, Al-Khawaja I, Hinge DA, Lahiri A, Raftery EB. Radionuclide left ventricular ejection fraction: a comparison of three methods. Br Heart J. 1987 Mar;57(3):242–246. [PMC free article] [PubMed]
  • Romhilt DW, Estes EH., Jr A point-score system for the ECG diagnosis of left ventricular hypertrophy. Am Heart J. 1968 Jun;75(6):752–758. [PubMed]
  • Mather HM, Boyd MJ, Jenkins JS. Heart size and function in acromegaly. Br Heart J. 1979 Jun;41(6):697–701. [PMC free article] [PubMed]
  • Wright AD, Hill DM, Lowy C, Fraser TR. Mortality in acromegaly. Q J Med. 1970 Jan;39(153):1–16. [PubMed]
  • Harris CN, Aronow WS, Parker DP, Kaplan MA. Treadmill stress test in left ventricular hypertrophy. Chest. 1973 Mar;63(3):353–357. [PubMed]
  • Smallridge RC, Rajfer S, Davia J, Schaaf M. Acromegaly and the heart. An echocardiographic study. Am J Med. 1979 Jan;66(1):22–27. [PubMed]
  • Savage DD, Henry WL, Eastman RC, Borer JS, Gorden P. Echocardiographic assessment of cardiac anatomy and function in acromegalic patients. Am J Med. 1979 Nov;67(5):823–829. [PubMed]
  • Diamond G, Forrester JS. Effect of coronary artery disease and acute myocardial infarction on left ventricular compliance in man. Circulation. 1972 Jan;45(1):11–19. [PubMed]
  • Hughes LO, Lahiri A, Raftery EB. Improvement in indices of myocardial ischaemia in a case of hypertrophic obstructive cardiomyopathy treated with verapamil. Nucl Med Commun. 1987 Mar;8(3):177–182. [PubMed]

Articles from British Heart Journal are provided here courtesy of BMJ Group

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • MedGen
    MedGen
    Related information in MedGen
  • PubMed
    PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...