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Clin Endocrinol (Oxf). 2013 Jan;78(1):94-101. doi: 10.1111/j.1365-2265.2012.04472.x.

Acromegalic cardiomyopathy in an extensively admixed population: is there a role for GH/IGF-I axis?

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1
Endocrinology Unit, Hospital Universitário Presidente Dutra, Universidade Federal do Maranhão, Rua Barão de Itapary, São Luís, Brazil. gilvancortes@uol.com.br

Abstract

BACKGROUND:

A specific acromegaly-related cardiomyopathy has been described in the literature, largely in Caucasians, which is independent of other risk factors, mainly hypertension.

OBJECTIVE:

This study assessed the cardiac changes in acromegalics of significant ethnic diversity and also the relevance of the aetiopathogenic factors involved, such as disease activity and hypertension.

DESIGN:

It is a cross-sectional study with a comparative control group.

PATIENTS AND METHODS:

In this study, 37 acromegalic patients (20 Intermediate-skinned (IS), 14 Dark-skinned (DS) and three Light-skinned (LS) individuals) and 74 controls matched by age, gender and hypertension were evaluated. Cardiac morphology and function were addressed using echocardiography parameters.

RESULTS:

The mean age of patients was 46.9 ± 12.8 years, with 67.6% being women and 43.2% hypertensive. The prevalence of left ventricular hypertrophy (LVH) between acromegalics was 56.8% vs 10.8% in the controls (P < 0.001). About 86% of patients with LVH had active disease (P = 0.023). Logistic regression revealed that disease activity presented a stronger association (OR = 5.925; CI = 1.085-32.351; P = 0.040) with LVH than hypertension (OR = 3.237; CI = 0.702-14.924; P = 0.132). When DS acromegalics were compared with IS ones, no statistically significant differences were observed.

CONCLUSION:

Chronically hyperactive somatotropic axis remains as an independent and determining factor in the development of left ventricular hypertrophy, as it is more associated with this condition than hypertension in a largely admixed population with a high degree of African ancestry.

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