Pulsed tissue Doppler identifies subclinical myocardial biventricular dysfunction in active acromegaly

Maurizio Galderisi, Giovanni Vitale, Antonio Bianco, Rosario Pivonello, Gaetano Lombardi, Oreste De Divitiis, Annamaria Colao

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objective: The aim of this study was to assess the role of pulsed tissue Doppler (TD) to identify left (LV) and right ventricular (RV) myocardial regional involvement in acromegaly. Patients and measurements: Thirty active acromegaly patients, free of diabetes mellitus, thyroid dysfunction, valvular and coronary heart disease, clinically overt heart failure, and 30 sex- and age-matched healthy controls underwent standard Doppler echocardiography and pulsed TD, by placing the sample volume at the level of basal posterior septum, LV lateral mitral annulus and RV lateral tricuspid annulus. Myocardial systolic (Sm) and diastolic velocities (Em/Am ratio) and time-intervals of relaxation (RTm), precontraction (PCTm) and contraction (CTm) and the PCTm/CTm ratio were measured at each level. Results: The two groups had similar heart rate, whereas acromegaly patients had higher body mass index, systolic and diastolic blood pressure, LV mass and impaired Doppler indexes of LV and RV diastolic function, without any difference in the global systolic function. At TD, acromegaly patients showed significantly delayed RTm and PCT m, reduced Em/Am, Sm and increased PCTm/CTm of posterior septum, mitral annulus and tricuspid annulus in comparison with controls. By separate multilinear regression analyses, after adjusting for body mass index, heart rate, diastolic blood pressure and LV mass index, age was the main independent determinant of tissue Doppler diastolic but not of systolic indexes. Conclusions: In active acromegaly, pulsed TD confirms LV and RV diastolic abnormalities detectable by standard Doppler, additionally identifying subclinical biventricular impairment of systolic function.

Original languageEnglish
Pages (from-to)390-397
Number of pages8
JournalClinical Endocrinology
Volume64
Issue number4
DOIs
Publication statusPublished - Apr 2006

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Acromegaly
Blood Pressure
Body Mass Index
Heart Rate
Doppler Pulsed Echocardiography
Right Ventricular Function
Heart Valve Diseases
Coronary Disease
Diabetes Mellitus
Thyroid Gland
Heart Failure
Regression Analysis

ASJC Scopus subject areas

  • Endocrinology

Cite this

Pulsed tissue Doppler identifies subclinical myocardial biventricular dysfunction in active acromegaly. / Galderisi, Maurizio; Vitale, Giovanni; Bianco, Antonio; Pivonello, Rosario; Lombardi, Gaetano; Divitiis, Oreste De; Colao, Annamaria.

In: Clinical Endocrinology, Vol. 64, No. 4, 04.2006, p. 390-397.

Research output: Contribution to journalArticle

Galderisi, Maurizio ; Vitale, Giovanni ; Bianco, Antonio ; Pivonello, Rosario ; Lombardi, Gaetano ; Divitiis, Oreste De ; Colao, Annamaria. / Pulsed tissue Doppler identifies subclinical myocardial biventricular dysfunction in active acromegaly. In: Clinical Endocrinology. 2006 ; Vol. 64, No. 4. pp. 390-397.
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N2 - Objective: The aim of this study was to assess the role of pulsed tissue Doppler (TD) to identify left (LV) and right ventricular (RV) myocardial regional involvement in acromegaly. Patients and measurements: Thirty active acromegaly patients, free of diabetes mellitus, thyroid dysfunction, valvular and coronary heart disease, clinically overt heart failure, and 30 sex- and age-matched healthy controls underwent standard Doppler echocardiography and pulsed TD, by placing the sample volume at the level of basal posterior septum, LV lateral mitral annulus and RV lateral tricuspid annulus. Myocardial systolic (Sm) and diastolic velocities (Em/Am ratio) and time-intervals of relaxation (RTm), precontraction (PCTm) and contraction (CTm) and the PCTm/CTm ratio were measured at each level. Results: The two groups had similar heart rate, whereas acromegaly patients had higher body mass index, systolic and diastolic blood pressure, LV mass and impaired Doppler indexes of LV and RV diastolic function, without any difference in the global systolic function. At TD, acromegaly patients showed significantly delayed RTm and PCT m, reduced Em/Am, Sm and increased PCTm/CTm of posterior septum, mitral annulus and tricuspid annulus in comparison with controls. By separate multilinear regression analyses, after adjusting for body mass index, heart rate, diastolic blood pressure and LV mass index, age was the main independent determinant of tissue Doppler diastolic but not of systolic indexes. Conclusions: In active acromegaly, pulsed TD confirms LV and RV diastolic abnormalities detectable by standard Doppler, additionally identifying subclinical biventricular impairment of systolic function.

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