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Echocardiographic findings in acromegaly: prevalence of concentric left ventricular remodeling in a large single-center cohort

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Abstract

Purpose

Acromegaly is a rare disease and is associated with increased cardiovascular (CV) morbidity and mortality, especially in patients with uncontrolled disease. We aimed to analyze the prevalence and severity of cardiomyopathy and valvular heart disease in a large cohort of patients with a confirmed acromegaly diagnosis, at baseline and after treatment.

Methods

We retrospectively reviewed an institutional approved database; 190 patients with confirmed acromegaly and follow-up data available (years 2006–2018). Patients with at least one baseline echocardiogram, were included. Demographic, disease control and echocardiogram variables were collected for analysis.

Results

Of the 190 patients 110 (58%) had a baseline echocardiogram and 43 (39.1%) had at least one follow-up echocardiogram after surgical, medical or multimodal treatment. Baseline left ventricular hypertrophy (LVH) prevalence was 17.8% (64.7% concentric; 35.3% eccentric), diastolic and systolic dysfunction, and overt cardiomyopathy with heart failure were 15.8, 7.9, and 3.0%, respectively. Concentric remodeling of the left ventricle (LV) was noted in 31.4% of patients without LVH. Valve defects were found in 87.3% of patients (14.6% with significant valvular heart disease).

Conclusion

Early diagnosis of acromegaly and disease control should be attempted to prevent LVH/LV dysfunction and development of valvular heart disease. Concentric LV remodeling develops prior to obvious LV hypertrophy in almost a third of patients with acromegaly, which is a novel finding. Similar to other epidemiological studies, we found a high prevalence of LVH/LV dysfunction. Although possible, reversal of systolic and diastolic dysfunction is sporadic after treatment of acromegaly.

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Funding

No funding source has been received for this project.

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Authors and Affiliations

  1. Department of Neurological Surgery, Oregon Health & Science University, Mail Code CH8N, 3303 South Bond Ave, Portland, OR, 97239, USA

    J. M. Hinojosa-Amaya, E. V. Varlamov, C. G. Yedinak, J. S. Cetas, S. McCartney, S. Banskota & M. Fleseriu

  2. Department of Medicine (Endocrinology, Diabetes and Clinical Nutrition), Oregon Health & Science University, 3181 S.W. Sam Jackson Park Road, Portland, OR, 97239, USA

    E. V. Varlamov & M. Fleseriu

  3. Pituitary Center, Oregon Health & Science University, Mail Code CH8N, 3303 South Bond Ave, Portland, OR, 97239, USA

    J. M. Hinojosa-Amaya, E. V. Varlamov, C. G. Yedinak, J. S. Cetas, S. McCartney, S. Banskota & M. Fleseriu

  4. Endocrinology Division, Department of Medicine, Hospital Universitario “Dr. José E. González”, Universidad Autonóma de Nuevo León, Monterrey, Nuevo León, Mexico

    J. M. Hinojosa-Amaya

  5. Operative Care Division, Portland Veterans Administration Hospital, 3710 SW US Veterans Hospital Road, Portland, OR, USA

    J. S. Cetas

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  1. J. M. Hinojosa-Amaya
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  3. C. G. Yedinak
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  4. J. S. Cetas
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  7. M. Fleseriu
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Correspondence to M. Fleseriu.

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Conflict of interest

José Miguel Hinojosa-Amaya, Elena Varlamov, Justin Cetas, Shirley McCartney, Swechya Banskota have no disclosures and no conflict of interest; Christine Yedinak disclosure–consultant for Chiasma; Maria Fleseriu disclosures–principal investigator with research support to Oregon Health & Science University for clinical research studies with Novartis, Ionis, Crinetics, Chiasma and Pfizer, and she has been an occasional scientific consultant for Novartis, Ionis, Ipsen, Crinetics, Chiasma, Recordati and Pfizer.

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Hinojosa-Amaya, J.M., Varlamov, E.V., Yedinak, C.G. et al. Echocardiographic findings in acromegaly: prevalence of concentric left ventricular remodeling in a large single-center cohort. J Endocrinol Invest 44, 2665–2674 (2021). https://doi.org/10.1007/s40618-021-01579-4

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