Clinical Endocrinology

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

Authors

  • Gilvan Cortês Nascimento,

    Corresponding author
    1. Centro de Pesquisa Clínica, Universidade Federal do Maranhão, UFMA, São Luís, Brazil
    • Endocrinology Unit, Hospital Universitário Presidente Dutra, Universidade Federal do Maranhão, São Luís, Brazil
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  • Marina Torres de Oliveira,

    1. Centro de Pesquisa Clínica, Universidade Federal do Maranhão, UFMA, São Luís, Brazil
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  • Viviane Chaves Carvalho,

    1. Endocrinology Unit, Hospital Universitário Presidente Dutra, Universidade Federal do Maranhão, São Luís, Brazil
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  • Maria Honorina Cordeiro Lopes,

    1. Endocrinology Unit, Hospital Universitário Presidente Dutra, Universidade Federal do Maranhão, São Luís, Brazil
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  • Adriana Maria Guimarães Sá,

    1. Centro de Pesquisa Clínica, Universidade Federal do Maranhão, UFMA, São Luís, Brazil
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  • Marinilde Teles Souza,

    1. Centro de Pesquisa Clínica, Universidade Federal do Maranhão, UFMA, São Luís, Brazil
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  • Adalgisa de Souza Paiva Ferreira,

    1. Centro de Pesquisa Clínica, Universidade Federal do Maranhão, UFMA, São Luís, Brazil
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  • Pedro Antônio Muniz Ferreira,

    1. Cardiology Unit, Hospital Universitário Presidente Dutra, Universidade Federal do Maranhão, UFMA, São Luís, Brazil
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  • Manuel dos Santos Faria

    1. Endocrinology Unit, Hospital Universitário Presidente Dutra, Universidade Federal do Maranhão, São Luís, Brazil
    2. Centro de Pesquisa Clínica, Universidade Federal do Maranhão, UFMA, São Luís, Brazil
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Correspondence: Gilvan Cortês Nascimento, Rua Almirante Tamandaré, 1, Centro, São Luís, Maranhão, Brazil. Tel.: 55 98 99934393; Fax: 55 98 32465312; E-mail: gilvancortes@uol.com.br

Summary

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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