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

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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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