Diastolic Function Study with Conventional and Pulsed Tissue Doppler Echocardiography Imaging in Acromegalic Patients

Leães, Carolina García Soares; Kramer, Caroline; Pereira-Lima, Júlia Fernanda Semmelmann; Hatem, Domingos; Castro, Iran; Oliveira, Miriam da Costa

doi:10.1111/j.1540-8175.2008.00857.x

Cited by 7 publications

(5 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…16 Previous studies demonstrated negative effects of LV hypertrophy on LV functions by conventional and tissue Doppler echocardiography in various circumstances. [17][18][19] In addition, a positive and significant correlation of increased LV mass with myocardial dysfunction was demonstrated in the literature. 20,21 Based on these data, an increased LV mass may contribute to impaired MPI in patients with PV.…”

Section: Discussionmentioning

confidence: 86%

“…Also, LV hypertrophy was related to increased total plasma volume in patients with PV 16 . Previous studies demonstrated negative effects of LV hypertrophy on LV functions by conventional and tissue Doppler echocardiography in various circumstances 17–19 . In addition, a positive and significant correlation of increased LV mass with myocardial dysfunction was demonstrated in the literature 20,21 .…”

Section: Discussionmentioning

confidence: 88%

See 1 more Smart Citation

Assessment of Left Ventricular Myocardial Performance by Tissue Doppler Echocardiography in Patients with Polycythemia Vera

Kayrak¹,

Acar

Gül³

et al. 2011

Echocardiography

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 88%

Assessment of Left Ventricular Myocardial Performance by Tissue Doppler Echocardiography in Patients with Polycythemia Vera

Kayrak¹,

Acar

Gül³

et al. 2011

Echocardiography

View full text Add to dashboard Cite

show abstract

“…A normal EF was found in all patients studied, including those with active and inactive acromegaly. Normal systolic function in acromegalic patients has also been reported in other studies [21].…”

Section: Discussionmentioning

confidence: 58%

Is left ventricular dysfunction reversed after treatment of active acromegaly?

et al. 2010

View full text Add to dashboard Cite

It has been suggested that control of GH and IGF excess can arrest the progression of cardiovascular abnormalities and normalize cardiac performance. The aim of the present study was to investigate the reversibility of acromegalic cardiomyopathy in patients with active and inactive disease and to evaluate the effect of the inactivity of the disease on left ventricular (LV) diastolic dysfunction, irrespective of the applied treatment. The patient population consisted of 55 patients who were studied in the active and/or inactive phase. A complete M-mode, two-dimensional and color-flow Doppler echocardiographic examination was performed. LV mass index and posterior wall index were significantly lower in patients with inactive acromegaly compared to those with active disease (P < 0.03 respectively). Diastolic dysfunction was improved in patients with inactive compared to those with active disease (E/A ratio P < 0.009). IGF was positively correlated with LV mass index (r = 0.28, P < 0.02). Multivariate linear regression analysis showed that in active patients the E/A ratio was independently related to age (β = -0.674, P < 0.001) and GH (β = 0.282, P < 0.03), whereas in inactive patients none of the parameters were related significantly with the E/A ratio. In a subgroup of 15 patients who were studied in both the active and inactive phase of the disease, the reduction in GH levels was correlated positively with the reduction in LV mass index (r = 0.89, P < 0.0001) and negatively with the improvement in E/A ratio (r = -0.74, P < 0.001). In conclusion, the results of the present study indicate an improvement of left ventricular diastolic function and a significant improvement of cardiac hypertrophy in patients with inactive acromegaly and normal systolic cardiac function compared to those with active disease.

show abstract

“…A previous study, which used only the Em/Am ratio as pwTDI, suggested conventional (E/A) and pwTDI techniques are equally effective in demonstrating LVDD. 18) On the contrary, we found a reduced ratio of LVDD by using new criteria based on the E/Em ratio. We think that previous studies might have overestimated the prevalence of LVDD by using old methods.…”

Section: Discussionmentioning

confidence: 64%

Evaluation of Left Ventricular Diastolic Function According to New Criteria and Determinants in Acromegaly

et al. 2012

View full text Add to dashboard Cite

SummaryLeft ventricular diastolic dysfunction (LVDD) develops in the early stages of acromegaly. The purpose of this study was to identify LVDD analyzing by new echocardiograpic criteria as well as to evaluate determinants of the LVDD in acromegaly. This cross-sectional study examined 42 patients with acromegaly; 16 in active disease (AA) and 26 cured/ well controlled (CA), and compared them with 30 healthy controls (CG). Ventricular systolic and diastolic functions were studied by conventional and tissue Doppler imaging based on the E/Em ratio and myocardial performance index (MPI). Other clinical parameters possibly contributing to LVDD in acromegaly were also investigated. The prevalence of LV hypertrophy (33%) and LVDD (35.7%) were increased in acromegaly, however, there were no differences between the AA and CA groups. Acromegalic patients had higher LV volumes and LV mass, and septal E/Em ratio compared to CG, whereas LV ejection fraction and MPI were not different. The presence of acromegaly (r = 0.29, P = 0.013), diabetes mellitus (DM) (r = 0.41, P < 0.001), hypertension (r = 0.35, P = 0.002), and sleep apnea (r = 0.56, P = 0.003) were found to be correlated with LVDD, whereas duration and activity of acromegaly were not. In regression analysis, advanced age (OR: 8.53, P = 0.006) and DM (OR: 25.9, P = 0.007) were found to be independent risk factors for LVDD. The risk of LVDD according to new criteria increases in acromegaly. However, it seems to be related to the presence of DM and advanced age and is independent of disease duration and activity. ( Cardiac involvement is known to be a major determinant of the shortened life expectancy in acromegalic patients. 1,2) Increased GH, directly and via insulin like growth factor 1 (IGF-1), induces myocardial hypertrophy and fibrosis in the absence of increased wall stress.3) Left ventricular hypertrophy (LVH) causes diastolic and more rarely systolic dysfunction and arrhythmias. Echocardiographic studies of acromegalic patients have suggested left ventricular diastolic dysfunction (LVDD) in the early stages of the disease while LV systolic function was preserved. 4) However, previous studies have evaluated diastolic function by old methods including the transmitral E/A ratio. This ratio is not sufficient to evaluate the diastolic function in patients with preserved systolic function. Pulsed-wave (pw) tissue Doppler imaging (TDI) allows quantitative measurements of the myocardial contraction and relaxation velocities of a selected myocardial segment.5) The Em velocity is considered as an index of ventricular relaxation, which is relatively independent from variation of the atrial pressure and its ratio to velocity peak of transmitral flow (E/Em) is related with the LV filling pressure. The E/Em ratio is recommended at the first step for evaluation of LVDD by echocardiography according to a new guideline. 6) Peak systolic mitral annular velocity (Sm) is used to evaluate LV systolic function. Another parameter used in the evaluation of cardiac function is the myo...

show abstract

Diastolic Function Study with Conventional and Pulsed Tissue Doppler Echocardiography Imaging in Acromegalic Patients

Abstract: In this study, DC and TDI were equally effective in demonstrating diastolic dysfunction, a common finding in acromegalic patients.

Cited by 7 publications

References 46 publications

Assessment of Left Ventricular Myocardial Performance by Tissue Doppler Echocardiography in Patients with Polycythemia Vera

Assessment of Left Ventricular Myocardial Performance by Tissue Doppler Echocardiography in Patients with Polycythemia Vera

Is left ventricular dysfunction reversed after treatment of active acromegaly?

Evaluation of Left Ventricular Diastolic Function According to New Criteria and Determinants in Acromegaly

Contact Info

Product

Resources

About