The Evaluation of QT Intervals During Diagnosis and After Follow-Up in Acromegaly Patients

Abstract

Introduction: It was aimed to calculate QT intervals in patients with acromegaly and to reveal its correlation between QT intervals, and growth hormone and insulin like growth factor-1. Material and Methods: Forty-one patients with acromegaly were enrolled into the study. Another 41 individuals with similar features, such as comorbid diseases, age and sex constituted the control group. The electrocardiographies of patients with acromegaly were evaluated at the baseline and after the follow-up. Only one electrocardiography was performed for controls. QT maximum, QT minimum, QT dispersion, corrected QT maximum, corrected QT minimum and corrected QT dispersion were calculated. Results: Baseline QT maximum, QT dispersion, corrected QT maximum and corrected QT dispersion were significantly longer than the values of controls. Corrected QT maximum and corrected QT dispersion were significantly shorter after the follow-up, compared to the baseline in patients. QT maximum, QT dispersion, corrected QT maximum and corrected QT dispersion after the follow-up were not statistically different from the values of controls. Except the negative correlation between growth hormone and corrected QT dispersion in patients after the follow-up, no other correlation was detected between QT values and growth hormone or insulin like growth factor-1 levels. Corrected QT dispersion was found to be related with the disease duration in patients. Discussion: For acromegaly patients, it is important to detect clinical predictors of cardiac arrhytmias. QT dispersion is considered a beneficial predictor for ventricular arrhytmias. When compared to controls, prolonged QT intervals were determined in our acromegalic patients. Conclusion:We consider that QT intervals may also be utilized in the evaluation of increased cardiovascular risk in patients with acromegaly. Keywords: Acromegaly; Arrhythmias, Cardiac; Electrocardiography; Heart Rate. RESUMO

Increased risk of arrhythmias in active acromegaly with complications and persistent uncontrolled active acromegaly

“…In the current study, we assess association of QTc with these clinical and echocardiographic variables. Previous studies have reported no relationship between GH/IGF-1 levels and QTc (12,19,24). However, we found signi cant positive relationship between GH level and QTc.…”

“…Fatti et al have reported QTc signi cantly reduced in acromegalic patients with primary somatostatin analogues therapy (12). Recently, acromegalic patients with surgery was also found have statistically signi cant improvement QTc (19). These studies suggested effective therapy can decrease the risk of ventricular arrhythmias in acromegaly.…”

“…QTc, correcting heart rate in QT intervals, has long been recognized as a marker of increased cardiovascular risk and provide important prognostic information in clinical practice (23). Only a few studies investigated the alteration of QTc in acromegaly and found prolonged QTc compare with healthy population with a relatively small sample size (12,19,24). In our study, 307 acromegalic patients and 303 patients with non-functional pituitary adenoma were included to study the difference of QTc between two group.…”

“…QT interval duration corrected for heart rate (QTc) at conventional electrocardiography (ECG) has long been recognized as a marker for predict serious ventricular arrhythmias and sudden cardiac death (17,18). In the past decades, some studies demonstrated prolongation of QTc in acromegaly relative to healthy subjects and treatment of these patients is able to improve and even normalize this alteration (12,19).…”

Επίδραση Αυξητικών Παραγόντων Προσδεμένων Σε Βιολογικό Ικρίωμα Στη Μετεμφραγματική Αρρυθμιογένεση

“…Τα τελευταία χρόνια, πολυάριθμες μελέτες σε ασθενείς με υπερέκκριση GH (μεγαλακρία), καθώς και σε ασθενείς με ανεπάρκεια GH, προβάλλουν το ρόλο της GH στα καρδιαγγειακά νοσήματα. Συγκεκριμένα, τόσο η υπερέκκριση όσο και η ανεπάρκεια της αυξητικής ορμόνης έχουν συσχετισθεί με αυξημένη καρδιαγγειακή θνητότητα ([110],[111]). ΜεγαλακρίαΗ πρώτη παρατήρηση σε ασθενείς με μεγαλακρία έγινε το 1895 από τον Huchard, ο οποίος περιέγραψε στη Journal de Practiciens 3 αυτοψίες ασθενών και συσχέτισε την καρδιακή δυσλειτουργία με τη μεγαλακρία[112].Το επιστημονικό ενδιαφέρον για την καρδιαγγειακή συν-νοσηρότητα στους ασθενείς με μεγαλακρία εντάθηκε τις επόμενες ΚΕΦΑΛΑΙΟ 1: ΓΕΝΙΚΟ ΜΕΡΟΣ ΕΠΙΔΡΑΣΗ ΑΥΞΗΤΙΚΩΝ ΠΑΡΑΓΟΝΤΩΝ ΠΡΟΣΔΕΜΕΝΩΝ ΣΕ ΒΙΟΛΟΓΙΚΟ ΙΚΡΙΩΜΑ ΣΤΗ ΜΕΤΕΜΦΡΑΓΜΑΤΙΚΗ ΑΡΡΥΘΜΙΟΓΕΝΕΣΗ | 87 δεκαετίες, με αποκορύφωμα τα τελευταία 30 έτη, οπότε και άρχισε να αναδεικνύεται ο ρόλος της GH σε αυτή.…”