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Increased Aortic Root Diameters in Patients with Acromegaly

A van der Klaauw, Endocrinology and Metabolism, Leiden University Medical Center, Leiden, 2333 ZA, Netherlands
J Bax, Cardiology, Leiden University Medical Centre, Leiden, Netherlands
J Smit, Endocrinology and Metabolic Diseases, Leiden University Medical Center, Leiden, Netherlands
E Holman, Leiden, Netherlands
V Delgado, Leiden, Netherlands
G Bleeker, Cardiology, Leiden University Medical Center, leiden, Netherlands
N Biermasz, Endocrinology and Metabolic Diseases, Leiden University Medical Center, Leiden, Netherlands
F Roelfsema, Endocrinology and Metabolic Diseases, Leiden University Medical Center, Leiden, Netherlands
J Romijn, Endocrinology and Metabolic Diseases, Leiden University Medical Center, Leiden, Netherlands
A Pereira, leiden, Netherlands

Correspondence: Aa van der Klaauw, Email: a.a.van_der_klaauw{at}lumc.nl

Abstract

Objective: The clinical manifestations of acromegalic cardiomyopathy include arrhythmias, valvular regurgitation, concentric left ventricular (LV) hypertrophy, and LV systolic and diastolic dysfunction. At present, it is unknown whether acromegaly also affects the aortic root.

Design: Aortic root diameters were prospectively assessed in 37 acromegalic patients (18 patients with active disease, and 19 with controlled disease) by conventional two-dimensional and Doppler echocardiography before, and after, an observation period of 1.9 years (range 1.5-3.0 yr). Baseline parameters were compared to healthy controls.

Results: The diameters of the aortic root at the sino-tubular junction and the ascending aorta were increased in patients with acromegaly: 30 ± 4 vs. 26 ± 3 mm (P=0.0001) and 33 ± 5 vs. 30 ± 4 mm (P=0.006), respectively. The diameter of the aortic root at the aortic annulus and aortic sinus were not different from controls. During follow-up, the aortic root diameters increased at the levels of the annulus and the sinotubular junction (P=0.025 and P=0.024, resp.), whereas there was no change in the diameters at the levels of the sinus and the ascending aorta during follow-up. Baseline aortic root diameters were not influenced by disease duration, current disease activity or blood pressure. When patients with active and patients with inactive disease were analyzed separately, only the diameter of the sinotubular junction increased in patients with inactive acromegaly during follow-up (P=0.031).

Conclusion: Aortic root diameters are increased in patients with acromegaly compared to healthy controls.