The Assessment of Atrial Electromechanical Delay in Patients With Acromegaly

Background: We aimed to evaluate whether atrial electromechanical delay (AEMD) measured by tissue Doppler imaging (TDI), which is an indicator for structural and electrical remodelling of the atria, is prolonged in patients with active or inactive acromegaly, or both, compared with a control group. Methods: A total of 34 patients with acromegaly (18 active/16 inactive) and 35 patients as a control group were enrolled. Both intra-and inter-AEMD were calculated by TDI. The correlation between clinical variables and AEMD were analyzed. Results: Both inter-AEMD and right and left intra-AEMD were prolonged in patients with acromegaly compared with the control group (P < 0.001, P < 0.001, and P = 0.004, respectively). Also, patients with active acromegaly showed higher inter-AEMD and right intra-AEMD compared with patients with inactive acromegaly (P < 0.05). There was no significant difference in left intra-AEMD between patients with active acromegaly and those with inactive acromegaly (P = 0.977). The growth hormone and insulin-like growth factor (IGF-1) levels positively correlated with inter-AEMD (r = 0.577; P < 0.001; r = 0.614; P < 0.001, respectively). Additionally, we found that inter-AEMD was significantly and positively correlated with relationship between maximal values of passive mitral inflow (E, PW-Doppler) and lateral early diastolic mitral annular velocities (e', TDI) (r = 0.316; P = 0.008). Only the serum IGF-1 level was independently associated with inter-AEMD in multivariate linear regression analysis (beta = 0.500; P = 0.011). Conclusions: Our study findings showed that both inter-and intra-AEMD are prolonged in patients with acromegaly. Also, AEMD was observed to be more prolonged in patients with active acromegaly than in those with inactive acromegaly. IGF-1 was an independent predictor of inter-AEMD in patients with acromegaly. Being a noninvasive, inexpensive, and simple technique, AEMD may be used as an indicator for atrial electrical and structural remodelling in patients with acromegaly.