Left ventricular twist is impaired in acromegaly: Insights from the three-dimensional speckle tracking echocardiographic MAGYAR-Path Study

IntroductionAcromegaly is a rare, chronic, disfiguring, and debilitating disease caused, in 90% of cases, by a benign monoclonal growth hormone-secreting pituitary adenoma. The present study aimed to assess left ventricular (LV) rotational and twist mechanics in acromegalic patients and to compare their results to age- and gender-matched healthy controls. MethodsThe present study comprised 24 acromegalic patients, from which 4 were excluded due to insufficient image quality (mean age: 57.813.7 years, 7 men). The control group consisted of 18 age- and gender-matched healthy individuals (mean age: 54.86.9 years, 8 men). ResultsIn 4 out of 20 acromegalic patients, LV showed near absence of twist, as the so-called LV rigid body rotation (RBR). Between all acromegalic patients without LV-RBR and controls, both LV basal (-3.76 +/- 1.73 vs. -6.17 +/- 2.66 degrees, P=.004) and apical rotation (6.12 +/- 4.03 vs. 10.81 +/- 3.65 degrees, P=.001) and LV twist (9.88 +/- 4.74 vs. 16.98 +/- 3.88 degrees, P<.001) differed significantly. Between active and nonactive acromegaly subgroups, only the time-to-peak LV twist (377 +/- 78 vs. 229 +/- 97 ms, P=.005) showed significant difference. ConclusionsAcromegaly is associated with impaired LV rotation and twist as assessed by 3-dimensional speckle tracking echocardiography. LV-RBR is a frequent phenomenon in acromegaly.