Subclinical left ventricular systolic dysfunction in patients with naive acromegaly - assessment with two-dimensional speckle-tracking echocardiography: retrospective study.

Objective: To evaluate global longitudinal strain (GLS) in patients with naive acromegaly with normal left ventricular (LV) ejection fraction (EF). Patients and measurements: Forty-three consecutive patients with naive acromegaly with normal LV systolic function as measured by EF, examined from 2008 to 2016, and 52 patients of a control group matched for age and sex underwent two-dimensional speckle-tracking echocardiography to assess GLS. Results: The median GLS was significantly lower in the acromegaly group than in the control group (in %, -16.6 vs. -20.7; p<0.01). The majority of acromegalic patients (N=26; 60.5%) had abnormal GLS. Patients with impairment in GLS had a longer median duration of acromegaly symptoms (in years, 10.0 vs. 5.0; p<0.05) and greater LV thickness (posterior wall in mm, 12.5 vs. 12.0; p<0.05) compared to those with normal GLS. Patients with abnormal GLS had higher IGF-1 concentration, but without statistical significance. Diabetes mellitus and arterial hypertension, which are more common in acromegaly, were not significant determinants of abnormal GLS. The mean left ventricular mass index (LVMI) was increased in the acromegaly group compared to controls (in g/m2, 136 vs. 97; p<0.01). There was a significant negative correlation between LVMI and GLS (R=-0.47; p<0.01). Conclusions: Naive acromegalic patients presented abnormal GLS, which indicates subclinical systolic dysfunction in these patients. The complex action of IGF-1 on the microcirculation and duration of the disease have the strongest effects on GLS in acromegalic patients. The potential positive effect of acromegaly treatment on GLS values requires further prospective studies.