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Horm Metab Res 2003; 35(3): 183-188
DOI: 10.1055/s-2003-39079
Original Clinical
© Georg Thieme Verlag Stuttgart · New York

Myocardial Perfusion Abnormalities in Patients with Active Acromegaly

B.  L.  Herrmann 1 , K.  Brandt-Mainz 2 , B.  Saller 1 , C.  Bruch 3 , H.  Wieneke 3 , C.  Kügler 4 , S.  Ferdin 1 , S.  Hahn 1 , R.  Erbel 3 , A.  Bockisch 2 , K.  Mann 1
  • 1 Division of Endocrinology, University of Essen, Germany
  • 2 Division of Nuclear Medicine, University of Essen, Germany
  • 3 Division of Cardiology, University of Essen, Germany
  • 4 Department of Angiology, University of Essen, Germany
Further Information

Publication History

Received 23 May 2002

Accepted after revision 14 October 2002

Publication Date:
07 May 2003 (online)

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Abstract

Cardiomyopathy is often seen in patients with a long history of acromegaly. In order to screen for perfusion abnormalities, patients with active acromegaly without evidence for coronary heart disease were examined by single photon emission computed tomography (SPECT). The study included a group of 11 strictly selected patients with active acromegaly (7 males and 4 females; age 51 ± 12 y [mean ± S.D.]) with elevated age-adjusted IGF-I levels (IGF-I 569 ± 193 µg/l; GH 31.2 ± 56.3 µg/l) compared to an age- and sex-matched non-acromegalic control group with comparable muscle mass index of the left ventricle (126 ± 41 active vs. 122 ± 33 g/m2 control group) and body mass index (26.6 ± 2.7 vs. 27.0 ± 5.0 kg/m2). To address this issue, myocardial perfusion was investigated by single photon emission computed tomography (SPECT) using a triple head gamma-camera. 70 MBq 201TlCl was injected, and post-stress (from bicycle ergometer) images were obtained. Images were interpreted quantitatively by bull's eye polary map (16 regions of the left ventricle) and were compared to the control group. In the patients with active acromegaly, the mean nuclide uptake of the 16 regions of the left ventricle after bicycle stress examination was lower than in the control group (82.99 ± 2.85 active vs 85.48 ± 1.29 control group, p < 0.01). Non-homogeneity of nuclide uptake was defined as the standard deviations of the 16 regions and was higher in patients with active acromegaly (11.11 ± 2.35 active vs. 8.77 ± 1.39 control group, p < 0.01). In conclusion, myocardial perfusion is impaired in patients with active acromegaly, thus representing an early stage of cardiac involvement in acromegaly that may be directly mediated by growth hormone excess.

Key words

Acromegaly - Impaired Myocardial Perfusion - Scintigraphy

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B. L. Herrmann, M.D.

University of Essen · Center of Internal Medicine · Division of Endocrinology

Hufelandstr. 55 · 45122 Essen · Germany

Phone: + 49 (201) 723-2821

Fax: + 49 (201) 723-5972

Email: burkhard.herrmann@uni-essen.de