Нарушение ритма и проводимости сердца у больных акромегалией: роль магнитно-резонансной томографии сердца
Нарушение ритма и проводимости сердца у больных акромегалией: роль магнитно-резонансной томографии сердца
Мелкозёров К.В., Пржиялковская Е.Г., Тарбаева Н.В. и др. Нарушение ритма и проводимости сердца у больных акромегалией: роль магнитно-резонансной томографии сердца. Терапевтический архив. 2020; 92 (10): 70–77.
DOI: 10.26442/00403660.2020.10.000787
DOI: 10.26442/00403660.2020.10.000787
________________________________________________
Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Аннотация
Сердечно-сосудистые осложнения, включая нарушение ритма и проводимости сердца (НРПС), являются одной из основных причин высокой летальности при акромегалии, однако в настоящее время недостаточно изучены.
Цель. Оценить частоту аритмий у пациентов с акромегалией, выявить факторы риска, способствующие развитию НРПС, определить роль магнитно-резонансной томографии (МРТ) сердца в выявлении структурных и функциональных изменений.
Материалы и методы. Проведено одноцентровое проспективное когортное исследование, в которое включен 461 пациент (151 мужчина и 310 женщин) с акромегалией. Всем пациентам проведено стандартное медицинское обследование, включающее гормональное исследование крови, регистрацию электрокардиограммы (ЭКГ), эхокардиографию, холтеровское мониторирование ЭКГ. МРТ сердца с контрастированием гадолинием выполнено 18 пациентам с НРПС (11 мужчин и 7 женщин).
Результаты. Результаты нашего исследования демонстрируют высокую встречаемость НРПС среди пациентов с акромегалией – 42%. Наиболее частыми видами являлись синусовая брадикардия – 19,1% случаев, а также нарушения проводимости по ножкам пучка Гиса – 14,5%. Мужчины чаще страдали НРПС, чем женщины (54,2 и 37,4% соответственно, р=0,0005). Мы показали, что развитие НРПС зависит, в первую очередь, от длительности акромегалии, в то время как активность заболевания не оказывает значимого влияния. Анамнез акромегалии у пациентов с НРПС и без них составил 10 и 7 лет соответственно (p=0,04). Кроме того, важным фактором риска оказалась терапия аналогами соматостатина. Доля пациентов, получающих данный вид лечения, составила 50% с НРПС и 38,6% среди пациентов без НРПС (р=0,004). Мы продемонстрировали, что 61% пациентов с акромегалией и НРПС, которым провели МРТ сердца, имели признаки фиброза миокарда. При этом значение фракции выброса левого желудочка по данным МРТ оказалось статистически выше, чем при эхокардиографии (p=0,04).
Заключение. НРПС часто встречаются у пациентов с акромегалией, несмотря на достижение ремиссии заболевания. Группа высокого риска требует более тщательной диагностики и мониторинга. МРТ сердца является «золотым стандартом» визуализации структурно-морфологических изменений сердца. Проведение МРТ сердца у пациентов с акромегалий расширяет наше представление о развитии НРПС при данном заболевании. В настоящее время отсутствуют специфические лабораторные маркеры диффузного миокардиального фиброза, а его роль в возникновении нарушений ритма и проводимости сердца требует дальнейшего изучения.
Ключевые слова: акромегалия, нарушение ритма и проводимости сердца, магнитно-резонансная томография сердца, акромегалическая кардиомиопатия, миокардиальный фиброз, гипертрофия миокарда.
Aim. To estimate arrhythmias frequency in acromegaly, identify risk factors leading to the development of arrhythmia and cardiac conduction disorder, to determine the role of cardiac MRI in detecting structural and functional changes.
Materials and methods. A single-center prospective cohort study, which included 461 patients (151 men and 310 women) with acromegaly, was conducted. All the patients underwent a standard medical examination, including hormonal blood test, electrocardiogram, echocardiography, electrocardiogram daily monitoring. 18 patients with arrhythmias (11 men and 7 women) had cardiac MRI with gadolinium-based contrast.
Results. The results of our research show high frequency of arrhythmias and cardiac conduction disorders in patients with acromegaly – 42%. Most frequent kinds of arrhythmias and cardiac conduction disorders were sinus bradycardia – 19.1% of the cases and conduction disorders of bundle branch blocks – 14.5%. Men were more likely to suffer from arrhythmias and cardiac conduction disorders than women (54.2% and 37.4%, respectively, p=0.0005). Not acromegaly activity but duration of the disease was a main risk factor of arrhythmias and cardiac conduction disorders. Patients with arrhythmias had a long anamnesis of acromegaly (10 and 7 years, respectively, p=0.04). Meanwhile, cardiac conduction disorders were commonly observed in the patients who were treated with somatostatin analogs comparing to the patients who didn’t undergo this therapy (50% and 38.6% respectively, p=0.004). We showed that 61% of patients with acromegaly and cardiac conduction disorders who underwent magnetic resonance imaging (MRI) had the signs of myocardial fibrosis. The value of the ejection fraction of the left ventricle according to MRI was higher than with echocardiography (p=0.04).
Conclusion. Arrhythmias and cardiac conduction disorders are often observed in patients with acromegaly even with remission of the disease. High risk group need careful diagnostic and monitoring approaches. Cardiac MRI is the "gold" standard for visualization of structural and morphological changes in the heart. Use of cardiac MRI in acromegalic patients expands our understanding of arrhythmias and cardiac conduction disorders in this disease. There are no specific laboratory markers of diffuse myocardial fibrosis, and the role of myocardial fibrosis in the occurrence of cardiac arrhythmias and conduction disorders needs further studying.
Keywords: acromegaly, heart arrhythmia and conduction disorder, cardiac magnetic resonance imaging, acromegalic cardiomyopathy, myocardial fibrosis, myocardial hypertrophy.
Цель. Оценить частоту аритмий у пациентов с акромегалией, выявить факторы риска, способствующие развитию НРПС, определить роль магнитно-резонансной томографии (МРТ) сердца в выявлении структурных и функциональных изменений.
Материалы и методы. Проведено одноцентровое проспективное когортное исследование, в которое включен 461 пациент (151 мужчина и 310 женщин) с акромегалией. Всем пациентам проведено стандартное медицинское обследование, включающее гормональное исследование крови, регистрацию электрокардиограммы (ЭКГ), эхокардиографию, холтеровское мониторирование ЭКГ. МРТ сердца с контрастированием гадолинием выполнено 18 пациентам с НРПС (11 мужчин и 7 женщин).
Результаты. Результаты нашего исследования демонстрируют высокую встречаемость НРПС среди пациентов с акромегалией – 42%. Наиболее частыми видами являлись синусовая брадикардия – 19,1% случаев, а также нарушения проводимости по ножкам пучка Гиса – 14,5%. Мужчины чаще страдали НРПС, чем женщины (54,2 и 37,4% соответственно, р=0,0005). Мы показали, что развитие НРПС зависит, в первую очередь, от длительности акромегалии, в то время как активность заболевания не оказывает значимого влияния. Анамнез акромегалии у пациентов с НРПС и без них составил 10 и 7 лет соответственно (p=0,04). Кроме того, важным фактором риска оказалась терапия аналогами соматостатина. Доля пациентов, получающих данный вид лечения, составила 50% с НРПС и 38,6% среди пациентов без НРПС (р=0,004). Мы продемонстрировали, что 61% пациентов с акромегалией и НРПС, которым провели МРТ сердца, имели признаки фиброза миокарда. При этом значение фракции выброса левого желудочка по данным МРТ оказалось статистически выше, чем при эхокардиографии (p=0,04).
Заключение. НРПС часто встречаются у пациентов с акромегалией, несмотря на достижение ремиссии заболевания. Группа высокого риска требует более тщательной диагностики и мониторинга. МРТ сердца является «золотым стандартом» визуализации структурно-морфологических изменений сердца. Проведение МРТ сердца у пациентов с акромегалий расширяет наше представление о развитии НРПС при данном заболевании. В настоящее время отсутствуют специфические лабораторные маркеры диффузного миокардиального фиброза, а его роль в возникновении нарушений ритма и проводимости сердца требует дальнейшего изучения.
Ключевые слова: акромегалия, нарушение ритма и проводимости сердца, магнитно-резонансная томография сердца, акромегалическая кардиомиопатия, миокардиальный фиброз, гипертрофия миокарда.
________________________________________________
Aim. To estimate arrhythmias frequency in acromegaly, identify risk factors leading to the development of arrhythmia and cardiac conduction disorder, to determine the role of cardiac MRI in detecting structural and functional changes.
Materials and methods. A single-center prospective cohort study, which included 461 patients (151 men and 310 women) with acromegaly, was conducted. All the patients underwent a standard medical examination, including hormonal blood test, electrocardiogram, echocardiography, electrocardiogram daily monitoring. 18 patients with arrhythmias (11 men and 7 women) had cardiac MRI with gadolinium-based contrast.
Results. The results of our research show high frequency of arrhythmias and cardiac conduction disorders in patients with acromegaly – 42%. Most frequent kinds of arrhythmias and cardiac conduction disorders were sinus bradycardia – 19.1% of the cases and conduction disorders of bundle branch blocks – 14.5%. Men were more likely to suffer from arrhythmias and cardiac conduction disorders than women (54.2% and 37.4%, respectively, p=0.0005). Not acromegaly activity but duration of the disease was a main risk factor of arrhythmias and cardiac conduction disorders. Patients with arrhythmias had a long anamnesis of acromegaly (10 and 7 years, respectively, p=0.04). Meanwhile, cardiac conduction disorders were commonly observed in the patients who were treated with somatostatin analogs comparing to the patients who didn’t undergo this therapy (50% and 38.6% respectively, p=0.004). We showed that 61% of patients with acromegaly and cardiac conduction disorders who underwent magnetic resonance imaging (MRI) had the signs of myocardial fibrosis. The value of the ejection fraction of the left ventricle according to MRI was higher than with echocardiography (p=0.04).
Conclusion. Arrhythmias and cardiac conduction disorders are often observed in patients with acromegaly even with remission of the disease. High risk group need careful diagnostic and monitoring approaches. Cardiac MRI is the "gold" standard for visualization of structural and morphological changes in the heart. Use of cardiac MRI in acromegalic patients expands our understanding of arrhythmias and cardiac conduction disorders in this disease. There are no specific laboratory markers of diffuse myocardial fibrosis, and the role of myocardial fibrosis in the occurrence of cardiac arrhythmias and conduction disorders needs further studying.
Keywords: acromegaly, heart arrhythmia and conduction disorder, cardiac magnetic resonance imaging, acromegalic cardiomyopathy, myocardial fibrosis, myocardial hypertrophy.
Список литературы
1. Дедов И.И., Молитвословова Н.Н., Рожинская Л.Я., Мельниченко ГА. Федеральные клинические рекомендации по клинике, диагностике, дифференциальной диагностике и методам лечения акромегалии. Проблемы эндокринологии. 2013;59(6):4-18 [Dedov II, Molitvoslovova NN, Rozhinskaia LY, Melnichenko GA. Federal clinical guidelines for the clinic, diagnosis, differential diagnosis and treatment of acromegaly. Endocrinological problems. Problemy endokrinologii. 2013;59(6):4-18. (In Russ.)].
2. Maffei P, Martini C, Milanesi A, et al. Late potentials and ventricular arrhythmias in acromegaly. Int J Cardiol. 2005;30;104(2):197-203. doi: 10.1016/j.ijcard.2004.12.010
3. Dekkers OM, Biermasz NR, Pereira AM, et al. Mortality in acromegaly: a metaanalysis. J Clin Endocrinol Metab. 2008;93(1):61-7. doi: 10.1210/jc.2007-1191
4. Katznelson L, Laws ER, Melmed S, et al. Endocrine Society. Acromegaly: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2014;99(11):3933-51. doi: 10.1210/jc.2014-2700
5. Ritvonen E, Löyttyniemi E, Jaatinen P, et al. Mortality in acromegaly: a 20-year follow-up study. Endocr Relat Cancer. 2016;23(6):469-80. doi: 10.1530/ERC-16-0106
6. López-Velasco R, Escobar-Morreale HF, Vega B, et al. Cardiac involvement in acromegaly: specific myocardiopathy or consequence of systemic hypertension? J Clin Endocrinol Metab. 1997;82(4):1047-53. doi: 10.1210/jcem.82.4.3876
7. Losa M, von Werder K. The heart in acromegaly. In: Giustina A. Growth Hormone and the Heart. Boston: Kluwer Academic, 2001; p. 33-43. doi: 10.1007/978-1-4615-1579-1_5
8. Isgaard J, Arcopinto M, Karason K, Cittadini A. GH and the cardiovascular system: an update on a topic at heart. Endocrine. 2015;48(1):25-35. doi: 10.1007/s12020-014-0327-6
9. Abreu A, Tovar AP, Castellanos R, et al. Challenges in the diagnosis and management of acromegaly: a focus on comorbidities. Pituitary. 2016;19(4):448-57. doi: 10.1007/s11102-016-0725-2
10. Исмаилов С.И., Халимова З.Ю., Холикова А.О., Сафарова Ш.М. Сердечно-сосудистые осложнения акромегалии. Междунар. эндокринологический журн. 2010;7(31) [Ismailov SI, Xalimova ZY, Xolikova AO, Safarova SM. Cardiovascular complications of acromegaly. International endocrinological journal. 2010;7(31) (In Russ.)].
11. Ramos-Leví AM, Marazuela M. Cardiovascular comorbidities in acromegaly: an update on their diagnosis and management. Endocrine. 2017;55(2):346-59. doi: 10.1007/s12020-016-1191-3
12. Kahaly G, Olshausen KV, Mohr-Kahaly S, et al. Arrhythmia profile in acromegaly. Eur Heart J. 1992;13(1):51-6. doi: 10.1093/oxfordjournals.eurheartj.a060047
13. Mosca S, Paolillo S, Colao A, et al. Cardiovascular involvement in patients affected by acromegaly: an appraisal. Int J Cardiol. 2013;1;167(5):1712-8. doi: 10.1016/j.ijcard.2012.11.109
14. Weiss V, Sonka K, Pretl M, et al. Prevalence of the sleep apnea syndrome in acromegaly population. J Endocrinol Invest. 2000;23(8):515-9. doi: 10.1007/BF03343767
15. Marques dos Santos Silva C, Gottlieb I, Volschan I, et al. Low Frequency of Cardiomyopathy Using Cardiac Magnetic Resonance Imaging in an Acromegaly Contemporary Cohort. J Clin Endocrinol Metab. 2015;100(12):4447-55 doi: 10.1210/jc.2015-2675
16. Xiaopeng Guo, Jian Cao, Peijun Liu, et al. Cardiac Abnormalities in Acromegaly Patients: A Cardiac Magnetic Resonance Study. Int J Endocrinol. 2020;1-10. doi: 10.1155/2020/2018464
17. Bogazzi F, Lombardi M, Strata E, et al. High prevalence of cardiac hypertophy without detectable signs of fibrosis in patients with untreated active acromegaly: anin vivostudy using magnetic resonance imaging. Clin Endocrinol (Oxf). 2008;68(3):361-8. doi: 10.1111/j.1365-2265.2007.03047
18. Федеральные клинические рекомендации. Акромегалия: клиника, диагностика, дифференциальная диагностика, методы лечения. М., 2014 [Federal clinical guidelines. Clinic, diagnosis, differential diagnosis, methods of treatment of acromegaly. Moscow, 2014 (In Russ.)].
19. Pivonello R, Auriemma RS, Grasso LFS, et al. Complications of acromegaly: cardiovascular, respiratory and metabolic comorbidities. Pituitary. 2017;20(1):46-62. doi: 10.1007/s11102-017-0797-7
20. Lima-Martínez MM, López-Méndez G, Mangupli R. Octreotide-induced sinus bradycardia in a male patient with acromegaly. Endocrinol Nutr. 2013;60(8):e7-9. doi: 10.1016/j.endonu.2012.09.016
21. Arias MA, Pachón M, Rodríguez-Padial L. Ventricular tachycardia in acromegaly. Rev Port Cardiol. 2011;30(2):223-6.
22. An Z, He Y, Liu GH, et al. Malignant ventricular tachycardia in acromegaly: a case report. Sao Paulo Med J. 2015;133(1):55-9. doi: 10.1590/1516-3180.2012.6410005
23. Doimo S, Miani D, Finato N, et al. Acromegalic Cardiomyopathy With Malignant Arrhythmogenic Pattern Successfully Treated With Mechanical Circulatory Support and Heart Transplantation. Can J Cardiol. 2017;33(6):830.e9-830.e11. doi: 10.1016/j.cjca.2017.02.006
24. Tan TT, Gangaram HB, Yusoff K, Khalid BA. Third degree heart block in acromegaly. Postgrad Med J. 1992;68(799):389. doi: 10.1136/pgmj.68.799.389
25. Maffei P, Martini C, Mioni R, et al. Emergency pacemaker implantation in acromegaly. Int J Cardiol. 2004;97(1):161-4. doi: 10.1016/j.ijcard.2003.11.062
26. Yamamoto T, Nakamura H, Ogawa T, et al. Acromegaly with multiple cardiovascular complications – cardiomyopathy, chordae rupture of mitral valve, myocardial infarction and sick sinus syndrome. Intern Med. 2003;42(8):700-3. doi: 10.2169/internalmedicine.42.700
27. Herrmann BL, Bruch C, Saller B, et al. Occurrence of ventricular late potentials in patients with active acromegaly. Clin Endocrinol (Oxf). 2001;55(2):201-7. doi: 10.1046/j.1365-2265.2001.01319.x
28. Абраменко А.С., Вишнякова М.В., Древаль А.В., Ковалева Ю.А. Магнитно-резонансная томография в диагностике поражений сердца у больных акромегалией. Альманах клинической медицины. 2015;43 [Abramenko AS, Vishnyakova MV, Dreval' AV, Kovaleva YuA. Magnetic resonance imaging in the diagnosis of the heart lesions in patients with acromegaly. Almanac of Clinical Medicine. 2015;(43):19-26 (In Russ.)]. doi: 10.18786/2072-0505-2015-43-19-26
29. Ramos-Leví AM, Marazuela M. Bringing Cardiovascular Comorbidities in Acromegaly to an Update. How Should We Diagnose and Manage Them? Front Endocrinol (Lausanne). 2019;7(10):120. doi: 10.3389/fendo.2019.00120
30. Васюк Ю.А., Школьник Е.Л. Современные возможности и ограничения эхокардиографии при заболеваниях сердечно-сосудистой системы. Рос. кардиологический журн. 2013;4(102):28-32 [Vasyuk YuA, Shkolnik EL. Strengths and limitations of modern echocardiography in cardiovascular disease diagnostics. Russ J Cardiol. 2013;4(102):28-32 (In Russ.)]. doi: 10.15829/1560-4071-2013-4-28-32
31. Chen G, Chelu MG, Dobrev D, Li N. Cardiomyocyte Inflammasome Signaling in Cardiomyopathies and Atrial Fibrillation: Mechanisms and Potential Therapeutic Implications. Front Physiol. 2018;13;9:1115. doi: 10.3389/fphys.2018.01115
32. Liu M, Li W, Wang H, et al. CTRP9 Ameliorates Atrial Inflammation, Fibrosis, and Vulnerability to Atrial Fibrillation in Post-Myocardial Infarction Rats. J Am Heart Assoc. 2019;5;8(21):e013133. doi: 10.1161/JAHA.119.013133
33. Scott L, Li N, Dobrev D. Role of inflammatory signaling in atrial fibrillation. Int J Cardiol. 2019;15;287:195-200. doi: 10.1016/j.ijcard.2018.10.020
34. Colao A, Grasso LFS, Somma DC, Pivonello R. Acromegaly and Heart Failure. Heart Fail Clin. 2019;15(3):399-408. doi: 10.1016/j.hfc.2019.03.001
2. Maffei P, Martini C, Milanesi A, et al. Late potentials and ventricular arrhythmias in acromegaly. Int J Cardiol. 2005;30;104(2):197-203. doi: 10.1016/j.ijcard.2004.12.010
3. Dekkers OM, Biermasz NR, Pereira AM, et al. Mortality in acromegaly: a metaanalysis. J Clin Endocrinol Metab. 2008;93(1):61-7. doi: 10.1210/jc.2007-1191
4. Katznelson L, Laws ER, Melmed S, et al. Endocrine Society. Acromegaly: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2014;99(11):3933-51. doi: 10.1210/jc.2014-2700
5. Ritvonen E, Löyttyniemi E, Jaatinen P, et al. Mortality in acromegaly: a 20-year follow-up study. Endocr Relat Cancer. 2016;23(6):469-80. doi: 10.1530/ERC-16-0106
6. López-Velasco R, Escobar-Morreale HF, Vega B, et al. Cardiac involvement in acromegaly: specific myocardiopathy or consequence of systemic hypertension? J Clin Endocrinol Metab. 1997;82(4):1047-53. doi: 10.1210/jcem.82.4.3876
7. Losa M, von Werder K. The heart in acromegaly. In: Giustina A. Growth Hormone and the Heart. Boston: Kluwer Academic, 2001; p. 33-43. doi: 10.1007/978-1-4615-1579-1_5
8. Isgaard J, Arcopinto M, Karason K, Cittadini A. GH and the cardiovascular system: an update on a topic at heart. Endocrine. 2015;48(1):25-35. doi: 10.1007/s12020-014-0327-6
9. Abreu A, Tovar AP, Castellanos R, et al. Challenges in the diagnosis and management of acromegaly: a focus on comorbidities. Pituitary. 2016;19(4):448-57. doi: 10.1007/s11102-016-0725-2
10. Ismailov SI, Xalimova ZY, Xolikova AO, Safarova SM. Cardiovascular complications of acromegaly. International endocrinological journal. 2010;7(31) (In Russ.)
11. Ramos-Leví AM, Marazuela M. Cardiovascular comorbidities in acromegaly: an update on their diagnosis and management. Endocrine. 2017;55(2):346-59. doi: 10.1007/s12020-016-1191-3
12. Kahaly G, Olshausen KV, Mohr-Kahaly S, et al. Arrhythmia profile in acromegaly. Eur Heart J. 1992;13(1):51-6. doi: 10.1093/oxfordjournals.eurheartj.a060047
13. Mosca S, Paolillo S, Colao A, et al. Cardiovascular involvement in patients affected by acromegaly: an appraisal. Int J Cardiol. 2013;1;167(5):1712-8. doi: 10.1016/j.ijcard.2012.11.109
14. Weiss V, Sonka K, Pretl M, et al. Prevalence of the sleep apnea syndrome in acromegaly population. J Endocrinol Invest. 2000;23(8):515-9. doi: 10.1007/BF03343767
15. Marques dos Santos Silva C, Gottlieb I, Volschan I, et al. Low Frequency of Cardiomyopathy Using Cardiac Magnetic Resonance Imaging in an Acromegaly Contemporary Cohort. J Clin Endocrinol Metab. 2015;100(12):4447-55 doi: 10.1210/jc.2015-2675
16. Xiaopeng Guo, Jian Cao, Peijun Liu, et al. Cardiac Abnormalities in Acromegaly Patients: A Cardiac Magnetic Resonance Study. Int J Endocrinol. 2020;1-10. doi: 10.1155/2020/2018464
17. Bogazzi F, Lombardi M, Strata E, et al. High prevalence of cardiac hypertophy without detectable signs of fibrosis in patients with untreated active acromegaly: anin vivostudy using magnetic resonance imaging. Clin Endocrinol (Oxf). 2008;68(3):361-8. doi: 10.1111/j.1365-2265.2007.03047
18. Federal clinical guidelines. Clinic, diagnosis, differential diagnosis, methods of treatment of acromegaly. Moscow, 2014 (In Russ.)
19. Pivonello R, Auriemma RS, Grasso LFS, et al. Complications of acromegaly: cardiovascular, respiratory and metabolic comorbidities. Pituitary. 2017;20(1):46-62. doi: 10.1007/s11102-017-0797-7
20. Lima-Martínez MM, López-Méndez G, Mangupli R. Octreotide-induced sinus bradycardia in a male patient with acromegaly. Endocrinol Nutr. 2013;60(8):e7-9. doi: 10.1016/j.endonu.2012.09.016
21. Arias MA, Pachón M, Rodríguez-Padial L. Ventricular tachycardia in acromegaly. Rev Port Cardiol. 2011;30(2):223-6.
22. An Z, He Y, Liu GH, et al. Malignant ventricular tachycardia in acromegaly: a case report. Sao Paulo Med J. 2015;133(1):55-9. doi: 10.1590/1516-3180.2012.6410005
23. Doimo S, Miani D, Finato N, et al. Acromegalic Cardiomyopathy With Malignant Arrhythmogenic Pattern Successfully Treated With Mechanical Circulatory Support and Heart Transplantation. Can J Cardiol. 2017;33(6):830.e9-830.e11. doi: 10.1016/j.cjca.2017.02.006
24. Tan TT, Gangaram HB, Yusoff K, Khalid BA. Third degree heart block in acromegaly. Postgrad Med J. 1992;68(799):389. doi: 10.1136/pgmj.68.799.389
25. Maffei P, Martini C, Mioni R, et al. Emergency pacemaker implantation in acromegaly. Int J Cardiol. 2004;97(1):161-4. doi: 10.1016/j.ijcard.2003.11.062
26. Yamamoto T, Nakamura H, Ogawa T, et al. Acromegaly with multiple cardiovascular complications – cardiomyopathy, chordae rupture of mitral valve, myocardial infarction and sick sinus syndrome. Intern Med. 2003;42(8):700-3. doi: 10.2169/internalmedicine.42.700
27. Herrmann BL, Bruch C, Saller B, et al. Occurrence of ventricular late potentials in patients with active acromegaly. Clin Endocrinol (Oxf). 2001;55(2):201-7. doi: 10.1046/j.1365-2265.2001.01319.x
28. Abramenko AS, Vishnyakova MV, Dreval' AV, Kovaleva YuA. Magnetic resonance imaging in the diagnosis of the heart lesions in patients with acromegaly. Almanac of Clinical Medicine. 2015;(43):19-26 (In Russ.) doi: 10.18786/2072-0505-2015-43-19-26
29. Ramos-Leví AM, Marazuela M. Bringing Cardiovascular Comorbidities in Acromegaly to an Update. How Should We Diagnose and Manage Them? Front Endocrinol (Lausanne). 2019;7(10):120. doi: 10.3389/fendo.2019.00120
30. Vasyuk YuA, Shkolnik EL. Strengths and limitations of modern echocardiography in cardiovascular disease diagnostics. Russ J Cardiol. 2013;4(102):28-32 (In Russ.) doi: 10.15829/1560-4071-2013-4-28-32
31. Chen G, Chelu MG, Dobrev D, Li N. Cardiomyocyte Inflammasome Signaling in Cardiomyopathies and Atrial Fibrillation: Mechanisms and Potential Therapeutic Implications. Front Physiol. 2018;13;9:1115. doi: 10.3389/fphys.2018.01115
32. Liu M, Li W, Wang H, et al. CTRP9 Ameliorates Atrial Inflammation, Fibrosis, and Vulnerability to Atrial Fibrillation in Post-Myocardial Infarction Rats. J Am Heart Assoc. 2019;5;8(21):e013133. doi: 10.1161/JAHA.119.013133
33. Scott L, Li N, Dobrev D. Role of inflammatory signaling in atrial fibrillation. Int J Cardiol. 2019;15;287:195-200. doi: 10.1016/j.ijcard.2018.10.020
34. Colao A, Grasso LFS, Somma DC, Pivonello R. Acromegaly and Heart Failure. Heart Fail Clin. 2019;15(3):399-408. doi: 10.1016/j.hfc.2019.03.001
2. Maffei P, Martini C, Milanesi A, et al. Late potentials and ventricular arrhythmias in acromegaly. Int J Cardiol. 2005;30;104(2):197-203. doi: 10.1016/j.ijcard.2004.12.010
3. Dekkers OM, Biermasz NR, Pereira AM, et al. Mortality in acromegaly: a metaanalysis. J Clin Endocrinol Metab. 2008;93(1):61-7. doi: 10.1210/jc.2007-1191
4. Katznelson L, Laws ER, Melmed S, et al. Endocrine Society. Acromegaly: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2014;99(11):3933-51. doi: 10.1210/jc.2014-2700
5. Ritvonen E, Löyttyniemi E, Jaatinen P, et al. Mortality in acromegaly: a 20-year follow-up study. Endocr Relat Cancer. 2016;23(6):469-80. doi: 10.1530/ERC-16-0106
6. López-Velasco R, Escobar-Morreale HF, Vega B, et al. Cardiac involvement in acromegaly: specific myocardiopathy or consequence of systemic hypertension? J Clin Endocrinol Metab. 1997;82(4):1047-53. doi: 10.1210/jcem.82.4.3876
7. Losa M, von Werder K. The heart in acromegaly. In: Giustina A. Growth Hormone and the Heart. Boston: Kluwer Academic, 2001; p. 33-43. doi: 10.1007/978-1-4615-1579-1_5
8. Isgaard J, Arcopinto M, Karason K, Cittadini A. GH and the cardiovascular system: an update on a topic at heart. Endocrine. 2015;48(1):25-35. doi: 10.1007/s12020-014-0327-6
9. Abreu A, Tovar AP, Castellanos R, et al. Challenges in the diagnosis and management of acromegaly: a focus on comorbidities. Pituitary. 2016;19(4):448-57. doi: 10.1007/s11102-016-0725-2
10. Исмаилов С.И., Халимова З.Ю., Холикова А.О., Сафарова Ш.М. Сердечно-сосудистые осложнения акромегалии. Междунар. эндокринологический журн. 2010;7(31) [Ismailov SI, Xalimova ZY, Xolikova AO, Safarova SM. Cardiovascular complications of acromegaly. International endocrinological journal. 2010;7(31) (In Russ.)].
11. Ramos-Leví AM, Marazuela M. Cardiovascular comorbidities in acromegaly: an update on their diagnosis and management. Endocrine. 2017;55(2):346-59. doi: 10.1007/s12020-016-1191-3
12. Kahaly G, Olshausen KV, Mohr-Kahaly S, et al. Arrhythmia profile in acromegaly. Eur Heart J. 1992;13(1):51-6. doi: 10.1093/oxfordjournals.eurheartj.a060047
13. Mosca S, Paolillo S, Colao A, et al. Cardiovascular involvement in patients affected by acromegaly: an appraisal. Int J Cardiol. 2013;1;167(5):1712-8. doi: 10.1016/j.ijcard.2012.11.109
14. Weiss V, Sonka K, Pretl M, et al. Prevalence of the sleep apnea syndrome in acromegaly population. J Endocrinol Invest. 2000;23(8):515-9. doi: 10.1007/BF03343767
15. Marques dos Santos Silva C, Gottlieb I, Volschan I, et al. Low Frequency of Cardiomyopathy Using Cardiac Magnetic Resonance Imaging in an Acromegaly Contemporary Cohort. J Clin Endocrinol Metab. 2015;100(12):4447-55 doi: 10.1210/jc.2015-2675
16. Xiaopeng Guo, Jian Cao, Peijun Liu, et al. Cardiac Abnormalities in Acromegaly Patients: A Cardiac Magnetic Resonance Study. Int J Endocrinol. 2020;1-10. doi: 10.1155/2020/2018464
17. Bogazzi F, Lombardi M, Strata E, et al. High prevalence of cardiac hypertophy without detectable signs of fibrosis in patients with untreated active acromegaly: anin vivostudy using magnetic resonance imaging. Clin Endocrinol (Oxf). 2008;68(3):361-8. doi: 10.1111/j.1365-2265.2007.03047
18. Федеральные клинические рекомендации. Акромегалия: клиника, диагностика, дифференциальная диагностика, методы лечения. М., 2014 [Federal clinical guidelines. Clinic, diagnosis, differential diagnosis, methods of treatment of acromegaly. Moscow, 2014 (In Russ.)].
19. Pivonello R, Auriemma RS, Grasso LFS, et al. Complications of acromegaly: cardiovascular, respiratory and metabolic comorbidities. Pituitary. 2017;20(1):46-62. doi: 10.1007/s11102-017-0797-7
20. Lima-Martínez MM, López-Méndez G, Mangupli R. Octreotide-induced sinus bradycardia in a male patient with acromegaly. Endocrinol Nutr. 2013;60(8):e7-9. doi: 10.1016/j.endonu.2012.09.016
21. Arias MA, Pachón M, Rodríguez-Padial L. Ventricular tachycardia in acromegaly. Rev Port Cardiol. 2011;30(2):223-6.
22. An Z, He Y, Liu GH, et al. Malignant ventricular tachycardia in acromegaly: a case report. Sao Paulo Med J. 2015;133(1):55-9. doi: 10.1590/1516-3180.2012.6410005
23. Doimo S, Miani D, Finato N, et al. Acromegalic Cardiomyopathy With Malignant Arrhythmogenic Pattern Successfully Treated With Mechanical Circulatory Support and Heart Transplantation. Can J Cardiol. 2017;33(6):830.e9-830.e11. doi: 10.1016/j.cjca.2017.02.006
24. Tan TT, Gangaram HB, Yusoff K, Khalid BA. Third degree heart block in acromegaly. Postgrad Med J. 1992;68(799):389. doi: 10.1136/pgmj.68.799.389
25. Maffei P, Martini C, Mioni R, et al. Emergency pacemaker implantation in acromegaly. Int J Cardiol. 2004;97(1):161-4. doi: 10.1016/j.ijcard.2003.11.062
26. Yamamoto T, Nakamura H, Ogawa T, et al. Acromegaly with multiple cardiovascular complications – cardiomyopathy, chordae rupture of mitral valve, myocardial infarction and sick sinus syndrome. Intern Med. 2003;42(8):700-3. doi: 10.2169/internalmedicine.42.700
27. Herrmann BL, Bruch C, Saller B, et al. Occurrence of ventricular late potentials in patients with active acromegaly. Clin Endocrinol (Oxf). 2001;55(2):201-7. doi: 10.1046/j.1365-2265.2001.01319.x
28. Абраменко А.С., Вишнякова М.В., Древаль А.В., Ковалева Ю.А. Магнитно-резонансная томография в диагностике поражений сердца у больных акромегалией. Альманах клинической медицины. 2015;43 [Abramenko AS, Vishnyakova MV, Dreval' AV, Kovaleva YuA. Magnetic resonance imaging in the diagnosis of the heart lesions in patients with acromegaly. Almanac of Clinical Medicine. 2015;(43):19-26 (In Russ.)]. doi: 10.18786/2072-0505-2015-43-19-26
29. Ramos-Leví AM, Marazuela M. Bringing Cardiovascular Comorbidities in Acromegaly to an Update. How Should We Diagnose and Manage Them? Front Endocrinol (Lausanne). 2019;7(10):120. doi: 10.3389/fendo.2019.00120
30. Васюк Ю.А., Школьник Е.Л. Современные возможности и ограничения эхокардиографии при заболеваниях сердечно-сосудистой системы. Рос. кардиологический журн. 2013;4(102):28-32 [Vasyuk YuA, Shkolnik EL. Strengths and limitations of modern echocardiography in cardiovascular disease diagnostics. Russ J Cardiol. 2013;4(102):28-32 (In Russ.)]. doi: 10.15829/1560-4071-2013-4-28-32
31. Chen G, Chelu MG, Dobrev D, Li N. Cardiomyocyte Inflammasome Signaling in Cardiomyopathies and Atrial Fibrillation: Mechanisms and Potential Therapeutic Implications. Front Physiol. 2018;13;9:1115. doi: 10.3389/fphys.2018.01115
32. Liu M, Li W, Wang H, et al. CTRP9 Ameliorates Atrial Inflammation, Fibrosis, and Vulnerability to Atrial Fibrillation in Post-Myocardial Infarction Rats. J Am Heart Assoc. 2019;5;8(21):e013133. doi: 10.1161/JAHA.119.013133
33. Scott L, Li N, Dobrev D. Role of inflammatory signaling in atrial fibrillation. Int J Cardiol. 2019;15;287:195-200. doi: 10.1016/j.ijcard.2018.10.020
34. Colao A, Grasso LFS, Somma DC, Pivonello R. Acromegaly and Heart Failure. Heart Fail Clin. 2019;15(3):399-408. doi: 10.1016/j.hfc.2019.03.001
________________________________________________
2. Maffei P, Martini C, Milanesi A, et al. Late potentials and ventricular arrhythmias in acromegaly. Int J Cardiol. 2005;30;104(2):197-203. doi: 10.1016/j.ijcard.2004.12.010
3. Dekkers OM, Biermasz NR, Pereira AM, et al. Mortality in acromegaly: a metaanalysis. J Clin Endocrinol Metab. 2008;93(1):61-7. doi: 10.1210/jc.2007-1191
4. Katznelson L, Laws ER, Melmed S, et al. Endocrine Society. Acromegaly: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2014;99(11):3933-51. doi: 10.1210/jc.2014-2700
5. Ritvonen E, Löyttyniemi E, Jaatinen P, et al. Mortality in acromegaly: a 20-year follow-up study. Endocr Relat Cancer. 2016;23(6):469-80. doi: 10.1530/ERC-16-0106
6. López-Velasco R, Escobar-Morreale HF, Vega B, et al. Cardiac involvement in acromegaly: specific myocardiopathy or consequence of systemic hypertension? J Clin Endocrinol Metab. 1997;82(4):1047-53. doi: 10.1210/jcem.82.4.3876
7. Losa M, von Werder K. The heart in acromegaly. In: Giustina A. Growth Hormone and the Heart. Boston: Kluwer Academic, 2001; p. 33-43. doi: 10.1007/978-1-4615-1579-1_5
8. Isgaard J, Arcopinto M, Karason K, Cittadini A. GH and the cardiovascular system: an update on a topic at heart. Endocrine. 2015;48(1):25-35. doi: 10.1007/s12020-014-0327-6
9. Abreu A, Tovar AP, Castellanos R, et al. Challenges in the diagnosis and management of acromegaly: a focus on comorbidities. Pituitary. 2016;19(4):448-57. doi: 10.1007/s11102-016-0725-2
10. Ismailov SI, Xalimova ZY, Xolikova AO, Safarova SM. Cardiovascular complications of acromegaly. International endocrinological journal. 2010;7(31) (In Russ.)
11. Ramos-Leví AM, Marazuela M. Cardiovascular comorbidities in acromegaly: an update on their diagnosis and management. Endocrine. 2017;55(2):346-59. doi: 10.1007/s12020-016-1191-3
12. Kahaly G, Olshausen KV, Mohr-Kahaly S, et al. Arrhythmia profile in acromegaly. Eur Heart J. 1992;13(1):51-6. doi: 10.1093/oxfordjournals.eurheartj.a060047
13. Mosca S, Paolillo S, Colao A, et al. Cardiovascular involvement in patients affected by acromegaly: an appraisal. Int J Cardiol. 2013;1;167(5):1712-8. doi: 10.1016/j.ijcard.2012.11.109
14. Weiss V, Sonka K, Pretl M, et al. Prevalence of the sleep apnea syndrome in acromegaly population. J Endocrinol Invest. 2000;23(8):515-9. doi: 10.1007/BF03343767
15. Marques dos Santos Silva C, Gottlieb I, Volschan I, et al. Low Frequency of Cardiomyopathy Using Cardiac Magnetic Resonance Imaging in an Acromegaly Contemporary Cohort. J Clin Endocrinol Metab. 2015;100(12):4447-55 doi: 10.1210/jc.2015-2675
16. Xiaopeng Guo, Jian Cao, Peijun Liu, et al. Cardiac Abnormalities in Acromegaly Patients: A Cardiac Magnetic Resonance Study. Int J Endocrinol. 2020;1-10. doi: 10.1155/2020/2018464
17. Bogazzi F, Lombardi M, Strata E, et al. High prevalence of cardiac hypertophy without detectable signs of fibrosis in patients with untreated active acromegaly: anin vivostudy using magnetic resonance imaging. Clin Endocrinol (Oxf). 2008;68(3):361-8. doi: 10.1111/j.1365-2265.2007.03047
18. Federal clinical guidelines. Clinic, diagnosis, differential diagnosis, methods of treatment of acromegaly. Moscow, 2014 (In Russ.)
19. Pivonello R, Auriemma RS, Grasso LFS, et al. Complications of acromegaly: cardiovascular, respiratory and metabolic comorbidities. Pituitary. 2017;20(1):46-62. doi: 10.1007/s11102-017-0797-7
20. Lima-Martínez MM, López-Méndez G, Mangupli R. Octreotide-induced sinus bradycardia in a male patient with acromegaly. Endocrinol Nutr. 2013;60(8):e7-9. doi: 10.1016/j.endonu.2012.09.016
21. Arias MA, Pachón M, Rodríguez-Padial L. Ventricular tachycardia in acromegaly. Rev Port Cardiol. 2011;30(2):223-6.
22. An Z, He Y, Liu GH, et al. Malignant ventricular tachycardia in acromegaly: a case report. Sao Paulo Med J. 2015;133(1):55-9. doi: 10.1590/1516-3180.2012.6410005
23. Doimo S, Miani D, Finato N, et al. Acromegalic Cardiomyopathy With Malignant Arrhythmogenic Pattern Successfully Treated With Mechanical Circulatory Support and Heart Transplantation. Can J Cardiol. 2017;33(6):830.e9-830.e11. doi: 10.1016/j.cjca.2017.02.006
24. Tan TT, Gangaram HB, Yusoff K, Khalid BA. Third degree heart block in acromegaly. Postgrad Med J. 1992;68(799):389. doi: 10.1136/pgmj.68.799.389
25. Maffei P, Martini C, Mioni R, et al. Emergency pacemaker implantation in acromegaly. Int J Cardiol. 2004;97(1):161-4. doi: 10.1016/j.ijcard.2003.11.062
26. Yamamoto T, Nakamura H, Ogawa T, et al. Acromegaly with multiple cardiovascular complications – cardiomyopathy, chordae rupture of mitral valve, myocardial infarction and sick sinus syndrome. Intern Med. 2003;42(8):700-3. doi: 10.2169/internalmedicine.42.700
27. Herrmann BL, Bruch C, Saller B, et al. Occurrence of ventricular late potentials in patients with active acromegaly. Clin Endocrinol (Oxf). 2001;55(2):201-7. doi: 10.1046/j.1365-2265.2001.01319.x
28. Abramenko AS, Vishnyakova MV, Dreval' AV, Kovaleva YuA. Magnetic resonance imaging in the diagnosis of the heart lesions in patients with acromegaly. Almanac of Clinical Medicine. 2015;(43):19-26 (In Russ.) doi: 10.18786/2072-0505-2015-43-19-26
29. Ramos-Leví AM, Marazuela M. Bringing Cardiovascular Comorbidities in Acromegaly to an Update. How Should We Diagnose and Manage Them? Front Endocrinol (Lausanne). 2019;7(10):120. doi: 10.3389/fendo.2019.00120
30. Vasyuk YuA, Shkolnik EL. Strengths and limitations of modern echocardiography in cardiovascular disease diagnostics. Russ J Cardiol. 2013;4(102):28-32 (In Russ.) doi: 10.15829/1560-4071-2013-4-28-32
31. Chen G, Chelu MG, Dobrev D, Li N. Cardiomyocyte Inflammasome Signaling in Cardiomyopathies and Atrial Fibrillation: Mechanisms and Potential Therapeutic Implications. Front Physiol. 2018;13;9:1115. doi: 10.3389/fphys.2018.01115
32. Liu M, Li W, Wang H, et al. CTRP9 Ameliorates Atrial Inflammation, Fibrosis, and Vulnerability to Atrial Fibrillation in Post-Myocardial Infarction Rats. J Am Heart Assoc. 2019;5;8(21):e013133. doi: 10.1161/JAHA.119.013133
33. Scott L, Li N, Dobrev D. Role of inflammatory signaling in atrial fibrillation. Int J Cardiol. 2019;15;287:195-200. doi: 10.1016/j.ijcard.2018.10.020
34. Colao A, Grasso LFS, Somma DC, Pivonello R. Acromegaly and Heart Failure. Heart Fail Clin. 2019;15(3):399-408. doi: 10.1016/j.hfc.2019.03.001
Авторы
К.В. Мелкозёров, Е.Г. Пржиялковская, Н.В. Тарбаева, А.А. Алмасханова, М.Д. Куклина, П.А. Алфёрова, И.С. Гомова, Л.А. Белоусов, Ж.Е. Белая, А.В. Воронцов, В.Ю. Калашников
ФГБУ «Национальный медицинский центр эндокринологии» Минздрава России, Москва, Россия
Endocrinology Research Centre, Moscow, Russia
ФГБУ «Национальный медицинский центр эндокринологии» Минздрава России, Москва, Россия
________________________________________________
Endocrinology Research Centre, Moscow, Russia
Цель портала OmniDoctor – предоставление профессиональной информации врачам, провизорам и фармацевтам.