Coronary calcification in patients with acromegaly (an electron beam CT study)

B. L. Herrmann; M. Severing; A. Schmermund; G. Kerkhoff; T. Budde; R. Erbel; K. Mann

doi:10.1055/s-2005-862837

Experimental and Clinical Endocrinology & Diabetes, Inhaltsverzeichnis

Coronary calcification in patients with acromegaly (an electron beam CT study)

BL Herrmann ¹, M Severing ¹, A Schmermund ², G Kerkhoff ³, T Budde ³, R Erbel ², K Mann ¹

¹University Hospital of Essen, Div. of Endocrinology, Dept. of Internal Medicine, Germany
²University Hospital of Essen, Div. of Cardiology, Dept. of Internal Medicine, Germany
³Alfried-Krupp-Krankenhaus Essen, Div. of Cardiology, Germany

Abstract

It is well established, that the increased mortality in patients with acromegaly is due to cardiac diseases. Cardiomyopathy is the predominant cardiac alteration in patients with acromegaly. There are no data about coronary heart disease or coronary calcifications. Electron beam computed tomography (EBCT) is the standard imaging modality for identification of coronary calcifications and can determine the exent and severity of coronary atherosclerosis.

The prospective study included 24 patients with acromegaly (mean age 53±14 yr; 13 females, 11 males; BMI 27.8±3.8kg/m²; GH 13±29µg/L; IGF-1 409±367µg/L; mean±SD). 6 patients had active disease, 11 were well-controlled and 7 were cured. 7 patients were treated with somatostatin analogues, 3 with dopamine agonists, and 2 with the GH-receptor antagonist pegvisomant. 50% had an increased left ventricular muscle mass index (>132g/m²), 50% had high cholesterol levels (193±56mg/dl), 50% were hypertensive, 13% had diabetes mellitus and 46% were smokers (pack-years 9.3±15.5 yr). For quantification of coronary calcium the Agatston calcium score (CAC score) was computed (EBCT).

54% (13/24) had coronary calcifications. 42% (10/24) had a high CAC score (75th percentile) and were categorized as cardiovascular high risk patients. The CAC score correlated with age (p=0.03, r²=0.21), pack-years (p=0.04, r²=0.19) and the disease duration (8.4±7.9 yr) of acromegaly (p=0.02, r²=0.21) but not with BMI, left ventricular muscle mass index, diabetes, hypertension or cholesterol levels.

In summary, the disease duration appears to influence the severity of CAC score in patients with acromegaly. The observation underlines the importance of early and sufficient treatment in this group of patients.