Details

Autor(en) / Beteiligte

• Lie, J.T.
• Grossman, Stanley J.

Titel

Pathology of the heart in acromegaly: anatomic findings in 27 autopsied patients

Ist Teil von

• The American heart journal, 1980-07, Vol.100 (1), p.41-52

Ort / Verlag

United States: Mosby, Inc

Erscheinungsjahr

1980

Link zum Volltext

Quelle

Elsevier Journal Backfiles on ScienceDirect (DFG Nationallizenzen)

Beschreibungen/Notizen

• The morphologic characteristics and pathogenesis of cardiac enlargement in acromegaly remain poorly understood, partly because of the paucity of detailed anatomic studies. Autopsy was performed on 41 acromegalic patients at Mayo in the 60-year period 1919 to 1978, of which 27 cases with adequate clinical data and tissue were included in this pathologic review of the heart in acromegaly. Cardiomegaly was common (22 of 27 cases, or 81%), and occurred in both hypertensive and nonhypertensive patients. The mean heart weight (618 g.) of 16 patients who died 10 or more years after the clinical onset of acromegaly was significantly higher (p<0.01) than that (348 g.) of 11 patients who died within 10 years of the clinical onset of the disease. Disproportionate cardiomegaly (compared to visceromegaly) occurred in about one-fourth to one-third of the cases. The enlarged hearts seldom exceeded 200% (that is, twice) of the expected heart weights according to the patient's body weight and body length. Apart from hypertension, other conditions to which cardiomegaly in acromegaly has been atributed were uncommon in our series: diabetes, 15% (four of 27); significant coronary artery disease, 11% (three of 27); and valvular heart disease, 19% (five of 27). Myocardial hypertrophy (93%, or 25 of 27) and interstitial fibrosis (85%, or 23 of 27) were constantly observed. Other histological findings which have not been noted in earlier studies included lymphomononuclear cell infiltrate or myocarditis (59%, or 16 of 27) and small vessel disease of the myocardium (22%, six of 27). Although controversial, the possibility of a specific “acromegalic cardiomyopathy” cannot be discounted on the basis of the currently available evidence.