BACKGROUND Acromegaly is associated with an increased left ventricular (LV) mass, as reported in echo-based and, more recently, in a few cardiac magnetic resonance imaging (MRI) studies. One possible explanation for this increased LV mass could be water retention and subsequent myocardial edema. METHODS In this prospective cross-sectional study, 26 patients with active acromegaly before and after treatment and 31 controls of comparable age and sex were investigated using cardiac MRI. Cardiac morphology, function, and myocardial tissue characteristics were evaluated. Myocardial T2 relaxation time was used as the main outcome measure of myocardial edema. The study was registered with clinicaltrials.gov (NCT02948322). RESULTS Patients compared to controls had greater LV mass indexes (58.1 [54.7-68.6] vs 46.0 [41.3-49.8] g/m2; P < .001) and end-diastolic volume (EDV) indexes (97.3 [88-101.2] vs 81.6 [78.1-96.2] mL/m2; P = .0069) and had comparable global contractile function. T2 values were not different between patients and controls. Both intracellular (43.83 [41.0-50.0] vs 34.32 [28.9-38.7] g/m2; P < .001) and extracellular (15.06 [13.5-17.1] vs 11.6 [10.8-12.7] g/m2; P < .001) LV mass indexes were higher in patients compared to controls. Log growth hormone correlated with myocardial mass (r = 0.75; P < .001). Sex, systolic blood pressure (BP), and the presence of acromegaly were predictors of the LV mass index. The extracellular LV mass index was associated with sex and the presence of acromegaly, whereas the intracellular LV mass index was associated with sex, systolic BP, and high-density lipoprotein (HDL) cholesterol. Acromegaly treatment reduced EDV and total and intracellular LV mass indexes without significantly affecting extracellular mass. CONCLUSION Acromegaly results in a disease-specific form of LV hypertrophic remodeling, characterized by an increase in both intra- and extracellular mass. The LV mass index and intracellular mass were decreased by treatment.

中文翻译：

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肢端肥大症患者细胞内和细胞外心肌质量增加：心脏磁共振成像研究。

背景技术据基于回波的研究以及最近的一些心脏磁共振成像（MRI）研究报道，肢端肥大症与左心室（LV）质量增加有关。左心室质量增加的一种可能解释是水潴留和随后的心肌水肿。方法 在这项前瞻性横断面研究中，使用心脏 MRI 对 26 名治疗前后活动性肢端肥大症患者和 31 名年龄和性别相当的对照进行了调查。评估心脏形态、功能和心肌组织特征。心肌T2舒张时间被用作心肌水肿的主要结果指标。该研究已在 ClinicalTrials.gov 注册（NCT02948322）。结果 与对照组相比，患者的 LV 质量指数（58.1 [54.7-68.6] vs 46.0 [41.3-49.8] g/m2；P < .001）和舒张末期容积 (EDV) 指数（97.3 [88-101.2] vs 81.6 [78.1-96.2] mL/m2；P = .0069）并且具有相当的整体收缩功能。患者和对照组之间的 T2 值没有差异。细胞内 (43.83 [41.0-50.0] vs 34.32 [28.9-38.7] g/m2; P < .001) 和细胞外 (15.06 [13.5-17.1] vs 11.6 [10.8-12.7] g/m2; P < .001)与对照组相比，患者的左心室质量指数更高。对数生长激素与心肌质量相关（r = 0.75；P < .001）。性别、收缩压（BP）和肢端肥大症是左室质量指数的预测因素。细胞外左心室质量指数与性别和肢端肥大症的存在相关，而细胞内左心室质量指数与性别、收缩压和高密度脂蛋白（HDL）胆固醇相关。肢端肥大症治疗降低了 EDV 以及总的和细胞内的 LV 质量指数，而不显着影响细胞外质量。结论 肢端肥大症导致一种疾病特异性形式的左室肥厚重塑，其特征是细胞内和细胞外质量增加。治疗后左心室质量指数和细胞内质量有所下降。