哥伦比亚肢端肥大症患者心脏疾病的患病率和特征（RAPACO心脏研究）。

IF 1.9 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiology Pub Date : 2025-05-10 DOI:10.1159/000545875

Alin Abreu-Lomba, David Aristizábal-Colorado, Santiago Sierra-Castillo, Danilo Weir-Restrepo, Carlos Alberto Gómez-Mercado, David Alexander Vernaza Trujillo, Henry Mauricio Arenas-Quintero, Alejandro Castellanos-Pinedo, Clara I Saldarriaga-Giraldo, Alejandro Pinzón-Tovar

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引用次数: 0

摘要

肢端肥大症是一种以生长激素（GH）和胰岛素样生长因子1型（IGF-1）分泌过多为特征的慢性疾病，导致多系统受累。心血管并发症影响到高达80%的病例，是疾病晚期的一个主要问题。本研究旨在确定哥伦比亚人群中肢端肥大性心脏病（AHD）的患病率，并确定与其发展相关的因素。目的：探讨哥伦比亚肢端肥大症患者AHD的特点。方法：采用国家RAPACO登记处的数据进行回顾性、多中心病例对照研究。患者年龄16岁或以上，确诊肢端肥大症和可用的超声心动图。AHD的定义是由肢端肥大症引起的心脏结构或功能异常。结果：共分析193例肢端肥大症患者；61例（31.6%）患有adhd。与非AHD组相比，这些患者年龄较大，腹部周长增大4.5 cm，从发病到诊断的中位时间为8年（非AHD组为6年）。在61例AHD病例中，最常见的是孤立性左室肥厚（n=32, 52.4%），其次是双室肥厚（n=12, 19.7%）、瓣膜病（n=4, 6.6%）和左室并发瓣膜病（n=4, 6.6%）。AHD患者的GH和IGF-1水平略高。在多因素分析中，动脉高血压与AHD的比值比（OR）为1.75 (95% CI 0.67-4.65)，而腕管综合征显著增加AHD的比值比（OR 3.81, p=0.01, 95% CI 1.36-11.14）。结论：尽管治疗进展，AHD在哥伦比亚肢端肥大症患者中仍然很常见。值得注意的是，腕管综合征与AHD、高血压、心律失常和糖尿病独立相关。这些发现强调了在这一患者群体中进行主动心血管筛查和管理策略的必要性。

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Prevalence and Characteristics of Heart Disease in Patients with Acromegaly in Colombia (RAPACO HEART Study).

Introduction: Acromegaly is a chronic disorder characterized by excessive secretion of growth hormone (GH) and insulin-like growth factor type 1 (IGF-1), resulting in multisystem involvement. Cardiovascular complications affect up to 80% of cases and represent a major concern in advanced stages of the disease. This study aimed to determine the prevalence of acromegalic heart disease (AHD) and identify factors associated with its development in a Colombian population.

Methods: A retrospective, multicenter case-control study was carried out using data from the national RAPACO registry. Patients aged 16 years or older with confirmed acromegaly and an available echocardiogram were included. AHD was defined by structural or functional cardiac abnormalities attributable to acromegaly.

Results: A total of 193 patients with acromegaly were analyzed; 61 (31.6%) had AHD. Compared with the non-AHD group, these patients were older, had a 4.5 cm larger abdominal perimeter, and had a median time from disease onset to diagnosis of 8 years (vs. 6 years in those without AHD). Among the 61 AHD cases, the most frequent finding was isolated left ventricular hypertrophy (n = 32, 52.4%), followed by biventricular hypertrophy (n = 12, 19.7%), valvulopathy (n = 4, 6.6%), and combined LVH with valvulopathy (n = 4, 6.6%). GH and IGF-1 levels were modestly higher in AHD patients. In multivariate analysis, hypertension (HTN) showed an odds ratio (OR) of 1.75 (95% CI: 0.67-4.65) for AHD, while carpal tunnel syndrome significantly increased the odds of AHD (OR 3.81, p = 0.01, 95% CI: 1.36-11.14).

Conclusions: Despite therapeutic advances, AHD remains common in Colombian patients with acromegaly. Notably, carpal tunnel syndrome was independently associated with AHD, alongside HTN, arrhythmias, and type 2 diabetes mellitus. These findings underscore the need for proactive cardiovascular screening and management strategies in this patient population.

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来源期刊

Cardiology 医学-心血管系统

CiteScore

3.40

自引率

5.30%

发文量

审稿时长

1.5 months

期刊介绍： ''Cardiology'' features first reports on original clinical, preclinical and fundamental research as well as ''Novel Insights from Clinical Experience'' and topical comprehensive reviews in selected areas of cardiovascular disease. ''Editorial Comments'' provide a critical but positive evaluation of a recent article. Papers not only describe but offer critical appraisals of new developments in non-invasive and invasive diagnostic methods and in pharmacologic, nutritional and mechanical/surgical therapies. Readers are thus kept informed of current strategies in the prevention, recognition and treatment of heart disease. Special sections in a variety of subspecialty areas reinforce the journal''s value as a complete record of recent progress for all cardiologists, internists, cardiac surgeons, clinical physiologists, pharmacologists and professionals in other areas of medicine interested in current activity in cardiovascular diseases.