Open Access

P378<br />Heart rhythm disorders in Acromegaly

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Date: 18 June 2020
Journal: EP Europace Journal , Volume 22 , Issue Supplement_1
Authors: K. Melkozerov , E. Przhiyalkovskaya , N. Tarbaeva , V. Kalashnikov , Z. Belaya , A. Vorontsov , L. Belousov , P. Alferova

ESC Journals

AbstractAim

to evaluate the prevalence of heart rhythm disorders among hospitalized patients with acromegaly

Methods

we enrolled patients with acromegaly hospitalized in our Endocrinology Research Center in 2018. Acromegaly was established based on the clinical signs and symptoms, elevated levels of insulin-like growth factor-1 (IGF-1) and presence of pituitary adenoma. All patients underwent clinical examination, routine electrocardiogram (ECG). In patients with changes in the resting ECG and/or complaints of heart rhythm disorders, echocardiography and Holter ECG monitoring were performed. We also performed cardiac magnetic resonance imaging (MRI) with contrast in cases of arrhythmia confirmation.

Results

Among 107 enrolled patients with acromegaly (61 women, mediana of age 51 [40; 58] years) arrhythmia was first diagnosed in 21 (19,6%) patients: 7 patients had sick sinus syndrome, 5 patients suffered from atrial fibrillation, 4 patients had AV block, 5 patients - ventricular arrhythmias (1 patient had sustained ventricular tachycardia). The median level of the GH was 1,77 [0,8; 5,4] ng/ml, and the median of IGF-1 - 348,95 [233,4; 557,4] ng/ml, 16 (76,1%) patients with arrhythmia had active acromegaly. 21 patients underwent MRI of the heart: median of ejection fraction 54 [48; 60] %, in 8 patients we revealed focal fibrosis of left ventricle myocardium. Diffuse accumulation of contrast agent was observed in 11 patients of different severity and localization, mainly endocardium of mitral and tricuspid valves. We didn’t find a clear correlation between the levels of hormones, changes in the MRI of the heart and the type of cardiac arrhythmia. We implanted pacemakers in 4 patients, 1 patient – implantable cardioverter defibrillator.

Conclusion

The prevalence of cardiac arrhythmia in hospitalized patients with acromegaly is about 20%. New cases of arrhythmia could occur despite normal level of GH and IGF-1 in patients with acromegaly. Patients with acromegaly and cardiac arrhythmia often have abnormalities in MRI of the heart, which requires further investigation.

About the contributors

K Melkozerov

Role: Author

E Przhiyalkovskaya

Role: Author

N Tarbaeva

Role: Author