Decreased regional blood flow in patients with acromegaly

• Published in: Clinical endocrinology (Oxford) 1998-12, Vol.49 (6), p.725-731
• Main Authors: Chanson, Philippe, Megnien, Jean-Louis, Del Pino, Murielle, Coirault, Catherine, Merli, Isabelle, Houdouin, Laurence, Harris, Alan G., Levenson, Jaime, Lecarpentier, Yves, Simon, Alain, Chemla, Denis
• Format: Article
• Language: English
• Subjects: Acromegaly - diagnostic imaging; Acromegaly - physiopathology; Adult; Biological and medical sciences; Brachial Artery - diagnostic imaging; Cardiac Catheterization; Cardiac Output; Case-Control Studies; Endocrinopathies; Female; Humans; Hypothalamus. Hypophysis. Epiphysis (diseases); Male; Medical sciences; Middle Aged; Non tumoral diseases. Target tissue resistance. Benign neoplasms; Regional Blood Flow; Ultrasonography, Doppler, Pulsed; Vascular Resistance
• ISSN: 0300-0664; 1365-2265
• DOI: 10.1046/j.1365-2265.1998.00620.x

BACKGROUND AND AIMS One‐third of acromegalic patients have hypertension. Acromegaly is also associated with intrinsic cardiac abnormalities known collectively as a hyperkinetic heart syndrome, which is characterized by an increased cardiac index and decreased systemic vascular resistance. As a result, blood flow should be increased in the regional vascular beds of acromegalic patients. The aim of the study was to measure, using direct methods, blood flow and vascular resistance at the level of the brachial artery in acromegalic patients with a confirmed hyperkinetic heart syndrome. PATIENTS AND CONTROLS Twelve patients with active acromegaly (five females, seven males; mean (± SD) age, 43 ± 10 years) were studied. Twelve age‐and sex‐matched normal subjects served as controls. METHODS Right heart catheterization was used to measure the cardiac index and stroke volume and to calculate systemic vascular resistance in the acromegalic patients. Brachial haemodynamics were evaluated with a two‐dimensional pulsed Doppler system (double transducer probe and range‐gated time system of reception). The mean diameter of the brachial artery and mean blood velocity were measured and used to calculate mean blood flow. Vascular resistance was calculated in the brachial artery as the mean arterial pressure/blood flow ratio. RESUTLS Age, body weight, height, body surface area and heart rate were similar in the acromegalic patients and controls, while mean arterial pressure was higher in patients. The cardiac index and stroke volume were increased in the acromegalic patients, at 4.08 ± 0.47 (mean ± SD) l/min/m2 body surface area and 116.7 ± 19.4 ml, respectively, while systemic vascular resistance was low (12.5 ± 2.1 U). Brachial artery diameter was similar in the patients and controls. Brachial artery mean blood velocity (P