THE EFFECT OF ARTERIAL HYPERTENSION AND GLUCOSE HOMEOSTASIS VIOLATIONS ON CARDIOMYOPATHY SEVERITY IN PATIENTS WITH ACROMEGALY
Keywords:acromegaly, diabetes mellitus, glucose homeostasis, arterial hypertension, cardiomyopathy
It was study 121 patients with acromegaly (75 women and 46 men) aged 18–75 years old.
Changes of glucose homeostasis were presented violations by glucose tolerance (n = 9) and diabetes
mellitus (n = 39). Hypertension was found in 74 patients. In patients with acromegaly without arterial
hypertension the age, the thickness of the back wall of the left ventricle during diastole, the thickness
of the interventricular septum, the index of left ventricular mass (LVMI) and isovolumetric relaxation
time were significantly lower than in patients with hypertension, the ratio of the maximum velocity
of early diastolic filling of the left ventricle and a top speed of left ventricular filling during atrial
systole (E/A) and ejection fraction (EF) were significantly higher. The results of multiple regression
analysis showed that increased levels of growth hormone in the blood and systolic blood pressure
are predictors of increased of LVMI. Elevated levels of diastolic blood pressure and the presence of
violations of glucose homeostasis are predictors of reduction in ejection fraction (EF). Older patient’s
age and increased levels of insulin-like growth factor-1 are predictors of increase in the ratio of E/A. In
patients with arterial hypertension and normal glucose tolerance rate of left ventricular hypertrophy
was significantly higher than in patients with normal glucose tolerance without hypertension, without
systolic (SLVD) and diastolic (DLVD) left ventricular dysfunction. In patients with hypertension and
diabetes frequency of the left ventricular hypertrophy, SLVD and DLVD was the highest.
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