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Context Several studies have reported increased risk of cardiovascular disease due to early development of endothelial dysfunction and structural vascular changes in patients with acromegaly. Objective The aim of this study was to evaluate subclinical cardiovascular disease with epicardial fat thickness ( EFT), aortic stiffness and serum levels of cell adhesion molecules ( CAMs) in patients with acromegaly. Design Cross-sectional study. Patients Twenty-seven patients with active acromegaly ( AA), 13 patients with remission acromegaly ( RA) and 37 age- and sex-matched healthy controls were studied. Measurements Epicardial fat thickness was evaluated by transthoracic echocardiography ( TTE). Aortic stiffness (β) index, aortic strain (AoS) and aortic distensibility ( AoD) were calculated from the aortic diameters measured by TTE. Serum levels of CAMs such as intercellular adhesion molecule ( ICAM)-1, vascular cell adhesion molecule ( VCAM)-1 and E-selectin were measured. Results Epicardial fat thickness was significantly increased in patients with RA and AA as compared to controls 9·71 ± 1·54 and 10·08 ± 1·95 mm vs 5·74 ± 0·92 mm, P < 0·001, respectively). A significant positive correlation was found between the EFT and growth hormone ( GH) levels ( r = 0·365, P = 0·024). β-index was similarly higher in patients with RA and AA than controls (15·68 ± 7·27 and 11·90 ± 8·24 vs 6·85 ± 2·87, P < 0·001, respectively). AoS and AoD were significantly decreased in patients with RA and AA as compared to the control group (3·81 ± 1·94 and 3·68 ± 1·99 vs 8·19 ± 4·19%, P < 0·001, respectively; and 1·21 ± 0·66 and 1·18 ± 0·63 vs 2·58 ± 1·50, 10−6 cm2/dyn, P < 0·001, respectively). Serum ICAM-1 and VCAM-1 levels were significantly higher in patients as compared to the control group ( P < 0·001 vs P = 0·032, respectively). There were no significant differences in EFT, AoD, AoS, β-index and serum CAMs between two patients groups ( AA vs RA, P > 0·05). There was a significant negative correlation between E-selectin and AoD ( r = −0·45, P = 0·008). In multiple linear regression analysis, EFT was found to be associated with GH levels (β-coefficient = 0·575, P = 0·008). Conclusion This study suggests that EFT and risk of subclinical cardiovascular disease are increased in patients with acromegaly. Serum GH level is an independent risk factor for EFT. [ABSTRACT FROM AUTHOR]

Objectives Left ventricular ( LV) synchronous contraction is impaired in patients with hypertension ( HT). The deleterious effects of HT on cardiovascular system are more evident in patients with nondipper HT than dippers. In this study, we aimed to investigate the effect of nondipping HT on LV systolic synchronicity compared with dippers and controls. Methods One hundred patients with newly diagnosed essential HT and 50 normotensive subjects were enrolled in this study. The hypertensive patients were assigned 2 groups comprising 55 dippers and 45 nondippers. Each subject underwent a comprehensive transthoracic echocardiographic examination. The evaluation of systolic dyssynchrony was performed by tissue synchronization imaging, and the time to regional peak systolic tissue velocity (Ts) in LV was measured on the basis of 12 segmental models. The standard deviation ( SD) of the 12 LV segments (Ts- SD-12) and maximal difference in Ts between any two of the 12 LV segments (Ts-12) were calculated. Results Compared with the control group, the synchronicity indexes were significantly prolonged in the hypertensive patients. Furthermore, Ts- SD-12 and Ts-12 values were found to be significantly impaired in patients with nondipper HT, compared with dippers: Ts- SD-12 (38.1 ± 18.7 vs. 31.8 ± 15.4, P ≤ 0.001); Ts-12 (123.0 ± 50.6 vs. 98.4 ± 42.3, P ≤ 0.001). Stepwise multivariate logistic regression analysis revealed a significant negative association between LV dyssynchrony indices and percentage decline in BP level from day to night. Conclusion Synchronous systolic contraction of LV is found to be significantly impaired in patients with nondipping circadian pattern of HT compared with dippers and the controls. [ABSTRACT FROM AUTHOR]