P614Contrast-enhanced magnetic resonance imaging identifies morphofunctional myocardial changes in patients with acromegaly and heart rhythm disorders

Abstract

Objective of study: to evaluate the morphofunctional changes of myocardium in patients with heart rhythm disorders in acromegaly using contrast-enhanced magnetic resonance imaging (MRI). Materials and methods: the study included 15 patients (5 women, 10 men) aged 46 to 73 years, with acromegaly and various heart rhythm disorders (atrial fibrillation, ventricular extrasystoles, AV block), secondary hypertension, without postinfarction cardiosclerosis. MRI of hearts was performed on the scanner General Electric Optima MR450w GEM 1.5T. Cine images were used for the assessment of left ventricular (LV) volumes, mass and function. T1-weighted images acquired 10 to 30 minutes after application of contrast agents (0.2 mmol/kg gadolinium). Results: focal myocardial fibrosis of LV was revealed in 4 patients. Diffuse accumulation of contrast agent was observed in 11 patients with different severity and localization, mainly endocardium of mitral and tricuspid valves, myocardium of LV without significant correlation with functional parameters. In patients with areas of local sites of violation of the kinetics of the walls of right ventricle and LV was not determined a clear relationship with the foci of post-contrast accumulation. Myocarditis was detected in 1 patient with focal myocardial fibrosis of LV. Conclusions: contrast-enhanced MRI allows for the noninvasive detection focal myocardial fibrosis, diffuse regions of endocardial fibrosis, inflammation in patients with heart rhythm disorders in acromegaly. Diffuse myocardial fibrosis requires further study.