Investig Magn Reson Imaging.  2019 Dec;23(4):395-400. 10.13104/imri.2019.23.4.395.

Dilated Cardiomyopathy in Acromegaly: a Case Report with Cardiac MR Findings

• Kim MS
• Choi HW
• Seo YS
• Lee W
• Park EA

• KMID: 2468059
• DOI: http://doi.org/10.13104/imri.2019.23.4.395

Abstract

Acromegaly is a rare endocrine disorder caused by excessive secretion of the growth hormone. There is a wide range of clinical manifestations from somatic symptoms to respiratory or cardiac failure. Among them, cardiovascular involvement is a leading cause of morbidity and mortality. There are relatively few cases reporting cardiac magnetic resonance imaging (CMR) findings of cardiomyopathy in patients with acromegaly. Thus, we report a case of acromegaly showing dilated cardiomyopathy focusing on the findings of CMR.

Keyword

Acromegaly; Magnetic resonance imaging; Cardiomyopathy

MeSH Terms

Acromegaly*
Cardiomyopathies
Cardiomyopathy, Dilated*
Growth Hormone
Heart Failure
Humans
Magnetic Resonance Imaging
Mortality
Growth Hormone

Figure

• 

  Fig. 1 Magnetic resonance images of the pituitary macroadenoma. Sagittal T1-weighted image (a) and axial T2-weighted image (b) shows intermediate to low signal intensity of the mass (arrows). Coronal (c) and sagittal (d) contrast-enhanced T1-weighted images of the brain reveal a strong, heterogeneously enhancing solid sellar mass (arrows). The normal pituitary gland is not discernible.

• 

  Fig. 2 (a, b) Transthoracic echocardiogram images of the patient. An apical 4-chamber view shows dilated left ventricle with decreased calculated ejection fraction (49%) and global hypokinesia with trivial mitral regurgitation and trivial tricuspid regurgitation.

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  Fig. 3 Cine images during end-diastolic (a) and end-systolic (b) phases demonstrate dilated left ventricle (LV) with mild global hypokinesia with ejection fraction of 44.8%. Late gadolinium enhancement (LGE) images with magnitude and phase-sensitive inversion recovery (c) show patchy delayed enhancement (arrow) in mid inferoseptal wall of LV. The enhancement pattern is distinct from that associated with coronary artery disease because of subendocardial sparing and non-coronary territory distribution. Native T1 map value (d) slightly increased at the LV septal wall both LGE positive and LGE negative myocardium (1280 and 1250 msec, respectively). Extracellular volume fraction of LV myocardium (e), measured at LGE negative myocardium, was 28.0%.

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