Cardiovascular System Changes and Related Risk Factors in Acromegaly Patients: A Case-Control Study

Abstract

Background. Cardiovascular complications are known to be the main determinants of reduced life expectancy and decreased quality of life in acromegaly patients. Our study aimed to provide insight into the cardiovascular changes that occur in acromegaly patients and to investigate the correlative risk factors. Methods. A total of 108 patients definitively diagnosed with acromegaly and 108 controls matched for age and gender were recruited into study and control groups, respectively. Standard echocardiography was performed on all of the participants, and data were collected and analyzed. Results. All acromegaly patients presented with structural cardiac changes, including a larger heart cavity, thicker myocardial walls, and increased great vessel diameters compared with the control group. Additionally, the acromegaly patients presented with reduced diastolic function. Aging and increased body mass index (BMI) were correlated with myocardial hypertrophy and diastolic dysfunction; a longer disease duration was correlated with larger great vessel diameters. Conclusions. Ageing and increased BMI are independent risk factors for acromegalic cardiomyopathy, and a long disease duration results in the expansion of great vessels. Increased efforts should be made to diagnose acromegaly at an early stage and to advise acromegaly patients to maintain a healthy weight.

Cardiac Abnormalities in Acromegaly Patients: A Cardiac Magnetic Resonance Study

“…However, we found that 6 of the 9 patients with MCF had lesions indicating both LVH and IVSH, and 3 of these 9 patients developed LVSD, In this study, we found that, in the included acromegaly patients, the levels of GH and IGF-1 were not correlated with the occurrence of cardiac abnormalities or quantitative cardiac parameters. In the literature, cardiovascular diseases are generally evaluated in acromegaly patients with echocardiography, and many studies have concluded that having high levels of GH and IGF-1 does not increase the risk of developing LVH or other cardiovascular diseases [7,23]. However, other parameters, including disease duration, age, BMI, hypertension, and diabetes, have been found to be significantly associated with cardiovascular changes [3,7,[24][25][26][27][28][29].…”

“…In the literature, cardiovascular diseases are generally evaluated in acromegaly patients with echocardiography, and many studies have concluded that having high levels of GH and IGF-1 does not increase the risk of developing LVH or other cardiovascular diseases [7,23]. However, other parameters, including disease duration, age, BMI, hypertension, and diabetes, have been found to be significantly associated with cardiovascular changes [3,7,[24][25][26][27][28][29]. We found that the results of the clinical correlation analysis of the cardiovascular changes reported in previous studies that used echocardiography were in accordance with the results found in our study using CMR.…”

GH, IGF-1, and Age Are Important Contributors to Thyroid Abnormalities in Patients with Acromegaly

“…Between January 2013 and December 2013, 146 patients who presented to the Department of Neurosurgery, Peking Union Medical College Hospital (PUMCH) were newly diagnosed with acromegaly [ 5 ]. The inclusion criteria were as follows: clinical features for acromegaly; GH levels that were greater than 1 ng/ml after an oral glucose tolerance test (OGTT) with 75 g of dextrose; elevated serum IGF-1 levels adjusted for gender and age; and a pituitary adenoma identified by contrast-enhanced magnetic resonance imaging (MRI).…”

Screening for comorbid conditions in patients enrolled in the SODA registry: a 2-year observational analysis

“…The prevalence of different features of cardiomyopathy is 3.3–14.2 times higher in the acromegalic than non-acromegalic population, with the disease duration as its major determinant [ 24 , 31 ]. Guidelines recommend routine echocardiogram and electrocardiogram at diagnosis and annually during follow-up, especially in patients who have evidence of ventricular hypertrophy by electrocardiography or who are symptomatic, particularly if older [ 2 , 6 ].…”