Heart Failure Responding to Octreotide in Patient With Acromegaly

Chanson, Philippe; Timsit, José; Masquet, C; Guillausseau, Pierre-Jean; Warnet, A; Lubetzki, J

doi:10.1016/s0140-6736(89)92355-6

Cited by 19 publications

(10 citation statements)

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“…Based on this analysis, therapeutical success can consistently reduce both cardiovascular mortality and morbidity in acromegaly. A positive response to octreotide has been reported in acromegalic patients suffering from congestive heart failure, who gain a significant improvement of cardiac hypertrophy and an increase in cardiac output [40]. Similarly, we have demonstrated that an acute but sustained decrease in circulating GH levels, obtained via continuous infusion of octreotide as well as via a single i.m.…”

Section: Discussionsupporting

confidence: 78%

The long-term cardiovascular outcome of different GH-lowering treatments in acromegaly

et al. 2007

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The aim of this longitudinal study was to evaluate the echocardiographic outcome of acromegalic heart disease in patients undergoing different therapeutic approaches, in order to investigate whether SSA could provide therapeutic advantages as compared with neurosurgery. In total of 36, consecutive patients undergoing SSA treatment after neurosurgery were enrolled in this study (Gr.Surg.-SSA). After 12 months of treatment, 21 patients had a controlled disease, while the remaining 15 patients displayed uncontrolled disease. Twelve acromegalic patients who did not undergo SSA treatment due to controlled disease after neurosurgery were enrolled as control group (Gr.Surg). The echocardiographic-Doppler study was performed before neurosurgery and after 12-months of follow-up. After follow-up, a significant reduction in serum GH and IGF-I values, Left Ventricular Mass index (LVMi) and LVH rate with an improvement in diastolic function was observed in both groups of patients. We found a significant reduction of LVMi either in patients with controlled disease or in those with poorly controlled disease undergoing SSA treatment. Diastolic function and of LVH percentage improved in all groups, but significantly so only in controlled patients, no significant difference in any echocardiographic parameters and in the prevalence of the LVH rate were observed between the three groups of patients at the end of follow-up. Therefore, our data appear to show that for echographic parameters medical treatment additive beneficial effects is compared to neurosurgery alone. SSA also appears to contribute to the improvement of acromegalic cardiomyopathy also in patients who did not achieve biochemical control of the disease.

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Section: Discussionsupporting

confidence: 78%

The long-term cardiovascular outcome of different GH-lowering treatments in acromegaly

et al. 2007

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“…A significant improvement in LV ejection fraction was recorded in 13 patients achieving biochemical control of the disease, out of 30 patients subjected to a 1‐year treatment with s.c. octreotide (Colao et al ., 1999b). A positive response to octreotide has been reported also in acromegalic patients suffering from congestive heart failure, who gained a significant improvement of cardiac hypertrophy and an increase in cardiac output (Chanson et al ., 1989, 1990). Similarly, cardiopulmonary performance, impaired in acromegalic patients when compared to controls, was acutely improved by continuous infusion of s.c. octreotide for 24 h (Giustina et al ., 1995).…”

Section: The Effect Of Gh and Igf‐i Suppression On Acromegalic Cardiomentioning

confidence: 99%

Growth hormone and the heart

Colao

Marzullo

Somma

et al. 2001

Clinical Endocrinology

345

296

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Impaired cardiovascular function has recently been demonstrated to potentially reduce life expectancy both in GH deficiency and excess. Experimental and clinical studies have supported the evidence that GH and IGF-I are implicated in cardiac development. In most patients with acromegaly a specific cardiomyopathy, characterized by myocardial hypertrophy with interstitial fibrosis, lympho-mononuclear infiltration and areas of monocyte necrosis, results in biventricular concentric hypertrophy. In contrast, patients with childhood or adulthood-onset GH deficiency (GHD) may suffer both from structural cardiac abnormalities, such as narrowing of cardiac walls, and functional impairment, that combine to reduce diastolic filling and impair left ventricular response to peak exercise. In addition, GHD patients may have an increase in vascular intima-media thickness and a higher occurrence of atheromatous plaques, that can further aggravate the haemodynamic conditions and contribute to increased cardiovascular and cerebrovascular risk. However, several lines of evidence have suggested that the cardiovascular abnormalities can be partially reversed by suppressing GH and IGF-I levels in acromegaly or after GH replacement therapy in GHD patients. Recently, much attention has been focussed on the ability of GH to increase cardiac mass suggesting its possible use in the treatment of chronic nonendocrine heart failure. In fact, GH administration can induce an improvement in haemodynamic and clinical status in some patients. Although these data need to be confirmed in more extensive studies, such promising results seem to open new perspectives for GH treatment in humans.

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“…8,19,20) Treatment with somatostatin analogs has proved effective for acromegalics, even in those with advanced cardiac failure. 17,21,22) While others have observed worsening of congestive heart failure with octreotide, 23,24) Chanson, et al reported that a very low LVEF (<20%) might increase the risk of precipitating cardiac failure with octreotide, since this somatostatin analog exerts a negative inotropic effect by decreasing GH. 25) In the present patient, left ventricular ejection fraction increased from 11% to 27% after treatment with octreotide, then it further increased to 43% after trans-sphenoidal surgery.…”

Section: Discussionmentioning

confidence: 99%

Improvement of Cardiac Function after Treatment with Octreotide followed by Trans-sphenoidal Surgery in an Acromegalic Patient who Presented with Congestive Heart Failure.

et al. 2002

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SUMMARYCardiovascular disease is a major cause of mortality and morbidity in patients with acromegaly. We describe the case of a 43-year-old man with acromegaly who presented with severe congestive heart failure. Treatment with the somatostatin analog octreotide improved cardiac function with an increase in left ventricular ejection fraction (LVEF) from 11% to 27%. LVEF further increased to 43% after trans-sphenoidal surgery. Recovery was uneventful. We emphasize the need for early diagnosis and effective treatment of acromegaly to prevent cardiovascular complications. Octreotide therapy or trans-sphenoidal surgery, if possible, should be considered to control cardiac function even in acromegalic patients with severe congestive heart failure. (Jpn Heart J 2002; 43: 69-77)

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Heart Failure Responding to Octreotide in Patient With Acromegaly

Cited by 19 publications

References 1 publication

The long-term cardiovascular outcome of different GH-lowering treatments in acromegaly

The long-term cardiovascular outcome of different GH-lowering treatments in acromegaly

Growth hormone and the heart

Improvement of Cardiac Function after Treatment with Octreotide followed by Trans-sphenoidal Surgery in an Acromegalic Patient who Presented with Congestive Heart Failure.

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