Improvement of left ventricular hypertrophy and arrhythmias after lanreotide-induced GH and IGF-I decrease in acromegaly. A prospective multi-center study

Lombardi, Gaetano; Colao, Annamaria; Marzullo, Paolo; Biondi, Bernadette; Palmieri, Emiliano Antonio; Fazio, Serafino

doi:10.1007/bf03344070

Cited by 82 publications

(77 citation statements)

References 31 publications

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“…As far as geometric cardiac pattern is concerned, cardiac hypertrophy was present in the majority of our untreated patients, as expected (2,10,31). In agreement with several previous studies (10 -12), left ventricular mass significantly decreased after therapy, without a significant correlation with dCVF.…”

Section: Discussionsupporting

confidence: 92%

Evaluation of cardiac structure by echoreflectivity analysis in acromegaly: effects of treatment

Ciulla

Epaminonda

Paliotti

et al. 2004

European Journal of Endocrinology

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Objectives: Cardiac echoreflectivity is a noninvasive tool for evaluating cardiac fibrosis. The present paper aimed to study the modifications of cardiac echoreflectivity in a group of acromegalic patients before and after therapy, and to assess possible correlations with serum levels of procollagen III (PIIINP), a peripheral index of collagen synthesis. Design and methods: Cardiac echoreflectivity (as assessed by analyzing 2-D echocardiograms digitized off-line onto a personal computer) and PIIINP levels were evaluated in 16 acromegalic patients of new diagnosis not affected by arterial hypertension (10 males, six females, age^S.D.: 38^10 years), and in a group of 16 sex-and age-matched healthy subjects. All the patients were re-evaluated after surgical and/or medical therapy for acromegaly. The echo patterns were analyzed by software that supplies the derived collagen volume fraction (dCVF), an index of fibrosis. Results: At baseline, acromegalic patients showed significantly higher dCVF values and PIIINP levels than healthy controls (3.1^0.5% vs 1.6^0.3%, P , 0.01 and 8.7^2.2 vs 3.1^1.1 ng/ml, P , 0.05, respectively, by unpaired Student's t-test). After therapy, dCVF and PIIINP levels normalized in the six controlled patients (that is, GH of , 2.5 mg/l and IGF-I within normal range) (dCVF from 2.8^0.4% to 1.4^0.2%, P , 0.001; PIIINP from 8^2.7 to 3.3^1.9 ng/ml, P , 0.05), while no significant changes were found in noncontrolled patients (dCVF from 3.3^0.6% to 2.9^1.2% and PIIINP from 9.1^1.9 to 7.9^3.5 ng/ml, P ¼ NS). A positive correlation between dCVF and PIIINP (r ¼ 0.75, P , 0.001) and between IGF-I and both dCVF and PIIINP (r ¼ 0.65 and 0.61 respectively, P , 0.05) was found in acromegalic patients. Conclusions: Cardiac echoreflectivity, which may be a reflection of heart collagen content, is increased in patients with active acromegaly and correlates with PIIINP concentrations. After cure or adequate control of the disease, both parameters revert to normal. Echoreflectivity analysis could be a useful adjuvant parameter in the assessment of the activity of acromegalic disease.

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Section: Discussionsupporting

confidence: 92%

Evaluation of cardiac structure by echoreflectivity analysis in acromegaly: effects of treatment

Ciulla

Epaminonda

Paliotti

et al. 2004

European Journal of Endocrinology

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“…Almost a half of a small cohort of ACM patients presented complex ventricular arrhythmias (Lown III-IV) in one study, especially those with a long disease duration (Kahaly et al 1992). A multicentric study performed in Italy using 24-h ECG-Holter monitoring reported a lower but still very significant rate of ventricular extrasistoles (in 33% of the ACM cases evaluated; Lombardi et al 2002). Twenty-four-hour ECG-Holter monitoring might be useful in the preoperative evaluation of the patients (Fedrizzi & Czepielewski 2008), especially those with clinically detected abnormalities.…”

Section: Complicationsmentioning

confidence: 97%

60 YEARS OF NEUROENDOCRINOLOGY: Acromegaly

Căpățînă¹,

Wass²

2015

Journal of Endocrinology

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Acromegaly (ACM) is a chronic, progressive disorder caused by the persistent hypersecretion of GH, in the vast majority of cases secreted by a pituitary adenoma. The consequent increase in IGF1 (a GH-induced liver protein) is responsible for most clinical features and for the systemic complications associated with increased mortality. The clinical diagnosis, based on symptoms related to GH excess or the presence of a pituitary mass, is often delayed many years because of the slow progression of the disease. Initial testing relies on measuring the serum IGF1 concentration. The oral glucose tolerance test with concomitant GH measurement is the gold-standard diagnostic test. The therapeutic options for ACM are surgery, medical treatment, and radiotherapy (RT). The outcome of surgery is very good for microadenomas (80-90% cure rate), but at least half of the macroadenomas (most frequently encountered in ACM patients) are not cured surgically. Somatostatin analogs are mainly indicated after surgical failure. Currently their routine use as primary therapy is not recommended. Dopamine agonists are useful in a minority of cases. Pegvisomant is indicated for patients refractory to surgery and other medical treatments. RT is employed sparingly, in cases of persistent disease activity despite other treatments, due to its long-term side effects. With complex, combined treatment, at least three-quarters of the cases are controlled according to current criteria. With proper control of the disease, the specific complications are partially improved and the mortality rate is close to that of the background population.

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“…Cardiovascular system-Both octreotide LAR and lanreotide SR Hradec et al, 1999;Lombardi et al, 2002) reduced left ventricular hypertrophy and improved diastolic dysfunction especially in younger patients with shorter disease duration. Increased exercise capacity, normalization of ejection fraction and suppression of ventricular premature beats were also observed .…”

Section: Symptom Controlmentioning

confidence: 99%

Somatostatin agonists for treatment of acromegaly

Ben-Shlomo

Melmed

2008

Molecular and Cellular Endocrinology

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The discovery of somatotropin-release inhibitory factor (SRIF) in hypothalamic extract in 1970 led to the synthesis of the first somatostatin analog octreotide, discovery of five somatostatin receptor subtypes, and development of additional somatostatin receptor ligands (SRL) as pharmacotherapy for acromegaly and other neuroendocrine tumors. Long-acting formulations of SRL (octreotide LAR Depot, lanreotide SR and lanreotide autogel) assure improved patient compliance with weekly up to monthly injections, and are commonly used as primary or adjuvant treatment of acromegaly. We review SRL currently available, emphasizing long-acting compounds and their efficacy in controlling acromegaly. Disease control is evaluated by biochemical markers, tumor shrinkage, and diseasesymptom improvement balanced against drug-related side effects.

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Improvement of left ventricular hypertrophy and arrhythmias after lanreotide-induced GH and IGF-I decrease in acromegaly. A prospective multi-center study

Cited by 82 publications

References 31 publications

Evaluation of cardiac structure by echoreflectivity analysis in acromegaly: effects of treatment

Evaluation of cardiac structure by echoreflectivity analysis in acromegaly: effects of treatment

60 YEARS OF NEUROENDOCRINOLOGY: Acromegaly

Somatostatin agonists for treatment of acromegaly

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