Long-term echocardiographic follow-up of acromegalic heart disease

Hradec, J; Marek, Josef; Král, Josef; Janota, Tomáš; Poloniecki, Jan; Malik, Marek

doi:10.1016/0002-9149(93)90161-5

Cited by 43 publications

(14 citation statements)

References 18 publications

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“…Previous studies suggest that GH treatment has, at least in adults, an anabolic effect on the myocardium [24, 25, 26]. An increase in left ventricular mass and hypertension have been reported in acromegalic patients [26, 27].…”

Section: Other Effects Of Gh Treatmentmentioning

confidence: 99%

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Turner’s Syndrome: A Paediatric Perspective

Sas¹,

Keizer‐Schrama²

2001

Horm Res Paediatr

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In childhood the symptoms with the greatest impact on girls with Turner’s syndrome are: (1) congenital cardiac abnormalities (which can be corrected by surgical intervention); (2) short stature (mean adult height between 142 and 147 cm); and (3) ovarian failure (absent spontaneous puberty). Recent studies have shown that growth hormone (GH) treatment in young girls (8 years of age or younger) with Turner’s syndrome results in normalization of adult height in most of the girls when using the ‘standard’ GH dose of about 4 IU/m² per day (≈0.045 mg/kg per day). Higher GH doses (6 or 8 IU/m² per day) or the use of oxandrolone may be more effective, but their efficacy on adult height and safety in the very long term still have to be proven. If GH treatment is started early, low-dose oestrogens for induction of puberty can be given at 12 years of age without interfering with the capability of the GH treatment to normalize adult height. GH does not seem to have negative side effects on body proportions, cardiac dimensions, blood pressure, carbohydrate metabolism or bone mineral density.

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Section: Other Effects Of Gh Treatmentmentioning

confidence: 99%

“…An increase in left ventricular mass and hypertension have been reported in acromegalic patients [26, 27]. …”

Section: Other Effects Of Gh Treatmentmentioning

confidence: 99%

Turner’s Syndrome: A Paediatric Perspective

Sas¹,

Keizer‐Schrama²

2001

Horm Res Paediatr

View full text Add to dashboard Cite

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“…An increase in left and right ventricular mass induced by GH excess has been documented largely by this means (5,14). In the majority of patients, cardiac hypertrophy was concentric and independent of preload and afterload modi®cations (3).…”

Section: Conventional Echocardiography: Global Systolic/diastolic Funmentioning

confidence: 99%

Cardiac dysfunction in acromegaly: evidence by pulsed wave tissue Doppler imaging

Mercuro

Zoncu²,

Colonna³

et al. 2000

European Journal of Endocrinology

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Objective: To verify whether the accuracy of data on myocardial function provided by pulsed-wave tissue Doppler imaging (PWTDI), a new echocardiographic application that allows quantitative measurements of myocardial wall velocities, could help towards a better understanding of the natural history of acromegalic cardiomyopathy. Design: Eighteen patients with active acromegaly (ten men and eight women; mean age 48.0 6 15.0 years) with no other detectable cause of heart disease underwent PWTDI. Thirteen healthy individuals matched for age and body mass index acted as a control group. Methods: Ejection fraction (EF), transmitral early/late diastolic velocity (E/A) ratio and isovolumic relaxation time (IVRT) were measured by conventional echocardiography; systolic peak (Sv) and early (Ev) and late (Av) diastolic peak velocities, Ev/Av ratio and regional IVRT (IVRTs) were obtained by PWTDI.Results: All patients showed appreciably abnormal left ventricular global diastolic function represented by prolongation of the IVRT (P < 0.001). Using PWTDI we found a prolongation of IVRTs and inversion of the Ev/Av ratio. In addition, the Ev/Av ratio proved to be signi®cantly negatively correlated with IVRT; this correlation was not present in the case of the E/A ratio. Furthermore, a decrease in Sv was detected in the basal segment of the lateral wall (P < 0.01), which had the greatest degree of diastolic dysfunction. Conclusions: PWTDI con®rmed the acknowledged diastolic dysfunction that accompanies acromegalic cardiomyopathy and highlighted the greater sensitivity of regional PWTDI with respect to global Doppler diastolic indexes. Furthermore, by revealing an impairment of regional systolic function in presence of a normal EF, the ®ndings with PWTDI contradicted the largely accepted theory that systolic function remains normal for several years in patients affected by acromegalic cardiomyopathy.

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“…6,7) Echocardiographic examinations reveal myocardial hypertrophy and a reduced left ventricular ejection fraction. 6,7) Histological examination demonstrates cellular hypertrophy, patchy fibrosis, and myofibrillar degeneration. 8) GH and IGF-1 are reported to play critical roles in cardiac hypertrophy.…”

Section: Discussionmentioning

confidence: 99%

Improvement of Ventricular Arrhythmia by Octreotide Treatment in Acromegalic Cardiomyopathy.

et al. 2003

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SUMMARYWe report a case of acromegalic cardiomyopathy in a 46-year-old Japanese man with pituitary adenoma. Increased secretion of growth hormone and insulin-like growth factor 1 were detected. He had left ventricular hypertrophy, impaired cardiac function, and frequent ventricular premature complexes. After 2-month treatment with octreotide, a longacting somatostatin analogue, levels of both hormones were decreased. At the same time, left ventricular hypertrophy (intraventricular septal thickness: 22.5 to 17.8 mm), cardiac function (ejection fraction: 38 to 50%), and frequency of ventricular premature complexes (17,249 to 2,882 beats a day) were improved. Transsphenoidal surgery was then safely performed. Treatment with octreotide is thought to have some effect on improvement of ventricular arrhythmia in acromegalic heart. (Jpn Heart J 2003; 44: 1027-1031

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Long-term echocardiographic follow-up of acromegalic heart disease

Cited by 43 publications

References 18 publications

Turner’s Syndrome: A Paediatric Perspective

Turner’s Syndrome: A Paediatric Perspective

Cardiac dysfunction in acromegaly: evidence by pulsed wave tissue Doppler imaging

Improvement of Ventricular Arrhythmia by Octreotide Treatment in Acromegalic Cardiomyopathy.

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