Malignant ventricular tachycardia in acromegaly: a case                     report

An, Zhe; He, Yan; Liu, Guohui; Ge, Lili; Zhang, Wenqi

doi:10.1590/1516-3180.2012.6410005

Cited by 7 publications

(5 citation statements)

References 18 publications

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“…The main cardiac histological characteristics are interstitial fibrosis and architectural subversion of the myocardium [19]. If this condition is not adequately and promptly treated, it is associated with an increased incidence of malignant arrhythmias, congestive heart failure, and sudden death [6,20,21]. The diagnosis of cardiomyopathy is based on the echocardiographic examination, recommended by the current international guidelines and consensus [18].…”

Section: Introductionmentioning

confidence: 99%

Acromegaly and ultrasound: how, when and why?

Parolin

Dassiè

Vettor

et al. 2019

J Endocrinol Invest

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Background Acromegaly is a rare disease caused by an excess of growth hormone and insulin-like growth factor 1. It is usually diagnosed because of typical signs such as macroglossia, acral enlargement, jaw prognathism and malocclusion. Systemic complications are a major cause of morbidity and mortality in acromegaly, and many patients remain undiagnosed for several years. Increased ultrasound (US) application in the general population, and including among acromegaly patients, has revealed many suggestive features which, taken together with clinical suspicion, could induce suspicion of this disease. Purpose This review describes main US features in acromegaly. Echocardiography shows a typical cardiomyopathy, characterized by left ventricular hypertrophy, diastolic and systolic dysfunction, aortic and mitral regurgitation, and increased aortic root diameters. US preclinical markers of atherosclerosis, such as intima media thickness (IMT), seem also to be impaired. Visceromegaly and increased organ stiffness are other features of acromegaly, including enlarged prostate, kidneys, liver, and thyroid. In addition, other US findings are: renal cysts, micronephrolithiasis, impairment of renal haemodynamic parameters, gallstones and gallbladder polyps, hepatic steatosis, thyroid nodules, multinodular goiter, and polycystic ovaries. Musculoskeletal US findings are increased cartilage thickness, impaired density and elasticity of bones, nerve enlargement, carpal and cubital tunnel syndrome, and trigger finger. Conclusions Acromegaly patients frequently present systemic complications and a diagnostic delay. US features of acromegaly are not specific, but could potentially have a key role in early detection of the disease in the presence of typical clinical features.

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Section: Introductionmentioning

confidence: 99%

Acromegaly and ultrasound: how, when and why?

Parolin

Dassiè

Vettor

et al. 2019

J Endocrinol Invest

View full text Add to dashboard Cite

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“…Patients are also at an increased risk for cardiovascular and cerebrovascular events, respiratory complications, and malignant neoplasms (16-18). Cardiovascular complications are regarded as the most common cause of death, accounting for 60% of cases (19). Sudden death is often associated with ventricular tachyarrhythmias and may be related to myocardial interstitial fibrosis (20).…”

Section: Discussionmentioning

confidence: 99%

“…The risk of cardiovascular disease is directly associated with elevated serum levels of GH and a prolonged clinical course, which affects cardiac morphology and performance, thereby inducing cardiomyopathy specific to the disease (21, 22). Left untreated or poorly controlled for many years, concentric hypertrophy and diastolic dysfunction develop, which may then progress further to valvular disease and impaired systolic performance (19). Histologically, acromegalic cardiomyopathy demonstrates interstitial fibrosis, myocyte apoptosis, and lymphocytic infiltrates (23, 24).…”

Section: Discussionmentioning

confidence: 99%

The Pituitary Gland: An Infrequent but Multifaceted Contributor to Death

Wang

Gill

2016

Academic Forensic Pathology

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The pituitary gland has an important role in homeostasis and disorders of it can result in endocrine dysfunction and/or produce mass effect on surrounding structures, including the hypothalamus, which can cause significant morbidity and mortality. A definitive clinical diagnosis may be delayed or remain elusive and lead to life-threatening conditions. Specifically, pituitary adenomas, pituitary necrosis, hypophysitis, and abscesses have all been reported in the literature to cause sudden and unexpected death and may only be first encountered at autopsy. Recognition by the forensic pathologist of these rare entities is crucial for appropriate death certification. This review emphasizes the need for a comprehensive, detailed forensic examination, including autopsy and routine histologic sampling of the pituitary gland, in order to ascertain its potential role in sudden unexpected death with no other apparent cause.

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“…По нашим данным, 2% пациентов с НРПС нуждались в антиаритмическом устройстве. Чаще всего в литературе встречаются описания развития желудочковых нарушений ритма и имплантации больным акромегалией кардиовертеров-дефибрилляторов [21,22], а в случае злокачественных желудочковых нарушений ритма -и пересадки сердца [23]. Вместе с тем небольшое количество публикаций посвящено клиническим случаям имплантации электрокардиостимуляторов пациентам с акромегалией [21][22][23][24][25][26].…”

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Heart arrhythmias and conduction disorders in patients with acromegaly: the role of cardiac magnetic resonance imaging

Melkozerov

Przhiyalkovskaya

Tarbaeva

et al. 2020

Terapevticheskii arkhiv

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Cardiovascular complications including arrhythmias and cardiac conduction disorders are one of the main reasons of high mortality rate in acromegaly, while they have not been well explored. Aim.To estimate arrhythmias frequency in acromegaly, identify risk factors leading to the development of arrhythmia and cardiac conduction disorder, to determine the role of cardiac MRI in detecting structural and functional changes. Materials and methods.A single-center prospective cohort study, which included 461 patients (151 men and 310 women) with acromegaly, was conducted. All the patients underwent a standard medical examination, including hormonal blood test, electrocardiogram, echocardiography, electrocardiogram daily monitoring. 18 patients with arrhythmias (11 men and 7 women) had cardiac MRI with gadolinium-based contrast. Results.The results of our research show high frequency of arrhythmias and cardiac conduction disorders in patients with acromegaly 42%. Most frequent kinds of arrhythmias and cardiac conduction disorders were sinus bradycardia 19.1% of the cases and conduction disorders of bundle branch blocks 14.5%. Men were more likely to suffer from arrhythmias and cardiac conduction disorders than women (54.2% and 37.4%, respectively,p=0.0005). Not acromegaly activity but duration of the disease was a main risk factor of arrhythmias and cardiac conduction disorders. Patients with arrhythmias had a long anamnesis of acromegaly (10 and 7 years, respectively, p=0.04). Meanwhile, cardiac conduction disorders were commonly observed in the patients who were treated with somatostatin analogs comparing to the patients who didnt undergo this therapy (50% and 38.6% respectively,p=0.004). We showed that 61% of patients with acromegaly and cardiac conduction disorders who underwent magnetic resonance imaging (MRI) had the signs of myocardial fibrosis. The value of the ejection fraction of the left ventricle according to MRI was higher than with echocardiography (p=0.04). Conclusion.Arrhythmias and cardiac conduction disorders are often observed in patients with acromegaly even with remission of the disease. High risk group need careful diagnostic and monitoring approaches. Cardiac MRI is the gold standard for visualization of structural and morphological changes in the heart. Use of cardiac MRI in acromegalic patients expands our understanding of arrhythmias and cardiac conduction disorders in this disease. There are no specific laboratory markers of diffuse myocardial fibrosis, and the role of myocardial fibrosis in the occurrence of cardiac arrhythmias and conduction disorders needs further studying.

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Malignant ventricular tachycardia in acromegaly: a case report

Cited by 7 publications

References 18 publications

Acromegaly and ultrasound: how, when and why?

Acromegaly and ultrasound: how, when and why?

The Pituitary Gland: An Infrequent but Multifaceted Contributor to Death

Heart arrhythmias and conduction disorders in patients with acromegaly: the role of cardiac magnetic resonance imaging

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