Regression of acromegalic left ventricular hypertrophy after lanreotide (a slow-release somatostatin analog)

Hradec, J; Král, Josef; Janota, Tomáš; Kršek, Michal; Hána, Václav; Marek, Josef; Malik, Marek

doi:10.1016/s0002-9149(99)00135-6

Cited by 65 publications

(59 citation statements)

References 17 publications

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“…402 The specificity of heart disease in acromegaly is also supported by the evidence that pharmacological suppression of GH production leads to significant regression of hypertrophy and improvement of cardiac dysfunction. 385,403,404 Several studies have demonstrated that LV hypertrophy can be reversed by suppression of GH and IGF-1 levels with surgical treatment for acromegaly or with administration of octreotide. 385,403,404 The increased prevalence of LV hypertrophy in patients with hypertension and glucose tolerance abnormalities emphasizes the need for optimal control of blood pressure and hyperglycemia together with efficacious suppression of GH and IGF-1 levels.…”

Section: 394mentioning

confidence: 99%

Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association

Bozkurt¹,

Colvin²,

Cook³

et al. 2016

Circulation

603

663

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CLINICAL STATEMENTS AND GUIDELINEST he intent of this American Heart Association (AHA) scientific statement is to summarize our current understanding of dilated cardiomyopathies. There is special emphasis on recent developments in diagnostic approaches and therapies for specific cardiomyopathies. Recommendations in this document are based on published studies, published practice guidelines from the American College of Cardiology (ACC)/AHA 1 and other organizations, 2,3 and the multidisciplinary expertise of the writing group. Existing evidence in epidemiology, classification, diagnosis, and management of specific cardiomyopathies is usually derived from nonrandomized observational studies, registries, case reports, or expert opinion based on clinical experience, not large-scale randomized clinical trials or systematic reviews. Therefore, in this document, rather than using the standard ACC/AHA classification schema of recommendations and level of evidence, 4 we have included key management strategies at the end of each section and categorized our recommendations according to the level of consensus. Although the format of our recommendations might resemble the ACC/AHA classification of recommendations used in the ACC/AHA practice guidelines, because of the preponderance of expert opinion or level of evidence C evidence in our document, we elected to use different terminology to provide a distinction from the practice guidelines, in which stronger levels and quality of evidence with randomized clinical trials or meta-analyses are usually present. 4 The levels of evidence follow the AHA and ACC methods of classifying the level of certainty of the treatment effect. 4 DEfINITIoN of DILATED CArDIoMyopAThyThe term dilated cardiomyopathy (DCM) refers to a spectrum of heterogeneous myocardial disorders that are characterized by ventricular dilation and depressed myocardial performance in the absence of hypertension, valvular, congenital, or ischemic heart disease. 5 In clinical practice, the pathogenesis of heart failure (HF) has often been placed into 2 categories: ischemic and nonischemic cardiomyopathy. The term nonischemic cardiomyopathy has been interchangeably used with DCM. Although this approach might be practical, it fails to recognize that nonischemic cardiomyopathy can include cardiomyopathies caused by volume or pressure overload (such as hypertension or valvular heart disease) that are not conventionally accepted under the definition of DCM. 1,5 Again, in general practice and clinical research trials, the term ischemic cardiomyopathy is defined as cardiomyopathy caused by ischemic heart disease. Current use of ischemic cardiomyopathy terminology implies ventricular dilation and depressed myocardial contractility caused by ischemia or infarction. CLASSIfICATIoN of CArDIoMyopAThIESThe first classification on this topic categorized cardiomyopathies as heart muscle diseases with dilated (DCM), hypertrophic, restrictive, arrhythmogenic right ventricular (ARVC), or nonclassifiable cardiomyopathy in 1980. 5 Subse...

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Section: 394mentioning

confidence: 99%

Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association

Bozkurt¹,

Colvin²,

Cook³

et al. 2016

Circulation

603

663

View full text Add to dashboard Cite

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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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“…The degree of left ventricular hypertrophy is related to GH level, or the magnitude of decrease in GH. 7,8) It has been suggested that a specific acromegalic cardiomyopathy exists as a distinct clinical entity. 9) .…”

Section: Discussionmentioning

confidence: 99%

“…[16][17][18][19] Chronic treatment with octreotide improved both left and right diastolic filling, left ventricular hypertrophy, hemodynamic responses, and cardiopulmonary performance during bicycle ergometry. 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.…”

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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Regression of acromegalic left ventricular hypertrophy after lanreotide (a slow-release somatostatin analog)

Cited by 65 publications

References 17 publications

Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association

Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association

Somatostatin agonists for treatment of acromegaly

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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