The Heart in Acromegaly

Courville, Cyril B.

doi:10.1001/archinte.1938.00180100014002

Cited by 99 publications

(39 citation statements)

References 4 publications

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“…Many patients are exposed to coronary risk factors like arterial hypertension, diabetes mellitus, or dyslipidemia promoted by chronic GH excess (1,5). Information about CAD in acromegalic patients is limited and controversial (1,(5)(6)(7)(8)(9)(14)(15)(16). Many studies investigated heterogeneous cohorts that included treatment-naive acromegalic patients, patients with uncontrolled and treatment-resistant disease, and patients in remission who were with or without various treatment regimens.…”

Section: Discussionmentioning

confidence: 99%

“…Acromegalic cardiomyopathy is a typical and frequent complication of chronic GH excess, which is characterized by a concentric biventricular hypertrophy, impairment of diastolic function, and mitral and aortic valve disease (3)(4)(5)(6). In addition, coronary artery disease (CAD) may contribute to the cardiac phenotype in acromegalic patients as suggested by early pathological studies (6)(7)(8)(9). Coronary risk factors like hypertension, insulin resistance, diabetes mellitus, and dyslipidemia are frequent complications of acromegaly, thus providing a possible link between GH hypersecretion and CAD (1,5).…”

Section: Introductionmentioning

confidence: 99%

“…In another prospective study, the risk of CAD was low, and none of the acromegalic patients developed a major cardiac event during the 5-year study period (15). Together, the data on CAD in acromegaly are limited, controversial, mainly refer to older pathological studies or are based on mixed patient populations comprising controlled and uncontrolled acromegaly without controls matched for CAD risk factors (1,(5)(6)(7)(8)(9)(14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

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Acromegaly per se does not increase the risk for coronary artery disease

Akutsu

Kreutzer²,

Wasmeier³

et al. 2010

European Journal of Endocrinology

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Context: Information about the risk and course of coronary artery disease (CAD) in acromegaly is limited. Objective: To evaluate CAD risk in acromegalic patients at diagnosis and after successful treatment during follow-up. Subjects and methods: Twenty-five consecutive patients (age 45.1G10.6 years, 15 women) were studied at the time of diagnosis, and 19 patients were re-evaluated after 4.6G1.1 years. The European Society of Cardiology (ESC) risk score was calculated, and a cardiac computed tomography was performed for detection and quantification (Agatston score (AS)) of coronary artery calcium (CACs). Fifty age-, sex-, and CAD risk-matched subjects and CAC data from the population-based Heinz Nixdorf Recall (HNR) study served as controls. Results: In 21 of the 25 patients, the 10-year risk of developing CAD according to the ESC risk score was low (!10%) and high (O20%) in four patients. The AS was lower than in controls (2.6G7.9 vs 66G182; PZ0.014) and less patients had a positive CAC (ASO0) (20 vs 48%, PZ0.024), which in the acromegalic patients was less than expected from the HNR study. The AS did not correlate with GH excess or disease duration. In 19 acromegalic patients, who were in remission and re-evaluated after 4.6G1.1 years, the ESC risk (PZ0.102) and the AS (PZ0.173) did not change significantly and no symptomatic CAD event occurred. Conclusion: CAD risk in newly diagnosed acromegalic patients was low and remained stable after successful treatment. CAC was lower than in controls suggesting that GH excess per se does not carry an additional CAD risk.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Acromegaly per se does not increase the risk for coronary artery disease

Akutsu

Kreutzer²,

Wasmeier³

et al. 2010

European Journal of Endocrinology

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“…Increased frequencies of systemic hypertension and premature coronary artery disease have also been described [3]. The index patient was suffering from systemic hypertension for stage 1 hypertension for past 1 year.…”

Section: Discussionmentioning

confidence: 91%

Acromegaly Presenting as Congestive Cardiac Failure

Chakrabarti¹,

Pan²

2014

JCR

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Abstract:Acromegaly is a relatively uncommon endocrinology disease which can cause hypertension, atherosclerosis and heart failure. Echocardiography usually reveals the presence of cardiomyopathy often called as acromegalic cardiomyopathy. Clinically evident heart failure as a presenting manifestation in acromegalics is an uncommon presentation. We report a case of a 40 year old female with features of acromegaly that came to medical attention due to congestive cardiac failure.Key words: Acromegaly, Cardiomyopathies, Hypertension, Heart failure, Atherosclerosis.

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“…The role of hypertrophic cardiomyopathy and myocardial fibrosis as key factors in the pathogenesis of rhythm disorders, including malignant ventricular arrhythmias and sudden death, has been extensively investigated and elucidated (27,28,29,30,31,32,33). Heart rate is reportedly inversely associated with LVM (27).…”

Section: Discussionmentioning

confidence: 99%

Treatment with GH receptor antagonist in acromegaly: effect on cardiac arrhythmias

Auriemma

Pivonello

Martino

et al. 2013

European Journal of Endocrinology

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Objective: To evaluate the effects of short-and long-term treatment with pegvisomant (PEG) on arrhythmias in acromegalic patients resistant to long-term, high-dose therapy with somatostatin analogs (SA). Materials and methods: Thirteen patients entered the study. All patients started PEG at initial dose of 10 mg daily and then titrated to 5 mg every 6 weeks on the basis of IGF1. A standard 24-h electrocardiography registration was performed in all patients at baseline and after 6 and 18 months of PEG to evaluate: mean (HR), maximum (MHR), and minimum (mHR) heart rate; pauses number (P) and duration (PD); supraventricular episodes (SEs) number and duration (SED); and ventricular ectopic beats (EB) number and duration (EBD). Left ventricular mass (LVM) was also evaluated by standard echocardiography. Results: A slight but not significant decrease in HR, MHR, and mHR was observed after 6-month PEG, whereas a significant decrease in HR (PZ0.03), MHR (PZ0.05), and mHR (PZ0.05) was found after 18-month PEG compared with baseline. LVM significantly (PZ0.05) correlated with MRH (rZK0.50) after short-term treatment, and with HR (rZK0.54) and mHR (rZK0.55) after long-term treatment. Long-term PEG induced the complete recovery of arrhythmias recorded at baseline in one patient and the improvement of rhythm disorders developed after 6-month therapy in another patient. The prevalence of conduction disturbances passed from 15 to 7.7% after long-term PEG. Conclusions: Long-term treatment with PEG reduces HR, MHR, and mHR and improves rhythm abnormalities in acromegaly.European Journal of Endocrinology 168 15-22

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The Heart in Acromegaly

Cited by 99 publications

References 4 publications

Acromegaly per se does not increase the risk for coronary artery disease

Acromegaly per se does not increase the risk for coronary artery disease

Acromegaly Presenting as Congestive Cardiac Failure

Treatment with GH receptor antagonist in acromegaly: effect on cardiac arrhythmias

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