Early vascular alterations in acromegaly

Area of Science:

• Cardiovascular Medicine
• Endocrinology
• Vascular Biology

Background:

• Acromegaly, a disorder caused by excess growth hormone (GH), is linked to higher cardiovascular mortality.
• Early atherosclerotic changes in acromegaly patients are not well understood.
• Vascular health assessment is crucial for managing acromegaly complications.

Purpose of the Study:

• To investigate early atherosclerotic changes in patients with active and treated acromegaly.
• To evaluate endothelial function (flow-mediated dilation) and arterial structure (intima-media thickness).
• To determine the impact of GH excess on vascular alterations.

Main Methods:

• B-mode ultrasound was used to measure brachial artery flow-mediated dilation (FMD) and carotid artery intima-media thickness (IMT).
• Study included patients with active acromegaly, cured acromegaly, matched controls, and healthy subjects.
• Endothelium-independent vasodilation was also assessed.

Main Results:

• Active acromegalic patients exhibited significantly lower FMD compared to healthy and matched controls.
• Acromegalic patients showed higher IMT than healthy controls, but not matched controls.
• Cured acromegalic patients had improved FMD compared to active patients but remained lower than healthy controls.
• No significant difference in IMT was found between active and cured acromegaly groups.

Conclusions:

• Acromegaly is associated with significant functional (FMD) and morphological (IMT) vascular alterations.
• These vascular changes appear to be, at least partially, a direct consequence of GH excess.
• Treatment of acromegaly may lead to partial recovery of endothelial function.