Improvement of ventricular arrhythmia by octreotide treatment in acromegalic cardiomyopathy

Area of Science:

• Cardiology
• Endocrinology
• Oncology

Background:

• Acromegalic cardiomyopathy is a serious complication of excess growth hormone (GH) and insulin-like growth factor I (IGF-I).
• Pituitary adenomas are the most common cause of GH excess, leading to significant cardiovascular morbidity.

Observation:

• A 46-year-old Japanese man with pituitary adenoma presented with symptoms of acromegalic cardiomyopathy.
• He exhibited left ventricular hypertrophy, impaired cardiac function, and frequent ventricular premature complexes.

Findings:

• Two months of octreotide treatment normalized GH and IGF-I levels.
• This resulted in significant improvements in left ventricular hypertrophy, cardiac function (ejection fraction increased from 38% to 50%), and a marked reduction in ventricular premature complexes (from 17,249 to 2,882 beats/day).
• Transsphenoidal surgery was safely performed post-treatment.

Implications:

• Octreotide therapy shows promise in ameliorating cardiac dysfunction and ventricular arrhythmias associated with acromegaly.
• This case highlights the importance of managing hormonal excess to improve cardiovascular outcomes in acromegalic patients.