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Increased prevalence of regurgitant valvular heart disease in acromegaly

Alberto M Pereira1, Sjoerd W van Thiel, Jonathan R Lindner

  • 1Department of Endocrinology and Metabolism, Leiden University Medical Center, 2300 RC Leiden, The Netherlands. a.m.pereira@lumc.nl

The Journal of Clinical Endocrinology and Metabolism
|January 13, 2004
PubMed

Insights

Acromegaly significantly increases the risk of valvular heart disease, particularly aortic and mitral regurgitation. This risk grows with disease duration, highlighting the need for vigilant monitoring in affected patients.

Area of Science:

  • Cardiology
  • Endocrinology

Background:

  • Cardiac involvement is a known complication of acromegaly.
  • The prevalence of valvular abnormalities in acromegaly patients remains undocumented.

Purpose of the Study:

  • To investigate the prevalence of valvular abnormalities in patients with acromegaly.
  • To compare valvular disease rates between acromegaly patients and matched controls.

Main Methods:

  • Prospective study design.
  • Involved 40 acromegaly patients and 120 controls matched for age, sex, hypertension, and left ventricular systolic function.
  • Utilized conventional two-dimensional and Doppler echocardiography for evaluation.

Main Results:

  • Significant valve disease was more prevalent in acromegaly patients (22%) compared to controls (6.7%; P = 0.005).
  • Aortic valve regurgitation was observed in 30% of patients versus 7% of controls (P < 0.001).
  • Mitral regurgitation was present in 5% of acromegaly patients but absent in controls (P = 0.014).
  • Disease duration was the sole significant predictor, with a 19% increased odds of valvular disease per year of exposure to elevated growth hormone (GH) concentrations.

Conclusions:

  • Acromegaly is associated with a higher prevalence of regurgitant valvular heart disease.
  • The risk of valvular disease is directly related to the duration of exposure to excess GH.
  • Patients with acromegaly require diligent monitoring for occult valvular disease, especially those with uncontrolled GH overproduction.

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