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Severe systemic complications of acromegaly
A Colao1, R Pivonello, P Marzullo
1Department of Molecular and Clinical Endocrinology and Oncology, Federico II University, Napoli, Italy. colao@unina.it
Journal of Endocrinological Investigation
|August 24, 2005
Summary
Acromegaly increases mortality due to cardiovascular and respiratory issues, with biventricular hypertrophy being common. Treatment improves heart health and sleep apnea, but its impact on mortality remains unproven.
Area of Science:
- Endocrinology
- Cardiology
- Pulmonology
- Oncology
Background:
- Acromegaly, a disorder of excess growth hormone, is associated with increased mortality.
- Cardiovascular and respiratory diseases are primary contributors to mortality in acromegaly patients.
- Neoplastic complications are less significant causes of mortality.
Purpose of the Study:
- To review the cardiovascular, respiratory, neoplastic, and bone-related complications of acromegaly.
- To discuss the pathogenesis and clinical characteristics of these complications.
- To evaluate the impact of acromegaly treatment on these complications and mortality.
Main Methods:
- Literature review and synthesis of existing evidence on acromegaly complications.
- Analysis of cardiovascular complications, including biventricular hypertrophy, dysfunction, and other cardiac disorders.
- Examination of respiratory issues like sleep apnea and ventilatory dysfunction.
- Assessment of neoplastic risks, particularly gastrointestinal polyps and malignancies.
- Review of bone changes and degenerative conditions associated with long-standing acromegaly.
Main Results:
- Biventricular hypertrophy is the most frequent cardiovascular complication, independent of hypertension.
- Diastolic and systolic dysfunction vary with age and disease duration.
- Sleep apnea is the most characterized respiratory disease; ventilatory dysfunction is linked to bony changes and lung overgrowth.
- Increased risk of colonic polyps, which recur if acromegaly is uncontrolled.
- Bone changes and degenerative conditions are common, especially in long-standing disease.
- Acromegaly treatment improves cardiovascular morbidity and sleep apnea.
Conclusions:
- Acromegaly is linked to significant cardiovascular and respiratory morbidity, with neoplastic and bone changes also being relevant.
- Effective control of acromegaly through surgery or pharmacotherapy, particularly somatostatin analogs, can ameliorate cardiovascular and respiratory complications.
- Further research is needed to establish whether improvements in complications translate to a reduction in overall mortality.