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Follow-up study of the heart in acromegaly: pre- and post-operative evaluation
1Department of Internal Medicine, University of Tsukuba, Japan.
Insights
Acromegaly often causes heart abnormalities like left ventricular hypertrophy and dilation. These cardiac changes persist even after growth hormone levels are reduced following treatment.
Area of Science:
- Cardiology
- Endocrinology
Background:
- Acromegaly, a condition caused by excess growth hormone, can lead to cardiovascular complications.
- Understanding the cardiac impact of acromegaly is crucial for patient management.
Observation:
- Echocardiographic data from 8 acromegaly patients were analyzed pre- and post-treatment.
- Pre-operative findings included left ventricular dilation (63%) and hypertrophy (38%).
- Left ventricular mass was elevated in all patients, but systolic function was generally preserved.
Findings:
- Post-hypophysectomy, growth hormone levels decreased significantly.
- Despite reduced growth hormone, persistent echocardiographic abnormalities, including left ventricular dilation and hypertrophy, were observed.
- No significant correlation was found between left ventricular mass and basal growth hormone levels.
Implications:
- Cardiac abnormalities are common in acromegaly and may not fully reverse after growth hormone normalization.
- Long-term cardiac monitoring is essential for patients with acromegaly.
- Further research is needed to understand the mechanisms and long-term prognosis of cardiac changes in acromegaly.
Abstract:
Pre-operative and post-operative echocardiographic data were analyzed from 8 patients with acromegaly. Pre-operatively, end-diastolic diameter was greater than 55 mm in 5 patients (63%) and concentric left ventricular hypertrophy was observed in 3 patients (38%). However, left ventricular function was normal (fractional shortening of the left ventricle greater than 28%) in all patients except 1. All patients had increased left ventricular mass. There was no significant correlation between left ventricular mass and basal plasma growth hormone concentration. An average of 23.9 months after hypophysectomy, growth hormone concentration was significantly decreased. However, the abnormal echocardiographic findings remained. In conclusion, echocardiographic abnormalities (left ventricular dilatation and hypertrophy) are common in patients with acromegaly, but systolic function is, in general, maintained. These cardiac abnormalities persist after reduction of plasma growth hormone concentration.