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[Cardiovascular involvement in acromegaly. Apropos of 3 cases]
P Cosnay1, A Legras, L F Garnier
1Service de cardiologie B, hôpital Trousseau, Tours.
Insights
Acromegaly can cause cardiovascular issues like hypertension and hypertrophic cardiomyopathy. Treating the pituitary adenoma improved symptoms, though some cardiac changes persisted.
Area of Science:
- Cardiology
- Endocrinology
Background:
- Acromegaly, a condition caused by excess growth hormone, is associated with cardiovascular complications.
- Cardiovascular disease is a significant cause of morbidity and mortality in patients with acromegaly.
Observation:
- Three patients with acromegaly were diagnosed during hospitalization for cardiovascular conditions, including arterial hypertension and hypertrophic cardiomyopathy.
- Patients presented with unexplained exercise-induced dyspnea despite normal cardiac catheterization results.
Findings:
- Myocardial hypertrophy and diastolic dysfunction were identified as likely causes of dyspnea.
- The severity of myocardial hypertrophy correlated with pituitary adenoma size and growth hormone levels, not hypertension duration.
- Hypertension resolved in most cases after pituitary adenoma excision, except for one with adrenal hyperplasia.
Implications:
- Early diagnosis and treatment of acromegaly are crucial for managing cardiovascular complications.
- While some symptoms improve post-surgery, persistent cardiac remodeling may occur.
- This highlights the complex interplay between endocrine disorders and cardiovascular health.
Abstract:
The authors report 3 cases of acromegaly diagnosed while the patients were in hospital for cardiovascular disease: arterial hypertension in two and hypertrophic myocardiopathy in all three. Coronary arteriography was normal in the 3 patients. The exercise-induced dyspnoea observed in these 3 cases was unexplained by right and left cardiac catheterization results (normal pressures, normal or increased cardiac index). It was most probably related to the myocardial hypertrophy and to abnormalities in diastolic function demonstrated by radioisotopic methods in patients 2 and 3. The degree of myocardial hypertrophy present in these 3 patients seemed to correlate with the size of the pituitary adenoma and the plasma level of growth hormone rather than with the duration or degree of arterial hypertension. After excision of the pituitary adenoma hypertension persisted in 1 case, due to associated adrenal gland hyperplasia, and subsided in the other cases. Abnormalities of diastolic function and dyspnoea are gradually regressing but left ventricular hypertrophy has not significantly decreased after 6 post-operative months.