Electrophysiological features in acromegaly: re-thinking the arrhythmic risk?

Area of Science:

• Cardiology
• Endocrinology
• Internal Medicine

Background:

• Acromegaly is linked to a distinct cardiomyopathy.
• The risk of arrhythmia in acromegaly is widely believed to be increased.

Purpose of the Study:

• To review the evidence for arrhythmia risk in acromegaly.
• To evaluate preclinical markers and clinical outcomes associated with arrhythmia.
• To discuss the impact of acromegaly treatments on cardiac rhythm.

Main Methods:

• Literature review of case-control studies and case reports.
• Analysis of preclinical markers of arrhythmia (e.g., heart rate variability, QT dispersion).
• Review of treatment effects on cardiac dysrhythmia.

Main Results:

• Limited evidence for significant arrhythmia, but increased premature ventricular beats (PVBs) reported.
• Impaired preclinical markers of arrhythmia are common in acromegaly.
• Case reports indicate risks of sudden cardiac death and advanced heart block.

Conclusions:

• Despite limited direct evidence of significant arrhythmia, preclinical markers suggest an increased risk.
• Routine electrocardiography (ECG) and transthoracic echocardiography (TTE) are recommended at diagnosis.
• Treatment strategies may influence cardiac rhythm, requiring careful monitoring.