Cardiovascular complications of acromegaly

Area of Science:

• Endocrinology
• Cardiology
• Internal Medicine

Background:

• Acromegaly results from excess growth hormone (GH) and insulin-like growth factor 1 (IGF-1).
• Cardiovascular disease is a significant complication of acromegaly, affecting approximately 20-30% of patients with arterial hypertension.
• Pathogenesis involves sodium retention by GH and IGF-1, alongside vascular abnormalities.

Purpose of the Study:

• To summarize the cardiovascular complications associated with acromegaly.
• To review the impact of acromegaly treatments on cardiovascular burden.
• To highlight current understanding of acromegaly's cardiovascular effects.

Main Methods:

• Review of existing literature on acromegaly and cardiovascular disease.
• Analysis of findings from echocardiography and cardiac MRI studies.
• Evaluation of treatment outcomes and mortality data.

Main Results:

• Hypertension is common, linked to plasma volume expansion and vascular factors.
• Left ventricular hypertrophy and diastolic dysfunction are frequently reported but often mild.
• Cardiac MRI shows lower hypertrophy rates than echocardiography; systolic dysfunction and heart failure are rare.
• Coronary heart disease and arrhythmias are not significantly increased.
• Acromegaly-related cardiac valve abnormalities may involve fibrosis and persist post-treatment.

Conclusions:

• Advances in acromegaly treatment have substantially decreased its cardiovascular impact.
• Cardiovascular disease is no longer the primary cause of death in acromegaly patients.
• While some complications persist, effective management improves patient outcomes.