Acromegaly: Cardiovascular risk factors, cardiovascular manifestations and early vascular alterations in relation to...

Area of Science:

• Cardiology
• Endocrinology
• Medical Imaging

Background:

• Acromegaly, a disorder caused by excess growth hormone (GH), is linked to higher rates of cardiovascular disease.
• Cardiovascular complications represent a major cause of morbidity and mortality in acromegaly patients.

Purpose of the Study:

• To assess cardiovascular risk factors and manifestations in acromegaly patients.
• To correlate cardiovascular parameters with disease activity, specifically growth hormone (GH) levels.

Main Methods:

• Echocardiography, including strain and strain-rate imaging, was used to evaluate left ventricular (LV) function.
• Carotid intima-media thickness (CIMT) and flow-mediated dilation (FMD) were measured to assess vascular health.
• Disease activity was defined by GH levels >1 ng/ml, with 32 of 49 patients classified as active.

Main Results:

• Active acromegaly patients exhibited significantly impaired LV function, evidenced by reduced strain (p=0.031) and strain rate (p=0.001).
• A trend towards lower ejection fraction (p=0.11) was observed, correlating with GH levels (cc=-0.252, p=0.05).
• Reduced FMD (p=0.042) was noted in active disease, while CIMT and cardiovascular risk factors did not differ based on disease activity.

Conclusions:

• Active acromegaly is associated with significant left ventricular dysfunction and impaired vascular endothelial function.
• Monitoring cardiovascular health, particularly LV function and FMD, is essential in patients with active acromegaly.
• These findings underscore the importance of disease control to prevent cardiovascular complications.