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Acromegalic cardiomyopathy: a neglected cause of cardiomyopathy

T Bonora1, E Rigamonti1, M Capoferri2

  • 1Internal Medicine Department, Ospedale Regionale Lugano, Ente Ospedaliero Cantonale, Switzerland.

La Clinica Terapeutica
|February 11, 2022
PubMed

Insights

Acromegaly, caused by excess growth hormone (GH) and insulin-like growth factor-1 (IGF-1), often leads to heart problems. Early diagnosis and treatment can reverse cardiac damage in this rare endocrine disorder.

Area of Science:

  • Endocrinology
  • Cardiology

Background:

  • Acromegaly is a rare endocrine disorder caused by excess growth hormone (GH) and insulin-like growth factor-1 (IGF-1), typically due to a pituitary adenoma.
  • Affecting 40-60 individuals per million, acromegaly has an average onset age of 44, with diagnosis often delayed by 4-10 years due to its slow progression.
  • Elevated GH and IGF-1 levels are linked to cardiac, respiratory, metabolic, and rheumatic complications, with cardiac involvement (acromegalic cardiomyopathy) significantly worsening prognosis.

Purpose of the Study:

  • To highlight the significant impact of acromegaly on cardiac health.
  • To emphasize the importance of early diagnosis and intervention in managing acromegalic cardiomyopathy.
  • To discuss the potential for reversibility of cardiac structural alterations with timely treatment.

Main Methods:

  • Review of existing literature on acromegaly and its cardiac manifestations.
  • Analysis of the relationship between GH/IGF-1 excess and acromegalic cardiomyopathy.
  • Evaluation of diagnostic and therapeutic strategies for early-stage myocardial damage.

Main Results:

  • Acromegaly is associated with significant cardiac morbidity, termed acromegalic cardiomyopathy.
  • Delayed diagnosis is common, contributing to disease progression and poorer outcomes.
  • Early detection and treatment of myocardial damage show potential for reversibility of structural cardiac changes.

Conclusions:

  • Acromegalic cardiomyopathy is a serious complication that impacts patient prognosis.
  • Prompt diagnosis and targeted therapy are crucial for managing cardiac involvement in acromegaly.
  • Intervention at the initial stages of myocardial damage may lead to reversible structural alterations.

Keywords:
Acromegalic cardiomyopathystress echocardiographystructural dilatative cardiomyopathy

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