Cardiovascular Disorders Associated With Acromegaly: an Update

The most common causes of increased cardiovascular mortality in acromegaly are cardiac arrhythmias and sudden cardiac death. Acromegalic cardiomyopathy is defined as concentric biventricular hypertrophy and diastolic dysfunction when other cardiac diseases such as hypertension, diabetes mellitus, and arrhythmias-related cardiac disorders have been excluded. This also contributes to significant morbidity and mortality in these patients. The main risk factors contributing to the development of cardiomyopathy include advancing age, disease duration, and body mass index. The duration of growth hormone excess is more closely associated with the development of biventricular enlargement, diastolic dysfunction, heart failure, and valvular disease than the degree of hormone elevation. Additionally, other cardiovascular disorders such as coronary artery disease, arrhythmias, valvular heart diseases, systemic hypertension, atherosclerosis, and rarely congestive cardiac failure are involved in the shortened life span of these patients especially if poorly controlled. Biochemical control of acromegaly with the recently available multimodal treatment along with better management of cardiovascular comorbidities has improved the morbidity and mortality rates of patients with acromegaly. However, with the recent advances in the treatment of acromegaly, neoplastic causes presently remain as the main leading cause of death in these patients.