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Heart disease in acromegaly
1III. interní klinika, 1. lékarské fakulty, Univerzity Karlovy, Prague, Crech Republic.
Insights
Acromegalic heart muscle disease, primarily left ventricular hypertrophy, is reversible. Successful treatment normalizing growth hormone levels leads to slow cardiac hypertrophy regression, confirmed by long-term patient follow-up.
Area of Science:
- Cardiology
- Endocrinology
- Internal Medicine
Background:
- Acromegalic heart muscle disease is unequivocally recognized.
- Cardiac hypertrophy, particularly left ventricular hypertrophy, is a major manifestation.
- Understanding the pattern, nature, and reversibility of this condition is crucial.
Purpose of the Study:
- To investigate the pattern, nature, and reversibility of acromegalic heart muscle disease.
- To assess the impact of normalizing growth hormone levels on cardiac hypertrophy.
- To confirm findings through long-term prospective follow-up.
Main Methods:
- Retrospective analysis of clinical and echocardiographic data in 78 acromegaly patients.
- 10-year prospective follow-up of the original patient cohort.
- Evaluation of treatment with lanreotide, a somatostatin analogue.
Main Results:
- Cardiac hypertrophy, especially left ventricular hypertrophy, is slowly reversible after growth hormone normalization.
- Retrospective analysis suggested reversibility.
- Prospective follow-up confirmed the slow regression of cardiac hypertrophy.
- Lanreotide treatment led to regression of cardiac hypertrophy.
Conclusions:
- Acromegalic heart muscle disease is a reversible condition.
- Normalization of growth hormone levels is key to reversing cardiac hypertrophy.
- Effective treatment, such as with lanreotide, promotes regression of cardiac hypertrophy.
Abstract:
Evidence has accumulated regarding acromegalic heart muscle disease which existence now appears to be unequivocal. We took an advantage of a large group of acromegalic patients being followed-up at our institution for a long time and have studied pattern, nature and reversibility of acromegalic heart disease. Its major manifestation is cardiac hypertrophy expressed especially as left ventricular hypertrophy. The cardiac hypertrophy is slowly reversible after normalization of plasma growth hormone levels due to successful treatment. This we have first suggested on the basis of a retrospective analysis of clinical and echocardiographic data in 78 patients with acromegaly and subsequently confirmed by a 10-year prospective follow-up of the original patient cohort. We have also showed that effective treatment of acromegaly with a new slow release somatostatine analogue lanreotide leads to regression of cardiac hypertrophy.