OCTREOTIDE TREATMENT INCREASES EXERCISE CAPACITY IN PATIENTS WITH ACROMEGALY

This prospective study was conducted to determine the effect of Octreo tide treatment on cardiovascular function in patients with active acro megaly. Ten acromegalic patients who failed to suppress growth hormone (GH) to < 5 mU/l during a 2h oral glucose tolerance test were treated with 100 mu g of Octreotide subcutaneously three times daily for 2 mo nths, followed by 200 mu g three times daily if the mean GH level was > 5 mU/l, for a total of 1 year. All patients had GK and insulin-like growth factor I (IGF-I) estimation, ejection fraction determined by Ec hocardiogram and multigated image acquisition scan, electrocardiogram (ECG), exercise ECG, 24-h ECG and chest x-ray. At 6 and 12 months, bot h GH and IGF-I were reduced but ECG, heart size and ejection fraction were unchanged. The patients improved symptomatically and had signific ant reduction in resting heart rate and increase in weight. Exercise t ime (mean +/- SD) increased from 637 +/- 137s at baseline to 787 +/- 1 01s at 1 year (p < 0.01) and work done increased from 9 +/- 3.3 to 11. 9 +/- 2.7 metabolic equivalents (p < 0.001). We conclude that the decr ease in GH and IGF-I following Octreotide treatment of acromegaly is a ccompanied by decreased heart rate and increased exercise capacity des pite an unchanged ejection fraction.