HEART-DISEASE IN ACROMEGALY - STUDY OF 27 PATIENTS

BACKGROUND: The patients with acromegaly have an increased propensity to develop cardiovascular complications. The aim of this study was to evaluate the most relevant clinic, echocardiographic and Hotter record ing findings in acromegaly and its correlation with the growth hormone (GH) levels and duration of the disease. PATIENTS AND METHODS: 27 pat ients with acromegaly were evaluated. The basal levels of GH and insul ine-like growth factor 1 (IGF-1) were measured at the time of cardiolo gical study and compared with the spontaneous GH secretion during 12-2 4 hours previously studied. Echocardiogram was made using complete M-m ode, two dimensional and spectral Doppler ultrasound mechanical system . Additionally an standard EKG and a Holter recording were performed d uring 24 hours. RESULTS: There was a strong correlation between basal levels of GH and integrated concentration of GH during the study of sp ontaneous secretion (r = 0.92; p < 0.01). The prevalence of symptomati c cardiovascular complications in this study was 49%, including 3 pati ents who died for cardiovascular events. The echocardiographic study s howed a high prevalence of left ventricular hypertrophy (66.7%), diast olic dysfunction (63%) and impaired systolic function (18.5%). There w as no correlation between GH and IGF-1 levels and echocardiographic fi ndings. Conversely the degree of hypertrophy was related to the durati on of the disease and the presence of arterial hypertension. The diast olic function only was related with the presence of hypertension. We f ound supraventricular arrhythmic events and malignant premature ventri cular complexes in 6 and 6 patients, respectively. The EKG showed a hi gh fiability to detect ventricular hypertrophy but no rhythm events. C ONCLUSIONS: The high prevalence of cardiovascular complications in acr omegaly, most of them asymptomatic, and its clinical relevance, advise the necessity to perform systematic cardiovascular evaluation in thes e patients.