CHRONIC TREATMENT WITH THE SOMATOSTATIN ANALOG OCTREOTIDE IMPROVES CARDIAC ABNORMALITIES IN ACROMEGALY

The aim of this study was to investigate the effects of a 6-month octr eotide treatment on cardiac mass and function by means of Doppler echo cardiography in 11 normotensive patients affected with active acromega ly. The GH and insulin-like growth factor-I levels were normalized dur ing octreotide therapy from 34 +/- 6.5 and 767.4 +/- 72.4 mug/L to 4.6 +/- 0.9 and 235 +/- 10.3 mug/L, respectively (P < 0.001; mean SEM). A fter the 6-month treatment, we observed a significant decrease in the left ventricular mass index from 138 +/- 11 to 116 +/- 13 g/m2 (P < 0. 001) and in the mean wall thickness/internal end-diastolic radius rati o from 0.47 +/- 0.1 to 0.44 +/- 0.1 (P < 0.001). No significant differ ences were found in systolic function indices, whereas diastolic filli ng indices improved over the course of the therapy; the isovolumic rel axation time decreased from 115 +/- 6 to 100 +/- 6 ms (P < 0.05), tric uspid late diastolic filling velocities decreased from 41 +/- 3 to 36 +/- 2 cm/s (P < 0.03), and tricuspid deceleration time decreased from 280 +/- 28 to 198 +/- 15 ms (P < 0.005); the ratio of early to late pe ak velocity of the right ventricular filling significantly increased f rom 1 +/- 0.01 to 1.3 +/- 0.1 (P < 0.03). A significant correlation wa s detected between left ventricular mass regression and increase in th e early to late peak velocity ratio of the left ventricular filling (r = 0.62; P < 0.05). The results of this study show an improvement in c ardiac structural and functional abnormalities during chronic treatmen t with octreotide, thus supporting the hypothesis of a specific heart disease secondary to high circulating GH levels.