Marked improvement in cardiovascular function after successful transsphenoidal surgery in acromegalic patients

Objective Transsphenoidal surgery results in biochemical remission of acrom egaly in 45-80% of patients; however, few studies have addressed the impact of transsphenoidal surgery on cardiovascular function in acromegalic patie nts. The aim of this prospective study was to investigate the effects of po stoperative GH/IGF-I normalization on echocardiographic parameters and bloo d pressure (BP) in a series of patients with active acromegaly. Design An open prospective study. Patients Thirty newly diagnosed acromegalic patients undergoing transspheno idal surgery. Measurements Doppler echocardiography and 24-h ambulatory blood pressure mo nitoring were performed before and 6 months after transsphenoidal surgery. Results Fifteen patients were considered to be well controlled postoperativ ely (group A), as defined by normal age-corrected IGF-I levels and glucose- suppressed GH levels less than 2 mU/I, the remaining 15 patients being cons idered as poorly controlled (group B). In group A, a postoperative decrease of left ventricular mass index was observed (104.4 +/-6.6 vs. 127.1 +/-7.7 g/m(2); P<0.001), associated with an improvement of some indices of diasto lic function, such as an increase of the early/late transmitral peak flow v elocity (P<0.05) and a decrease of isovolumic relaxation time (P<0.01). No significant change was observed in group B. A significant decrease of 24-h systolic BP was also observed in group A (P<0.05) and five of six patients normalized their BP circadian rythm. In contrast, a nonsignificant increase in BP values, with a persistent blunted BP profile where present, was obse rved in group B. Conclusions We conclude that successful transsphenoidal surgery is able to induce a significant improvement in some cardiac parameters and a slight re duction in systolic blood pressure in acromegalic patients.