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Cardiac Effects of Slow-Release Lanreotide, a Slow-Release Somatostatin Analog, in Acromegalic Patients¹

Departments of Endocrinology (R.B., G.I., G.M., B.C., G.T.), Internal Medicine (C.M., R.C.), and Experimental Medicine and Pathology (A.G.), University of Rome "La Sapienza", 00161 Rome, Italy; and Department of Experimental Medicine (E.F., M.-L.J.-R.), University of L’Aquila, L’Aquila, Italy

Address all correspondence and requests for reprints to: Roberto Baldelli, M.D., Clinica Medica II - Dipartimento di Endocrinologia, Università "La Sapienza", Viale del Policlinico, 00161 Rome, Italy.

Cardiac involvement, mostly characterized by left ventricular hypertrophy associated with various degrees of cardiac dysfunction, greatly contributes to the increased mortality and morbidity observed in acromegaly. Lanreotide is a new SRIF analog characterized by a slow-release (SR) formulation with the peculiarity of a 30-mg im administration every 10–14 days. In this study, 13 patients with postoperative active acromegaly (9 females, 4 males, 45.9 ± 16.3 yr old) underwent an echo-Doppler and hormonal study before and during a 12-month period of treatment with SR-lanreotide. GH and insulin-like growth factor I plasma levels (mean ± SD) decreased significantly throughout the study period (from 10.1 ± 2.2 to 3.9 ± 0.9 ng/mL for GH, P < 0.005; and from 511.0 ± 33.0 to 305.0 ± 34.2 ng/mL for insulin-like growth factor I, P < 0.0001). Left ventricular mass index (mean ± SD, 137.1 ± 7.5 g/m² at baseline) decreased after 3 months (120.0 ± 5.4 g/m²), 6 months (111.7 ± 5.7 g/m²), and 12 months (110.3 ± 5.2 g/m²) of treatment (P < 0.005 at each time-point). This reduction in left ventricular mass index was accompanied by an improvement in some indexes of left ventricular diastolic function, especially the isovolumetric relaxation time (mean ± SD, 109.1 ± 4.6 m/sec at baseline), which decreased after 3 months (91.9 ± 2.8 m/sec), 6 months (92.3 ± 3.2 m/sec), and 12 months (92.2 ± 3.0 m/sec) of treatment (P < 0.005 at each time-point). We conclude that SR-lanreotide is able to improve cardiac morphology and functional abnormalities in acromegaly; whether such beneficial effects on cardiac parameters will contribute to improve life expectancy in these patients should be further investigated.

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