| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Original Studies |
Departments of Molecular and Clinical Endocrinology and Oncology (A.Co., P.M., D.F., R.P., G.L.) and Nuclear Medicine Center of the National Council of Research, Department of Biomorphological and Functional Sciences (A.Cu., E.N., A.M.D.M., M.S.), Federico II University of Naples, 80131 Naples, Italy; and Scientific Institute for Research and Care Neuromed (A.Cu., R.P.), 86077 Pozzilli, Italy
Address correspondence and requests for reprints to: Annamaria Colao, M.D., Ph.D., Department of Molecular and Clinical Endocrinology and Oncology, Federico II University of Naples, via Sergio Pansini 5, 80131 Naples, Italy. E-mail: colao{at}unina.it * Partially supported by Grant 9906153187 from
Acromegalic patients are considered to be exposed to a doubled mortality rate, mostly for cardiovascular diseases. This open prospective study was designed to evaluate whether the impairment of cardiac performance could be reversed by the long-term suppression of GH and insulin-like growth factor I (IGF-I) levels.
Eighteen patients with active acromegaly were studied before and 5 yr
after surgery, followed by sc octreotide in 11 patients. Disease
control (GH levels 
1 µg/L after glucose load or 2.5 µg/L after
fasting, respectively, together with normalized IGF-I levels for age)
was achieved in seven patients after surgery and in six patients after
0.3–0.6 mg/day sc octreotide. Five patients were not controlled during
the 5-yr follow-up. Cardiac performance at rest and at peak exercise
was assessed by equilibrium radionuclide angiography at study entry and
5 yr after surgery alone or plus octreotide. Thirty-six sex- and
age-matched healthy subjects served as controls.
At study entry, patients had a lower left ventricular ejection fraction
(LVEF) at peak exercise and LVEF exercise-induced changes, exercise
duration, and capacity than controls (P < 0.001).
After 5 yr of treatment, a significant decrease of resting heart rate
(P = 0.03) and a significant increase of LVEF at
peak exercise (P = 0.003) was found in patients
achieving disease control. LVEF response at peak exercise worsened in
none of the patients with controlled disease and in three patients with
uncontrolled disease (60%) (
2 = 5.5;
P = 0.02). Diastolic filling, exercise duration,
and workload did not significantly change during the 5-yr follow-up. No
difference was found between patients controlled by surgery alone or by
surgery plus octreotide.
This 5-yr prospective study demonstrated that the LVEF response at peak exercise improved in all patients achieving disease control, while it was worsened in 60% of uncontrolled ones. These results strengthen the need of a stable suppression of GH and IGF-I hypersecretion to restore a normal cardiac performance in acromegaly.
This article has been cited by other articles:
 |
|
 |
|
  C Berg, T E Wessendorf, F Mortsch, M Forsting, H Teschler, T Weischer, K Mann, B Saller, and B L Herrmann Influence of disease control with pegvisomant on sleep apnoea and tongue volume in patients with active acromegaly Eur. J. Endocrinol., December 1, 2009; 161(6): 829 - 835. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Colao, R. S. Auriemma, M. Galdiero, G. Lombardi, and R. Pivonello Effects of Initial Therapy for Five Years with Somatostatin Analogs for Acromegaly on Growth Hormone and Insulin-Like Growth Factor-I Levels, Tumor Shrinkage, and Cardiovascular Disease: A Prospective Study J. Clin. Endocrinol. Metab., October 1, 2009; 94(10): 3746 - 3756. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Melmed, A. Colao, A. Barkan, M. Molitch, A. B. Grossman, D. Kleinberg, D. Clemmons, P. Chanson, E. Laws, J. Schlechte, et al. Guidelines for Acromegaly Management: An Update J. Clin. Endocrinol. Metab., May 1, 2009; 94(5): 1509 - 1517. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. A van der Klaauw, J. J Bax, G. B Bleeker, E. R Holman, V Delgado, J. W A Smit, J. A Romijn, and A. M Pereira Cardiac manifestations of GH deficiency after treatment for acromegaly: a comparison to patients with biochemical remission and controls Eur. J. Endocrinol., December 1, 2008; 159(6): 705 - 712. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. A van der Klaauw, J. J Bax, J. W A Smit, E. R Holman, V. Delgado, G. B Bleeker, N. R Biermasz, F. Roelfsema, J. A Romijn, and A. M Pereira Increased aortic root diameters in patients with acromegaly Eur. J. Endocrinol., August 1, 2008; 159(2): 97 - 103. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Colao, R. Pivonello, M. Galderisi, P. Cappabianca, R. S. Auriemma, M. Galdiero, L. M. Cavallo, F. Esposito, and G. Lombardi Impact of Treating Acromegaly First with Surgery or Somatostatin Analogs on Cardiomyopathy J. Clin. Endocrinol. Metab., July 1, 2008; 93(7): 2639 - 2646. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Nachtigall, A. Delgado, B. Swearingen, H. Lee, R. Zerikly, and A. Klibanski Changing Patterns in Diagnosis and Therapy of Acromegaly over Two Decades J. Clin. Endocrinol. Metab., June 1, 2008; 93(6): 2035 - 2041. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Gouya, O. Vignaux, P. Le Roux, P. Chanson, J. Bertherat, X. Bertagna, and P. Legmann Rapidly Reversible Myocardial Edema in Patients with Acromegaly: Assessment with Ultrafast T2 Mapping in a Single-Breath-Hold MRI Sequence Am. J. Roentgenol., June 1, 2008; 190(6): 1576 - 1582. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Pivonello, M. Galderisi, R. S. Auriemma, M. C. De Martino, M. Galdiero, A. Ciccarelli, A. D'Errico, I. Kourides, P. Burman, G. Lombardi, et al. Treatment with Growth Hormone Receptor Antagonist in Acromegaly: Effect on Cardiac Structure and Performance J. Clin. Endocrinol. Metab., February 1, 2007; 92(2): 476 - 482. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. R. Schwarz, P. Jammula, R. Gupta, and S. Rosanio A Case and Review of Acromegaly-Induced Cardiomyopathy and the Relationship Between Growth Hormone and Heart Failure: Cause or Cure or Neither or Both? Journal of Cardiovascular Pharmacology and Therapeutics, December 1, 2006; 11(4): 232 - 244. [Abstract] [PDF]
|
|
|
|
 |
|
 L. J. Woodhouse, A. Mukherjee, S. M. Shalet, and S. Ezzat The Influence of Growth Hormone Status on Physical Impairments, Functional Limitations, and Health-Related Quality of Life in Adults Endocr. Rev., May 1, 2006; 27(3): 287 - 317. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Calfee and P. Fadale Popular Ergogenic Drugs and Supplements in Young Athletes Pediatrics, March 1, 2006; 117(3): e577 - e589. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. H T Smith, R U. Nair, D. Adamson, M. T Kearney, S. G Ball, and A. J Balmforth Somatostatin receptor subtype expression in the human heart: differential expression by myocytes and fibroblasts J. Endocrinol., December 1, 2005; 187(3): 379 - 386. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. C. Nemergut, A. S. Dumont, U. T. Barry, and E. R. Laws Perioperative Management of Patients Undergoing Transsphenoidal Pituitary Surgery Anesth. Analg., October 1, 2005; 101(4): 1170 - 1181. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S W van Thiel, J J Bax, N R Biermasz, E R Holman, D Poldermans, F Roelfsema, H J Lamb, E E van der Wall, J W A Smit, J A Romijn, et al. Persistent diastolic dysfunction despite successful long-term octreotide treatment in acromegaly Eur. J. Endocrinol., August 1, 2005; 153(2): 231 - 238. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. R. Biermasz, A. M. Pereira, J. W. A. Smit, J. A. Romijn, and F. Roelfsema Morbidity after Long-Term Remission for Acromegaly: Persisting Joint-Related Complaints Cause Reduced Quality of Life J. Clin. Endocrinol. Metab., May 1, 2005; 90(5): 2731 - 2739. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Bihan, C. Espinosa, H. Valdes-Socin, S. Salenave, J. Young, S. Levasseur, P. Assayag, A. Beckers, and P. Chanson Long-Term Outcome of Patients with Acromegaly and Congestive Heart Failure J. Clin. Endocrinol. Metab., November 1, 2004; 89(11): 5308 - 5313. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Colao, D. Ferone, P. Marzullo, and G. Lombardi Systemic Complications of Acromegaly: Epidemiology, Pathogenesis, and Management Endocr. Rev., February 1, 2004; 25(1): 102 - 152. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Girnita, L. Girnita, F. d. Prete, A. Bartolazzi, O. Larsson, and M. Axelson Cyclolignans as Inhibitors of the Insulin-Like Growth Factor-1 Receptor and Malignant Cell Growth Cancer Res., January 1, 2004; 64(1): 236 - 242. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Attanasio, R. Baldelli, R. Pivonello, S. Grottoli, L. Bocca, V. Gasco, M. Giusti, G. Tamburrano, A. Colao, and R. Cozzi Lanreotide 60 mg, a New Long-Acting Formulation: Effectiveness in the Chronic Treatment of Acromegaly J. Clin. Endocrinol. Metab., November 1, 2003; 88(11): 5258 - 5265. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Colao, L. Spinelli, P. Marzullo, R. Pivonello, M. Petretta, C. Di Somma, G. Vitale, D. Bonaduce, and G. Lombardi High Prevalence of Cardiac Valve Disease in Acromegaly: An Observational, Analytical, Case-Control Study J. Clin. Endocrinol. Metab., July 1, 2003; 88(7): 3196 - 3201. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M J Rennie Claims for the anabolic effects of growth hormone: a case of the Emperor's new clothes? Br. J. Sports Med., April 1, 2003; 37(2): 100 - 105. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Ben-Shlomo and S. Melmed The Role of Pharmacotherapy in Perioperative Management of Patients with Acromegaly J. Clin. Endocrinol. Metab., March 1, 2003; 88(3): 963 - 968. [Full Text] [PDF]
|
|
|
|
|
|
A. Colao, L. Spinelli, A. Cuocolo, S. Spiezia, R. Pivonello, C. di Somma, D. Bonaduce, M. Salvatore, and G. Lombardi Cardiovascular Consequences of Early-Onset Growth Hormone Excess J. Clin. Endocrinol. Metab., July 1, 2002; 87(7): 3097 - 3104. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Endocrinology | Endocrine Reviews | J. Clin. End. & Metab. |
| Molecular Endocrinology | Recent Prog. Horm. Res. | All Endocrine Journals |
