Document Detail


Impact of treating acromegaly first with surgery or somatostatin analogs on cardiomyopathy.
MedLine Citation:
PMID:  18445662     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The objective of the study was to investigate whether first-line surgery or somatostatin analogs (SSA) have a different outcome on cardiomyopathy after 12 months. DESIGN: This was a retrospective, comparative, nonrandomized study. PATIENTS: Fifty-six patients treated with SSA and 33 operated on by transsphenoidal approach participated in the study. For the purposes of this study, only controlled patients were included. MEASUREMENTS: Primary outcome measures were changes in left ventricular mass index, diastolic (early to atrial mitral flow velocity), and systolic performance (left ventricular ejection fraction). Secondary outcome measures were reduction of total to high-density lipoprotein-cholesterol ratio as a cardiovascular risk parameter, and improvement of glucose profile and pituitary function as indirect causes of cardiovascular improvement. RESULTS: SSA and surgery groups were similar for gender, age, estimated disease duration, GH and IGF-I levels, and severity of cardiomyopathy lipid and glucose profile. Twelve months after treatment in both groups, left ventricular mass index, early to atrial mitral flow velocity, diastolic blood pressure, and heart rate decreased significantly, whereas only in SSA-treated patients, left ventricular ejection fraction increased significantly. The total to high-density lipoprotein-cholesterol ratio significantly reduced only in SSA-treated patients, whereas fasting glucose levels significantly decreased only in surgery-treated patients. A normal pituitary function was found in 46.4% of SSA- and 36.4% of surgery-treated patients, with results unchanged in the former and slightly reduced in the latter. CONCLUSIONS: Twelve months after first-line treatment with SSA or surgery, we found a similar improvement in left ventricular hypertrophy and diastolic filling. In contrast, systolic function improved more evidently in SSA-treated patients. Both a direct effect of SSA and a more preserved pituitary function might explain these results.
Authors:
Annamaria Colao; Rosario Pivonello; Maurizio Galderisi; Paolo Cappabianca; Renata S Auriemma; Mariano Galdiero; Luigi M Cavallo; Felice Esposito; Gaetano Lombardi
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-04-29
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  93     ISSN:  0021-972X     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-07-11     Completed Date:  2008-08-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2639-46     Citation Subset:  AIM; IM    
Affiliation:
Department of Molecular and Clinical Endocrinology and Oncology, Federico II University of Naples, via S. Pansini 5, Naples, Italy. colao@unina.it
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00615004
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MeSH Terms
Descriptor/Qualifier:
Acromegaly / drug therapy*,  physiopathology,  surgery*
Adult
Aged
Blood Glucose / analysis
Diastole
Female
Human Growth Hormone / blood
Humans
Hypertrophy, Left Ventricular / therapy*
Insulin-Like Growth Factor I / analysis
Lipids / blood
Male
Middle Aged
Pituitary Gland / physiopathology
Retrospective Studies
Somatostatin / analogs & derivatives*,  therapeutic use
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Lipids; 12629-01-5/Human Growth Hormone; 51110-01-1/Somatostatin; 67763-96-6/Insulin-Like Growth Factor I

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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