Document Detail

Improvement of intrinsic myocardial contractility and cardiac fibrosis degree in acromegalic patients treated with somatostatin analogues: a prospective study.
MedLine Citation:
PMID:  15853830     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Acromegalic patients have increased left ventricular (LV) mass (M) and impaired diastolic function. AIM: Using ultrasonic cardiac tissue characterization, we evaluated the early changes in cardiac fibrosis (IBS) and intrinsic myocardial contractility (CVI) as well as their reversibility after treatment with somatostatin analogues (SMSA) in patients with acromegaly. PATIENTS AND METHODS: Twenty-two acromegalic patients with active untreated disease (Acro(UNTR)) underwent conventional Doppler echocardiography and integrated backscattering; 25 healthy subjects (controls) and eight patients with acromegaly in remission after pituitary adenomectomy (Acro(REM)) served as controls. RESULTS: As expected, Acro(UNTR) at baseline had higher LVM than controls or Acro(REM) (P < 0.001); LVM reduced in acromegalic patients after SMSA (P < 0.005 vs. baseline) while LV ejection fraction did not change. LV diastolic function was reduced in all acromegalic patients, either at baseline or after SMSA therapy (E/A ratio, 0.96 +/- 0.3 and 1.1 +/- 0.3, respectively, P < 0.002 vs. controls, 1.6 +/- 0.3). CVI was reduced in Acro(UNTR) (14.3 +/- 5.8%, P < 0.003 vs. controls, 28.7 +/- 7.5%) and greatly improved after SMSA (22.5 +/- 4.5%, P < 0.003 vs. baseline). Cardiac fibrosis was increased in Acro(UNTR) (IBS(MSI), 53.7 +/- 5.3%P < 0.002 vs. controls) and reduced after SMSA (43.7 +/- 4.2%P < 0.002 vs. baseline) albeit not reaching values observed in controls. More importantly, five of 22 (23%) Acro(UNTR) patients had normal LVM, but increased cardiac fibrosis as revealed by back scattering. IBS values and CVI% were related with serum GH and IGF-1 (P < 0.0001) levels, and the estimated duration of disease (P < 0.005). CONCLUSIONS: The present study demonstrated that active acromegalic patients had early impairment of systolic function and increased cardiac fibrosis; increased fibrosis may precede LV hypertrophy; these changes are related to the activity of disease and might improve during treatment with SMSA.
Fausto Bogazzi; Vitantonio Di Bello; Caterina Palagi; Maria Grazia Delle Donne; Andrea Di Cori; Silvia Gavioli; Enrica Talini; Chiara Cosci; Chiara Sardella; Sandra Brogioni; Mario Mariani; Enio Martino
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Clinical endocrinology     Volume:  62     ISSN:  0300-0664     ISO Abbreviation:  Clin. Endocrinol. (Oxf)     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-04-27     Completed Date:  2005-07-14     Revised Date:  2009-04-16    
Medline Journal Info:
Nlm Unique ID:  0346653     Medline TA:  Clin Endocrinol (Oxf)     Country:  England    
Other Details:
Languages:  eng     Pagination:  590-6     Citation Subset:  IM    
Department of Endocrinology and Metabolism, University of Pisa, Pisa, Italy.
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MeSH Terms
Acromegaly / drug therapy*,  etiology,  pathology
Adenoma / complications,  surgery
Antineoplastic Agents, Hormonal / therapeutic use*
Case-Control Studies
Echocardiography, Doppler
Growth Hormone / blood
Insulin-Like Growth Factor I / analysis
Linear Models
Middle Aged
Myocardial Contraction / drug effects*
Myocardium / pathology*
Octreotide / therapeutic use*
Pituitary Neoplasms / complications,  surgery
Prospective Studies
Remission Induction
Reg. No./Substance:
0/Antineoplastic Agents, Hormonal; 67763-96-6/Insulin-Like Growth Factor I; 83150-76-9/Octreotide; 9002-72-6/Growth Hormone
Comment In:
Clin Endocrinol (Oxf). 2008 Oct;69(4):685-6   [PMID:  18394020 ]

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

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