| Treatment with growth hormone receptor antagonist in acromegaly: effect on cardiac structure and performance. | |
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MedLine Citation:
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PMID: 17105844 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM: The aim of the current study was to evaluate the effect of short-term (6 months) and long-term (18 months) treatment with pegvisomant on cardiac structure and performance in patients with acromegaly. PATIENTS: Seventeen patients (nine women, eight men, 27-61 yr) with active acromegaly entered and 12 completed the long-term study. After a baseline evaluation, including measurement of hemodynamic, biochemical, and hormonal parameters, and a standard Doppler echocardiography, treatment with pegvisomant was started at the initial dose of 10 mg/d, increasing by 5 mg/d every 6 wk on the basis of IGF-I levels until normalization or the achievement of a maximal dose of 40 mg/d. RESULTS: After short-term treatment, IGF-I levels were normalized in 10 of the 17 (59%) patients. Left ventricular mass index (LVMi) was significantly decreased without changes in diastolic and systolic performance. After long-term treatment, IGF-I levels were normalized in 10 of the 12 (83%) patients. Blood glucose and serum insulin levels were decreased compared with baseline. LVMi was further decreased compared with short-term treatment, so that the prevalence of left ventricle hypertrophy decreased from 50% at baseline to 17% after 18 months of treatment. Moreover, ejection fraction as well as early to late (atrial) peak velocity ratio (E/A) were significantly increased, whereas isovolumic relaxation time was significantly decreased compared with baseline, demonstrating an improvement of both diastolic and systolic function. A significant correlation was found between the change in IGF-I levels and that of left ventricular ejection fraction. In general, the prevalence of cardiac insufficiency was present in 13 of the 17 (76%) patients at baseline and in one (8%) patient after 18 months of treatment. CONCLUSIONS: Long-term treatment with the GH receptor antagonist improves acromegalic cardiomyopathy by decreasing cardiac hypertrophy and enhancing diastolic and systolic function, and consequently partially or completely reverting the cardiac insufficiency. |
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Authors:
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Rosario Pivonello; Maurizio Galderisi; Renata S Auriemma; Maria Cristina De Martino; Mariano Galdiero; Antonio Ciccarelli; Arcangelo D'Errico; Ione Kourides; Pia Burman; Gaetano Lombardi; Annamaria Colao |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't Date: 2006-11-14 |
Journal Detail:
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Title: The Journal of clinical endocrinology and metabolism Volume: 92 ISSN: 0021-972X ISO Abbreviation: J. Clin. Endocrinol. Metab. Publication Date: 2007 Feb |
Date Detail:
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Created Date: 2007-02-07 Completed Date: 2007-03-15 Revised Date: 2007-05-23 |
Medline Journal Info:
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Nlm Unique ID: 0375362 Medline TA: J Clin Endocrinol Metab Country: United States |
Other Details:
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Languages: eng Pagination: 476-82 Citation Subset: AIM; IM |
Affiliation:
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Department of Molecular and Clinical Endocrinology, Federico II University of Naples, via S. Pansini 5, 80131 Naples, Italy. rpivone@tin.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acromegaly
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complications,
drug therapy* Adult Cardiomegaly / drug therapy*, etiology, ultrasonography Cardiomyopathies / drug therapy*, etiology, ultrasonography Diastole / drug effects Echocardiography, Doppler Female Follow-Up Studies Human Growth Hormone / administration & dosage, analogs & derivatives* Humans Insulin-Like Growth Factor I / metabolism Male Middle Aged Prospective Studies Receptors, Somatotropin / antagonists & inhibitors* Systole / drug effects Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Receptors, Somatotropin; 0/pegvisomant; 12629-01-5/Human Growth Hormone; 67763-96-6/Insulin-Like Growth Factor I |
| Comments/Corrections | |
Erratum In:
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J Clin Endocrinol Metab. 2007 May;92(5):1605 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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