Abstract
Cardiovascular-related complications are one of the most common complications in patients with acromegaly, and can lead to an increased risk of death. Hypertension and cardiomyopathy are the main cardiovascular complications. The characteristics of acromegalic cardiomyopathy are concentric biventricular hypertrophy and diastolic dysfunction. In addition, arrhythmia and heart valve disease are common cardiac complications in acromegaly. Although the underlying pathophysiology has not been fully elucidated, the spontaneous overproduction of GH and IGF-1, increasing age, prolonged duration of disease and the coexistence of other cardiovascular risk factors are crucial to cardiac complications in patients with acromegaly. Early diagnosis and appropriate treatment of acromegaly might be beneficial for the prevention of cardiomyopathy and premature death.
Highlights
The results showed that when the concentration of insulin-like growth factor-1 (IGF-1) exceeded 191 ng/ml, blood pressure was significantly positively correlated with IGF-1 (r=0.31, P
Ronconi et al compared the blood of 13 patients with acromegaly and 12 sex- and age-matched normal blood pressure controls and found that the nitric oxide (NO) concentration decreased in platelets of patients with acromegaly, which was mainly related to the decreased expression of endothelial NO synthase, and the internal NO concentration was negatively correlated with growth hormone (GH)/IGF-1 levels and the duration of acromegaly [34]
The results showed that compared with the control group, patients with acromegaly had significantly higher intima media thickness (IMT) and epicardial adipose tissue thickness (EAT), while flow-mediated dilation (FMD) significantly decreased, compared with the control group the patients with acromegaly presented lower levels of highly sensitive C reactive protein and oxidative stress parameters, which suggested that inflammation and oxidative stress did not seem to contribute to the development of atherosclerosis in these patients [94]
Summary
Reviewed by: Giovanna Aparecida Balarini Lima, Fluminense Federal University, Brazil. This study suggested that in patients with acromegaly who had not yet been completely controlled, blood pressure might be positively correlated with IGF-I level. GH/IGF-I can directly act on the sodium channel (epithelial sodium channel, ENaC) of the kidney and renal tubular epithelial cells to increase its activity and cause water and sodium retention [32] There is another mechanism of hypertension in patients with acromegaly, which is increased peripheral vascular resistance. Ronconi et al compared the blood of 13 patients with acromegaly and 12 sex- and age-matched normal blood pressure controls and found that the NO concentration decreased in platelets of patients with acromegaly, which was mainly related to the decreased expression of endothelial NO synthase, and the internal NO concentration was negatively correlated with GH/IGF-1 levels and the duration of acromegaly [34]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
