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Low frequency of cardniac arrhythmias and lack of structural heart disease in medically-naïve acromegaly patients: a prospective study at baseline and after 1 year of somatostatin analogs treatment

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Abstract

Background

The incidence of arrhythmias may be increased in acromegaly, but the pathophysiologic mechanisms involved are still unclear, and it has never been correlated with structural heart changes analyzed by the gold-standard method cardiac magnetic resonance (CMR).

Aim

Evaluate the frequency of arrhythmias in drug-naïve acromegaly patients at baseline and after 1 year of somatostatin analogs (SA) treatment and to correlate the occurrence of arrhythmias with the presence of structural heart changes.

Patients and methods

Consecutive drug-naïve acromegaly patients were recruited. The occurrence of arrhythmias and structural heart changes were studied through 24-h Holter and CMR, respectively, at baseline and after 1-year SA treatment.

Results

Thirty-six patients were studied at baseline and 28 were re-evaluated after 1 year of SA treatment. There were 13 females and median age was 48 years (20–73 years). Nine patients (32 %) were controlled after treatment. No sustained arrhythmias were reported in the 24-h Holter. No arrhythmia-related symptoms were observed. Only two patients presented left ventricular hypertrophy and three patients presented fibrosis at baseline. There was no correlation of the left ventricular mass with the number of episodes of arrhythmias and they were not more prevalent in the patients presenting cardiac fibrosis.

Conclusion

We found no sustained arrhythmias and a lack of arrhythmia-related symptoms at baseline and after 1 year of SA treatment in a contemporary cohort of acromegaly patients that also present a low frequency of structural heart changes, indicating that these patients may have a lower frequency of heart disease than previously reported.

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Funding

The research has not received funding from any organization or company and was sponsored by the authors themselves.

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Authors and Affiliations

  1. Neuroendocrinology Research Center – Endocrine Section, Medical School and Hospital Universitário Clementino Fraga Filho – Universidade Federal do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 255, sala 9F, Ilha do Fundão, Rio de Janeiro, 21941-913, Brazil

    Leila Warszawski, Leandro Kasuki, Cintia Marques dos Santos Silva & Mônica R. Gadelha

  2. Endocrine Unit, Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione (IEDE), Rio de Janeiro, Brazil

    Leila Warszawski

  3. Neuroendocrine Section - Instituto Estadual do Cérebro Paulo Niemeyer, Secretaria Estadual de Saúde do Rio de Janeiro, Rio de Janeiro, Brazil

    Leandro Kasuki & Mônica R. Gadelha

  4. Endocrine Unit, Hospital Federal de Bonsucesso, Rio de Janeiro, Brazil

    Leandro Kasuki

  5. Cardiology Section, Medical School and Hospital Universitário Clementino Fraga Filho – Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil

    Rodrigo Sá, Isabela Volschan & Roberto Coury Pedrosa

  6. Clínica de Diagnóstico por Imagem/Multi-Imagem, Rio de Janeiro, Brazil

    Ilan Gottlieb

  7. Radiology Department, Casa de Saúde São Jose, Rio de Janeiro, Brazil

    Ilan Gottlieb

Authors
  1. Leila Warszawski
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  2. Leandro Kasuki
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  3. Rodrigo Sá
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  4. Cintia Marques dos Santos Silva
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  5. Isabela Volschan
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  6. Ilan Gottlieb
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  7. Roberto Coury Pedrosa
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  8. Mônica R. Gadelha
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Correspondence to Mônica R. Gadelha.

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Conflicts of interest

MRG has received unrestricted research grants and speaker fees from Novartis, Ipsen and Pfizer and has participated on advisory boards of Novartis and Ipsen. The other authors declare that they have no conflict of interest.

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Warszawski, L., Kasuki, L., Sá, R. et al. Low frequency of cardniac arrhythmias and lack of structural heart disease in medically-naïve acromegaly patients: a prospective study at baseline and after 1 year of somatostatin analogs treatment. Pituitary 19, 582–589 (2016). https://doi.org/10.1007/s11102-016-0749-7

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