Abstract
Cardiac involvement in 32 acromegalics was related to endocrine parameters, clinical score and duration of the disease as well as compared to that of 50 controls free of cardiac disease. Stress ECG, 24h Holter monitoring and echocardiography revealed that supraventricular premature complexes did not occur more often in acromegalics than in controls, both prevalence and severity of ventricular arrhythmia, however, were higher in patients compared to controls: 15/32 (48%) acromegalics had complex ventricular arrhythmia as compared with 6/50 (12%) normal subjects (p < 0.01). Repetitive ventricular arrhythmia was manifest in 10/32 (31%) patients but only in 4/50 (8%) controls (p < 0.01). Furthermore, frequency of ventricular premature complexes increased with duration of acromegaly (p < 0.01), the severity of the former being correlated with left ventricular mass and with clinical activity score (p < 0.01). No correlation, however, was found between the degree of ventricular arrhythmia and hormone levels. Left ventricular muscle mass was increased (p < 0.02) due to concentric hypertrophy. Thus, compared to controls, acromegalics show more frequent and complex ventricular arrhythmia and left ventricular hypertrophy. Duration of the disease rather than hormone levels seems to be relevant for these pathological changes.
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Huschard H. Anatomie pathologique, lésions et troubles cardio-vasculaires de l’acromegalie. J. Practiciens 9:249, 1895.
Courville C., Mason V.R. The heart in acromegaly. Arch. Intern. Med. 61:704, 1938.
Hejtmancik M.R., Bradfield J.Y., Herrmann G.R. Acromegaly and the heart: a clinical and pathologi cal study. Ann. Intern. Med. 34:1445, 1951.
Wright A.D., Hill D.M., Lowy C., Fraser T.R. Mortality in acromegaly. Q.J. Med. 39:1, 1970.
McGuffin W.L, Sherman B.M., Roth J., Gorden P., Kahn R., Roberts W.C., Frommer P.L. Acromegaly and Cardiovascular Disorders. A prospective Study. Ann. Intern. Med. 37:11, 1974.
Bodem R., Albig M., Barwich D. Cardiac findings in patients with acromegaly: an echocardiographic study. Z. Kardiol. 67:163, 1978.
Nieminen M.S., Elonen E., Pelkonen R., Frick M.H. Acromegaly and the Heart. Circulation 58: 757. 1978 (letter).
Smallridge R.C., Rajfer S., Davia J., Schaaf M. Acromegaly and the heart. An echocardiographic study. Am. J. Med. 66:22, 1979
Savage D.D., Henry W.L., Eastman R.C., Borer J.S., Gorden P. Echocardiographic assessment of cardiac anatomy and function in acromegalic patients. Am. J. Med. 37:823, 1979.
Mather H.M., Bojd M.J., Jenkins J.S. Heart size and function in acromegaly. Br. Heart. J. 47:697, 1979.
Csanady M., Gaspar L, Hdgye M., Gruber N. The heart in acromegaly: an echocardiographic study. Int. J. Cardiol. 2:349, 1983.
Bertoni P.D., Morandi G. Impaired left ventricular diastolic function in acromegaly: an echocardiographic study. Acta Cardiol. (Brux.) 15:1, 1987.
Martins J.B., Kerber R.E., Sherman B.M., Marcus M.L., Ehrhardt J.C. Cardiac size and function in acromegaly. Circulation 56:863, 1977.
Happ J., Gerspach A., Maul F.D., Standke R., Böttger B., Klepzig H., Reifart N., Althoff P.H., Hdr G. Linksventrikulare Funktion bei Akromegalie. Med. Klin. 37:79, 1986.
Hayward R.P., Emanuel R.W., Nabarro J.D.N. Acromegalic Heart Disease: Influence of treatment of the acromegaly on the heart. Q.J. Med. 32:41, 1987.
Hirsch E.Z., Sloman J.G.O, Martin F.I.R. Cardiac Function in Acromegaly. Am. J. Med. Sci 257:1, 1969.
Just H., Nieschlag E., Nicolescu R.F., Kröger F.J., Overzier C Cardiac Function in Acromegaly. A clinical and hemodynamic study. Acta Cardiologica XIX 2: 89, 1974.
Devereux R.B., Reichek N. Echocardiographic determination of left ventricular mass in man: anatomic validation of the method. Circulation 55:613, 1977.
Von Olshausen K., Bischoff S., Kahaly G., Mohr-Kahaly S., Erbel R., Beyer J., Meyer J. Cardiac Arrhythmias and Heart Rate in Hyperthyroidism. Am. J.Cardiol 33:930, 1989.
Kostis J.B., McCrone K., Moreyra A.E., Gotzoyannis S., Aglitz N.M., Natarajan N., Kuo P.T. Premature ventricular complexes in the absence of identifiable heart disease. Circulation 33:1351, 1981.
Rodrigues E.A., Caruana M.P., Lahiri A., Nabarro J.D.N., Jacobs H.S., Raferty E.B. Subclinical cardiac dysfunction in acromegaly: evidence for a specific disease of heart muscle. Br. Heart J. 62:185, 1989.
Rossi L, Thiene G., Caregaro L, Giordano R., Lauro S. Dysrhythmias and Sudden Death in Acromegalic Heart Disease. A clinicopathologic study. Chest 72:495, 1977.
Van den Heuvel P.A.C.M.B., Elbers H.R.J., Plokker H.W.M., Bruschke A.V.G. Myocardial involvement in acromegaly. Int. J. Cardiol. 6:550, 1984.
Lie J.T., Grossman S.J. Pathology of the heart in acromegaly: anatomic findings in 27 autopsied patients. Am. Heart J. 100: 41, 1980.
Nabarro J.D.N. Acromegaly. Clin. Endocrinol. (Oxf.) 26:481, 1987.
Randall R.V. Acromegaly and Gigantism. In: DeGroot L.J (Ed.), Endocrinology, Vol 1. W. B. Saunders Company, Phylodephia, 1989, p. 330.
Melmed S. Acromegaly. N. Engl. J. Med. 322: 966, 1990.
De Grandpre R., Raab W. Interrelated hormonal factors in cardiac hypertrophy, experiments in nonhypertensive hypophysectomized rats. Circ. Res. 7; 345, 1953.
Luboshitzki R., Hammerman H., Barzilai D., Markiewicz W. The heart in acromegaly: correlation of echocardio-graphic and clinical findings. Israel. J. Med. Sci. 16:378, 1980.
Thuesen L., Christensen S.E., Weeke J., Orskov H., Henningsen P. The cardiovascular effects of octreotide treatment in Acromegaly: An echocardiographic study. Clin. Endocrinol. (Oxf.) 36:619, 1989.
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Kahaly, G., Stover, C., Beyer, J. et al. Relation of endocrine and cardiac findings in acromegalics. J Endocrinol Invest 15, 13–18 (1992). https://doi.org/10.1007/BF03348647
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DOI: https://doi.org/10.1007/BF03348647