Endocrine

, Volume 55, Issue 2, pp 346–359 | Cite as

Cardiovascular comorbidities in acromegaly: an update on their diagnosis and management

Review

Abstract

Comorbidities related to the cardiovascular system are one of the most prevalent in patients with acromegaly, and contribute to an increased risk of morbidity and all-cause mortality. Specifically, hypertension, cardiomyopathy, heart valve disease, arrhythmias, atherosclerosis, coronary artery disease, and cardiac dysfunction may be frequent findings. Although the underlying physiopathology for each comorbidity may not be fully elucidated, uncontrolled growth hormone/insulin-like growth factor 1 excess, age, prolonged disease duration, and coexistence of other cardio-vascular risk factors are significant influencing variables. A simple diagnostic approach to screen for the presence of these comorbidities may allow prompt treatment and arrest the progression of cardiac abnormalities. In this article, we revise the most prevalent cardiovascular comorbidities and their pathophysiology in acromegalic patients, and we address some recommendations for their prompt diagnosis, management and treatment. Strengths and pitfalls of different diagnostic techniques that are currently being used and how different treatments can affect these complications will be further discussed.

Keywords

acromegaly acromegaly cardiovascular comorbidities acromegalic cardiomyopathy hypertension valve disease somatostatin analogs pegvisomant radiotherapy 

Notes

Funding and Acknowledgments

This work has not received specific grants or funding.

Compliance with ethical standards

Conflict of interest

ARL has received lecture fees from Ipsen and Novartis. MM has received lecture fees, advisor fees and research grants from Pfizer and lecture fees from Novartis and Ipsen. The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.

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© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Department of EndocrinologyHospital Universitario La Princesa, Instituto de Investigación Princesa, Universidad AutónomaMadridSpain

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