Cardiovascular Disease in Acromegaly

Sharma, Morali D.; Nguyễn, Anh Vũ; Brown, Spandana; Robbins, Richard J.

doi:10.14797/mdcj-13-2-64

Cited by 45 publications

(34 citation statements)

References 32 publications

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“…overt CVD and CVD-related and all-risk mortality [29,[31][32][33][34]. In contrast, supraphysiological IGF-1 levels are reported not to be protective, but rather evoke endothelial dysfunction (ED) and CVD [9,[35][36][37][38][39][40][41][42]. However, studies analyzing IGF-1 levels as an independent risk factor for CVD yielded inconclusive results [12] and therefore provide no indisputable evidence of a direct impact of IGF-1 on the process of atherosclerosis and CVD.…”

Section: The Relation Between Gh/igf-1 and Cvdmentioning

confidence: 99%

“…The chronic cardiotoxic and remodeling effects of GH/IGF-1 overload results in concentric biventricular hypertrophic cardiomyopathy, which may lead to heart failure [3,6,53], especially in patients with insufficiently controlled acromegaly [54,55]. Acromegaly treatment reverses some of the early stage morphological changes and improves cardiac function, especially when IGF-1 levels were normalized [36,[56][57][58][59].…”

Section: Acromegalic Cardiomyopathymentioning

confidence: 99%

“…Arrhythmias and cardiac valvular disease are also more common in acromegaly patients compared to the general population [6,7]. Treatment is reported to decrease the incidence of arrhythmias and prevent further deterioration, but did not reverse established cardiac valve disease [7,36,60].…”

Section: Acromegalic Cardiomyopathymentioning

confidence: 99%

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Acromegaly, inflammation and cardiovascular disease: a review

Wolters¹,

Netea

Riksen³

et al. 2020

Rev Endocr Metab Disord

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Acromegaly is characterized by Growth Hormone (GH) and Insulin-like Growth Factor 1 (IGF-1) excess. Uncontrolled acromegaly is associated with a strongly increased risk of cardiovascular disease (CVD), and numerous cardiovascular risk factors remain present after remission. GH and IGF-1 have numerous effects on the immune and cardiovascular system. Since endothelial damage and systemic inflammation are strongly linked to the development of CVD, and have been suggested to be present in both controlled as uncontrolled acromegaly, they may explain the presence of both micro- and macrovascular dysfunction in these patients. In addition, these changes seem to be only partially reversible after remission, as illustrated by the often reported presence of endothelial dysfunction and microvascular damage in controlled acromegaly. Previous studies suggest that insulin resistance, oxidative stress, and endothelial dysfunction are involved in the development of CVD in acromegaly. Not surprisingly, these processes are associated with systemic inflammation and respond to GH/IGF-1 normalizing treatment.

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Section: The Relation Between Gh/igf-1 and Cvdmentioning

confidence: 99%

Section: Acromegalic Cardiomyopathymentioning

confidence: 99%

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Acromegaly, inflammation and cardiovascular disease: a review

Wolters¹,

Netea

Riksen³

et al. 2020

Rev Endocr Metab Disord

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“…In addition, OSA contributed to IR in patients with acromegaly, which improved by CPAP in a RCT (237). Furthermore, OSA might play an important role in other acromegaly-related comorbidities such as hypertension and heart failure/ cardiomyopathy (238).…”

Section: Osa and Acromegalymentioning

confidence: 94%

“…The weakness of UA muscles (sternohyoid muscle) also contributes to the increased risk of UA collapsibility in patients with acromegaly (235). Other factors include hypothyroidism, large goitres (detailed later) (219,236,237), IR and dysglycaemia (219,224,238).…”

Section: Osa and The Dysregulation Of Gh/igf Axismentioning

confidence: 99%

MECHANISMS OF ENDOCRINOLOGY: Mechanisms of disease: the endocrinology of obstructive sleep apnoea

Lavrentaki

Ali

Cooper

et al. 2019

European Journal of Endocrinology

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Obstructive sleep apnoea (OSA) is a common disorder that is associated with serious comorbidities with a negative impact on quality of life, life expectancy and health costs. As OSA is related to obesity and is associated with sleep disruption, increased inflammation and oxidative stress, it is not surprising that OSA has an impact on the secretion of multiple hormones and is implicated in the development of many endocrine conditions. On the other hand, many endocrine conditions that can affect obesity and/or upper airways anatomy and stability have been implicated in the development or worsening of OSA. This bidirectional relationship between OSA and the endocrine system has been increasingly recognised in experimental and epidemiological studies and there are an increasing number of studies examining the effects of OSA treatment on endocrine conditions and vice versa. In this review article, we will critically appraise and describe the impact of OSA on the endocrine system including obesity, dysglycaemia, the pituitary, the thyroid, the adrenals, the reproductive system and the bones. In each section, we will assess whether a bidirectional relationship exists, and we will describe the potential underlying mechanisms. We have focused more on recent studies and randomised controlled trials where available and attempted to provide the information within clinical context and relevance.

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Aneurysmal dilation of sinus of Valsalva in a patient with undiagnosed acromegaly

Gharoy,

Taghavi,

Ghaemmaghami

et al. 2023

Clinical Case Reports

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Key Clinical MessageIn patients presenting with aortic ectasia and myxomatous valve diseases at young ages, possible underlying acromegaly should be in mind.AbstractAcromegaly is a chronic systemic disease mainly caused by the benign pituitary adenoma secreting growth hormone (GH) in excess. Acromegaly is associated with various complications such as cardiovascular diseases. In this regard, timely diagnosis, and management of these patients could be life‐saving. Herein, a case of aneurysmal dilation of the sinus of Valsalva with severe aortic and mitral regurgitation in a patient with undiagnosed acromegaly is presented.

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Cardiovascular Disease in Acromegaly

Cited by 45 publications

References 32 publications

Acromegaly, inflammation and cardiovascular disease: a review

Acromegaly, inflammation and cardiovascular disease: a review

MECHANISMS OF ENDOCRINOLOGY: Mechanisms of disease: the endocrinology of obstructive sleep apnoea

Aneurysmal dilation of sinus of Valsalva in a patient with undiagnosed acromegaly

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