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Acromegaly cardiomyopathy may be less prevalent than previously reported
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In patients with active acromegaly, cardiomyopathy as assessed through cardiac MRI appears to be less common than once reported, according to recent findings.
Mônica R. Gadelha, MD, PhD, of the Universidade Federal do Rio de Janeiro in Brazil, and colleagues evaluated 40 patients with acromegaly to determine the frequency of structural and cardiac alteration using cardiac MRI before and after 12 months of octreotide long-acting repeatable therapy. Echocardiography screening was also conducted before treatment and in 29 patients after treatment.
Frequency of left ventricular hypertrophy was 5% when determined by cardiac MRI. All patients had normal systolic function, mean left ventricular mass index was 61.73 g/m2 and mean left ventricular ejection fraction was 61.85%. One patient had increased extracellular volume and five had late gadolinium enhancement.
Forty percent of patients had criteria for disease control following treatment. The researchers found no differences in cardiac variables before and after treatment. Similarly, no differences were found between patients with and without disease control for left ventricular mass index and left ventricular ejection fraction.
When determined by echocardiography, 31% of patients had left ventricular hypertrophy, mean left ventricular mass index was 117.8 g/m2 and mean left ventricular ejection fraction was 67.3%. Again, all patients had normal systolic function.
The researchers cited other studies in which CVD has been found to no longer be the main cause of death in patients with acromegaly.
“This paradigm shift in the frequency of acromegaly cardiomyopathy and in the main cause of mortality [is] intriguing; we speculate that this shift could be a consequence of the advances in the treatment of acromegaly comorbidities, as acromegaly is associated with a high prevalence of arterial hypertension and diabetes, and both are associated with cardiac disease,” the researchers wrote. – by Jennifer Byrne
Disclosure: Gadelha reports various financial ties with Ipsen, Novartis and Pfizer. Please see the full study for a list of all other authors’ relevant financial disclosures.
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