Acromegalic cardiomyopathy in an extensively admixed population: is there a role for GH/IGF-I axis?

Summary Background A specific acromegaly‐related cardiomyopathy has been described in the literature, largely in Caucasians, which is independent of other risk factors, mainly hypertension. Objective This study assessed the cardiac changes in acromegalics of significant ethnic diversity and also the...

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Bibliographic Details
Published in:	Clinical endocrinology (Oxford) Vol. 78; no. 1; pp. 94 - 101
Main Authors:	Nascimento, Gilvan Cortês, de Oliveira, Marina Torres, Carvalho, Viviane Chaves, Lopes, Maria Honorina Cordeiro, Guimarães Sá, Adriana Maria, Souza, Marinilde Teles, de Souza Paiva Ferreira, Adalgisa, Ferreira, Pedro Antônio Muniz, Faria, Manuel dos Santos
Format:	Journal Article
Language:	English
Published:	Oxford Blackwell Publishing Ltd 01-01-2013 Blackwell Wiley Subscription Services, Inc
Subjects:	Acromegaly - complications Acromegaly - epidemiology Acromegaly - metabolism Adult Biological and medical sciences Cardiology. Vascular system Cardiomyopathies - epidemiology Cardiomyopathies - etiology Cross-Sectional Studies Endocrinopathies Female Fundamental and applied biological sciences. Psychology Heart Human Growth Hormone - metabolism Humans Hypothalamus. Hypophysis. Epiphysis (diseases) Insulin-Like Growth Factor I - metabolism Male Medical sciences Middle Aged Myocarditis. Cardiomyopathies Non tumoral diseases. Target tissue resistance. Benign neoplasms Vertebrates: endocrinology Endocrinopathy GH-IGF axis Cardiomyopathy Heart disease Pituitary diseases Diseases of the osteoarticular system Acromegaly Cardiovascular disease Population Myocardial disease Endocrinology
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Summary:	Summary Background A specific acromegaly‐related cardiomyopathy has been described in the literature, largely in Caucasians, which is independent of other risk factors, mainly hypertension. Objective This study assessed the cardiac changes in acromegalics of significant ethnic diversity and also the relevance of the aetiopathogenic factors involved, such as disease activity and hypertension. Design It is a cross‐sectional study with a comparative control group. Patients and methods In this study, 37 acromegalic patients (20 Intermediate‐skinned (IS), 14 Dark‐skinned (DS) and three Light‐skinned (LS) individuals) and 74 controls matched by age, gender and hypertension were evaluated. Cardiac morphology and function were addressed using echocardiography parameters. Results The mean age of patients was 46·9 ± 12·8 years, with 67·6% being women and 43·2% hypertensive. The prevalence of left ventricular hypertrophy (LVH) between acromegalics was 56·8% vs 10·8% in the controls (P < 0·001). About 86% of patients with LVH had active disease (P = 0·023). Logistic regression revealed that disease activity presented a stronger association (OR = 5·925; CI = 1·085–32·351; P = 0·040) with LVH than hypertension (OR = 3·237; CI = 0·702–14·924; P = 0·132). When DS acromegalics were compared with IS ones, no statistically significant differences were observed. Conclusion Chronically hyperactive somatotropic axis remains as an independent and determining factor in the development of left ventricular hypertrophy, as it is more associated with this condition than hypertension in a largely admixed population with a high degree of African ancestry.
Bibliography:	ArticleID:CEN4472 istex:DFF70A9FE04E1DF2F97582798C40194DB9D2FD5A ark:/67375/WNG-HG5XMDNR-T ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0300-0664 1365-2265
DOI:	10.1111/j.1365-2265.2012.04472.x