BES2018 BES 2018 Cardiovascular complications in pituitary gigantism (results of an international study) (1 abstracts)
Cardiovascular complications in pituitary gigantism (results of an international study)
Rostomyan Liliya 1 , Daly Adrian 1 , Shah Nalini 2 , A Naves Luciana 3 , Barlier Anne 4 , Jaffrain-Rea Marie-Lise 5 , Emy Philippe 6 , Neggers Sebastian 7 , Santamaria Beatriz Lecumberri 8 , Holdaway Ian 9 , Brue Thierry 4 , Stalla Gunter 10 , Salvatori Roberto 11 , Bertherat Jerome Yves 12 , Maiter Dominique 13 , Zacharin Margaret 14 , Lila Anurag 2 , Filipponi Silvia 5 , Mukhopadhyay Satinath 15 , Ebeling Tapani 16 , Ojaniemi Marja 17 , McCormack Ann I 18 , Kuismin Outi 19 , Lecoq Anne-Lise 20 , Sahnoun-Fathallah Mona 4 , Jung-Sievers Caroline 10 , Malchiodi Elena 21 , Rozhinskaya Liudmila 22 , Nazzari Elena 23 , Mittal Sachin 24 , Verrua Elisa 21 , Sorkina Ekaterina 25 , Dreval Alexander 26 , Devuyst France 27 , Bilbao Ismene 28 , Auriemma Renata Simona 29 , García Nuria Palacios 30 , Ilovaiskaya Irena 26 , Pronin Vyacheslav 25 , Colao Annamaria 29 , Ferone Diego 23 , Spada Anna 21 , Petrossians Patrick 1 , Beck-Peccoz Paolo 21 , Stratakis Constantine A 31 , Chanson Philippe 20 & Beckers Albert 1
1Department of Endocrinology, CHU De Liège, University of Liege, Liege, Belgium; 2Department of Endocrinology, Seth G S Medical College k.e.m.hospital Parel, Mumbai, India; 3Division of Endocrinology, University of Brasilia, Brasilia, Brazil; 4Service D’endocrinologie, Hopital De La Timone, Marseille, France; 5Department of Experimental Medicine, University of L’aquila, L’aquila, Italy; 6Service D’endocrinologie, Chr Orléans, Orléans, France; 7Section of Endocrinology, Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, Netherlands; 8Servicio De Endocrinología Y Nutrición, Hospital Universitario La Paz, Madrid, Spain; 9Department of Endocrinology, Greenlane Clinical Centre, Auckland, New Zealand; 10Department of Endocrinology, Max Planck Institute of Psychiatry, Munich, Germany; 11Division of Endocrinology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; 12Department of Endocrinology, Institut Cochin, Paris Descartes University, Paris, France; 13Department of Endocrinology, St. Luc University Hospital, Université Catholique De Louvain, Brussels, Belgium; 14Murdoch Childrens Research Institute, Royal Children’s Hospital and University of Melbourne, Parkville, Victoria, Australia; 15Department of Endocrinology & Metabolism, Institute of Postgraduate Medical Education & Research, Calcutta, India; 16Departments of Internal Medicine, University of Oulu and Oulu University Hospital, Oulu, Finland; 17Departments of Pediatrics, University of Oulu and Oulu University Hospital, Oulu, Finland; 18Cancer Genetics Unit, Hormones and Cancer Group, Kolling Institute of Medical Research, Royal North Shore Hospital, Sydney, NSW, Australia; 19Department of Clinical Genetics, University of Oulu, Oulu, Finland; 20Department of Endocrinology, Chu Le Kremlin Bicetre, Le Kremlin Bicetre, France; 21Department of Clinical Sciences and Community Health, University of Milan, Endocrine Unit, Fodazione Ospedale Maggiore Policlinico Irccs, Milan, Italy; 22Department of Neuroendocrinology and Bone Diseases, Federal State Research Centre for Endocrinology, Moscow, Russian Federation; 23Department of Endocrinology & Medical Sciences, Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy; 24Department of Endocrinology, T.n. Medical College & b.y.l. Nair Hospital, Mumbai, India; 25The Endocrinology Clinic, I.m. Sechenov First Moscow State Medical University, Moscow, Russian Federation; 26Endocrinologic Depatrment, Moscow Regional Research & Clinical Institute Named by Mf Vladimirsky, Moscow, Russian Federation; 27Endocrinology, Erasme Hospital, Faculty of Medicine, Université Libre De Bruxelles, Brussels, Belgium; 28Servicio De Endocrinología, Hospital Donostia, Donostia San Sebastián, Guipúzcoa, Spain; 29Department of Molecular and Clinical Endocrinology & Oncology, “Federico Ii” University of Naples, Naples, Italy; 30Servicio De Endocrinología, Hospital Universitario Puerta De Hierro, Majadahonda, Majadahonda, Madrid, Spain; 31Section on Endocrinology Genetics, Program on Developmental Endocrinology Genetics (Pdegen), Eunice Kennedy Shriver National Institute of Child Health & Human Development (Nichd), National Institute of Health (Nih), Bethesda, MD, USA.
Background: Cardiovascular disease is an important cause of morbidity/mortality in chronic GH hypersecretion.
Aim: To evaluate cardiovascular system in a large series of patients with pituitary gigantism. Standard case report forms were used with height assessments related to local country norms. Results: 151pts (123 male) with GH-excess and abnormal growth velocity for age or final height >2SD over local norms had complete data on cardiac assessments at baseline or on median 7,5 yr [3;17] of follow-up. Median ages at first symptoms and at diagnosis of pituitary adenoma (PA) were 14yr [11;16] and 21yr [16;27], respectively; latency was 6yrs [2.9;12]. Overall, cardiovascular disorders were reported in 38,3% during the period of follow-up. Clinical evaluation of cardiovascular system appeared normal in 65 pts who had no instrumental examination, 83 pts were evaluated by echocardiography either as routine examination or in aligned patients with cardiovascular symptomology, another 3 pts were reported as with heart disease without further details. Cardiovascular disorders prevalences in the group of 83 pts assessed by echocardiography: left ventricular hypertrophy- 56%; concentric biventricular hypertrophy- 9%; tachycardia- 7%; bradycardia- 3.6%; diastolic dysfunction- 23.6%); systolic dysfunction- 16.4%; heart failure- 7.3%; dilatative cardiomyopathy- 18.2%; arrhythmia- 18.2%; valvular disease- 27.3%; stroke- 1.8%; coronary heart disease- 3.6%; aortic dilatation- 3.6%. Cardiovascular disorders were related to older age at diagnosis of pituitary adenoma (P=0.04), longer latency period (P=0.02), delayed treatment (P=0.04) and disease control (P=0.001), but not to hormonal (GH/IGF-1) levels. In those patients with hormonal control achived before age of 20 yr, cardiovascular disease occurred less frequently (P=0.03). Impact of gender and gonadal status was not significant, whereas cardiovascular disorders were associated with more frequent impaired glucose metabolism (48% vs. 19%).
Conclusions: This first large, specific study of pituitary gigantism shows a high prevalence of cardiovascular disorders, mainly influenced by uncontrolled pituitary disease duration. Given their young age, particularly careful attention should be given to this complication and its adequate early management.
Volume 57
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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