Endocrine Abstracts

Background and Aims: Cardiometabolic comorbidity is a well-established complication related to GH hypersecretion. Several studies have highlighted an increased cardiovascular risk in this population. The objective of the current work was to investigate the cardiovascular complications in Tunisian patients diagnosed with acromegaly.

Patients and Method: We conducted a retrospective study that included all patients diagnosed with acromegaly who have been followed up, from 1997 to 2021, at the Endocrinology Department of Hedi Chaker University Hospital, Sfax, Tunisia. The review of medical charts provided a detailed cardiovascular evaluation in the investigated population.

Results: Our sample included 29 with a mean age at diagnosis of 45.8 ± 12.4 years old (extremes: 23-72 years) and slight male predominance (52.0%). The overall prevalence of arterial hypertension in the studied population was 20.7% with a mean duration of the evolution of 9.3 years (extremes: 2– 20 years). Hypertension was newly diagnosed in 6.9% of patients. Arrhythmia and cardiac conduction disorders were observed in 10.3%. The cardiac ultrasound assessment revealed a concentric left ventricular hypertrophy in 15.4% of patients. Severe complicated hypertrophic cardiomyopathy with left heart insufficiency was reported in 3.4%. Aortic valvulopathy was found in 3.4% of cases. Ischemic heart disease affected 6.9% of patients.

Conclusion: Cardiovascular complications represent the leading cause of mortality in patients with acromegaly [1]. A various spectrum of cardiovascular manifestations can occur due to GH exaggerated secretion. Hypertension, ischemic heart disease, and arrhythmia are the most common ones. Other acromegaly-specific cardiac conditions can be found such as acromegalic cardiomyopathy [2]. The GH and IGF-1 excess affects the heart morphology and may impair its performances leading to insidious alterations of heart tissue and functions, independently of additional cardiovascular factors. The optimal surgical and medical management of acromegaly is associated with an improvement of cardiovascular risk in this population [3].

References: 1. Lombardi, Gaetano, et al. ‘Acromegaly and the cardiovascular system.’ Neuroendocrinology 83.3-4 (2006): 211-217.

2. Pivonello, Rosario, et al. ‘Complications of acromegaly: cardiovascular, respiratory and metabolic comorbidities.’ Pituitary 20.1 (2017): 46-62.

3. Mosca, Susanna, et al. ‘Cardiovascular involvement in patients affected by acromegaly: an appraisal.’ International journal of cardiology 167.5 (2013): 1712-1718.