Endocrine Abstracts

Introduction: Chronic excess of growth hormone is responsible for numerous cardiovascular, respiratory, metabolic and neoplastic complications, leading to significant morbidity and mortality. The aim of this study is to analyze the different cardiovascular manifestations and cardiovascular risk factors in acromegaly.

Methods: A retrospective descriptive study including 44 patients hospitalized in the endocrinology department of University Hospital Mohamed VI of Marrakech, from October 2006 to February 2022. Data were collected from medical records.

Results: the sex ratio is 1, mean age of 46.7 years [15-68]. GH hypersecretion was related to a pituitary adenoma in all cases. The IGF-1 measured in 32 patients, was elevated in 31 (96.87%), GH was elevated under OGTT in 1 patient, and in 12 patients, the diagnosis was made retrospectively based on pathology results (27.3%). Cardiovascular risk factors: hypertension was present in 27.3% of cases, diabetes in 34% and dyslipidemia in 2.2%. thirty four percent of patients was overweight and 9% obese. None of the patients had a coronary syndrome or stroke. The ECG found electric left ventricular hypertrophy in 34% of cases. Chest X-rays showed cardiomegaly in 27.2% of cases. Echocardiography was performed in 29 patients, and showed abnormality in 4 cases (9%): left ventricular hypertrophy in 2 patients, hypertrophic dilated cardiomyopathy in one patient and stage 3 tricuspid valve disease in 1 patient.

Conclusion: Cardiovascular complications are very common in acromegaly (20-50% of cases), dominated by hypertension and hypertrophic heart disease. Compared with the general population, the risk of death in patients with acromegaly is increased to 61%, The main cause of mortality is cardiovascular complications. The higher the level of GH and the longer the course of the disease, the more serious these complications become. The evolution of cardiovascular complications during acromegaly management appears to vary greatly according to the disease history and the degree of control of GH excess. Some studies have shown that the cardiac structure and function improve significantly after the disease is controlled.

References: 1. Systemic complications of acromegaly: epidemiology, pathogenesis, and management. Endocr Rev 2004.2. Yang H, Tan H, Huang H and Li J (2021) Advances in Research on the Cardiovascular Complications of Acromegaly. Front. Oncol. 11:640999. doi: 10.3389/fonc.2021.640999