Acromegalic cardiomyopathy: Epidemiology, diagnosis, and management

Ajay N. Sharma, Marilyn Tan, Ezra A Amsterdam, Gagan Singh

Research output: Contribution to journalReview article

8 Scopus citations

Abstract

Acromegalic cardiomyopathy is the leading cause of morbidity and all-cause mortality in patients with acromegaly. Though acromegaly is a rare condition, the associated derangements are vast and severe. Stemming from an increase in circulating growth hormone (GH) and insulin-like growth factor-1 levels (IGF-1), acromegalic cardiomyopathy results in pathological changes in myocyte growth and structure, cardiac contractility, and vascular function. These molecular changes manifest commonly as biventricular hypertrophy, diastolic and systolic dysfunction, and valvular regurgitation. Early recognition of the condition is paramount, though the insidious progression of the disease commonly results in a late diagnosis. Biochemical testing, based on IGF-1 measurements, is the gold standard of diagnosis. Management should be centered on normalizing serum levels of both IGF-1 and GH. Transsphenoidal resection remains the most cost-effective and permanent treatment for acromegaly, though medical therapy possesses benefit for those who are not surgical candidates. Ultimately, achieving control of hormone levels results in a severe reduction in mortality rate, underscoring the importance of early recognition and treatment.

Original languageEnglish (US)
Pages (from-to)419-425
Number of pages7
JournalClinical Cardiology
Volume41
Issue number3
DOIs
StatePublished - Mar 1 2018

Keywords

  • Acromegalic Cardiomyopathy
  • Acromegaly
  • Clinical Manifestations
  • Diagnosis
  • Epidemiology
  • Prognosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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