TY - JOUR
T1 - Impact of successful transsphenoidal surgery on cardiovascular risk factors in acromegaly
AU - Jaffrain-Rea, Marie Lise
AU - Minniti, Giuseppe
AU - Moroni, Carlo
AU - Esposito, Vincenzo
AU - Ferretti, Elisabetta
AU - Santoro, Antonio
AU - Infusino, Tommaso
AU - Tamburrano, Guido
AU - Cantore, Giampaolo
AU - Cassone, Rosario
PY - 2003/2/1
Y1 - 2003/2/1
N2 - Background: Cardiac abnormalities develop in patients with acromegaly as a consequence of effects of GH/IGF-I on the heart and related cardiovascular risk factors. Objective: To evaluate the possible contribution of postoperative variations in blood pressure (BP), glucose tolerance and insulin sensitivity to the cardiac improvement reported in patients who have been cured of acromegaly. Design: Thirty-one patients with acromegaly were studied before and 6 months after successful transsphenoidal surgery, defined by normal age-related IGF-I concentrations and glucose-suppressed GH concentrations ISI and OGTTISI, respectively. Results: Successful surgery was confirmed to improve left ventricular mass index (LVMI) and diastolic filling significantly. Mean 24-h systolic BP values decreased (P = 0.009) and BP rhythm was restored in 12 of 15 patients with a blunted preoperative profile. Glucose tolerance normalized in patients with preoperative glucose intolerance (n = 7) or diabetes mellitus (n = 3). HOMAISI and OGTTISI increased (P = 0.0001 for each parameter), indicating a marked improvement in insulin sensitivity. The post-operative reduction in LVMI correlated with increased insulin sensitivity (P <0.001 for both indexes), but not with other parameters. Improved diastolic filling correlated with the reduction in LVMI. Conclusions: Successful surgery in patients with acromegaly induces a significant improvement in haemodynamic and metabolic risk factors. This study suggests a direct link between insulin resistance and acromegalic cardiomyopathy.
AB - Background: Cardiac abnormalities develop in patients with acromegaly as a consequence of effects of GH/IGF-I on the heart and related cardiovascular risk factors. Objective: To evaluate the possible contribution of postoperative variations in blood pressure (BP), glucose tolerance and insulin sensitivity to the cardiac improvement reported in patients who have been cured of acromegaly. Design: Thirty-one patients with acromegaly were studied before and 6 months after successful transsphenoidal surgery, defined by normal age-related IGF-I concentrations and glucose-suppressed GH concentrations ISI and OGTTISI, respectively. Results: Successful surgery was confirmed to improve left ventricular mass index (LVMI) and diastolic filling significantly. Mean 24-h systolic BP values decreased (P = 0.009) and BP rhythm was restored in 12 of 15 patients with a blunted preoperative profile. Glucose tolerance normalized in patients with preoperative glucose intolerance (n = 7) or diabetes mellitus (n = 3). HOMAISI and OGTTISI increased (P = 0.0001 for each parameter), indicating a marked improvement in insulin sensitivity. The post-operative reduction in LVMI correlated with increased insulin sensitivity (P <0.001 for both indexes), but not with other parameters. Improved diastolic filling correlated with the reduction in LVMI. Conclusions: Successful surgery in patients with acromegaly induces a significant improvement in haemodynamic and metabolic risk factors. This study suggests a direct link between insulin resistance and acromegalic cardiomyopathy.
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U2 - 10.1530/eje.0.1480193
DO - 10.1530/eje.0.1480193
M3 - Article
C2 - 12590638
AN - SCOPUS:0037296396
SN - 0804-4643
VL - 148
SP - 193
EP - 201
JO - European Journal of Endocrinology
JF - European Journal of Endocrinology
IS - 2
ER -