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Improvement of left ventricular hypertrophy and arrhythmias after lanreotide-induced GH and IGF-I decrease in acromegaly. A prospective multi-center study

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Abstract

We report the results of a prospective Italian multi-center study of the effects of lanreotide, a slow-release somatostatin analog, on left ventricular morphology and function and on the prevalence of ventricular arrhythmic events in 19 patients with active, newly diagnosed, uncomplicated acromegaly. Cardiac features were evaluated with Doppler-echocardiography and 24-h Holter ECG monitoring at baseline and after 6 months of lanreotide therapy. Fifteen patients (78.9%) had left ventricular hypertrophy. Lanreotide treatment significantly decreased the left ventricular mass (127.8±6.9 vs 140.7±7.1 g/m2, p<0.001) and left ventricular hypertrophy significantly disappeared in 6 of these patients. Treatment did not significantly affect systolic function, whereas it increased the Doppler- derived early-to-late mitral flow velocity, (E/A) ratio, of early-to-late trans-mitral flow velocity (1.34±0.1 vs 1.09±0.06, p=0.001). Stroke volume was slightly but not significantly increased after treatment, whereas systolic BP was significantly higher (134±14 vs 129±13 mmHg, p<0.05). The 24-h mean heart rate was significantly reduced after treatment (66.5±11 vs 71.5±20 beats/min, p<0.05). Supra-ventricular premature beats (>50/24 h) occurred in 16.6% of patients and were unaffected by treatment. Differently, ventricular premature beats (>50/24 h) occurred in 33.3% of patients before treatment vs 16.5%, after treatment. In conclusion, lanreotide reduced the left ventricular mass, and improved ventricular filling and ventricular arrhythmic profile. (J.

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References

  1. Saccà L., Cittadini A., Fazio S. Growth hormone and the heart. Endocr. Rev. 1994, 15: 555–573.

    Article  PubMed  Google Scholar 

  2. Isgaard J., Tivesten A., Friberg P., Bengtsson B.A. The role of the GH/IGF-I axis for cardiac function and structure. Horm. Metab. Res. 1999, 31: 50–54.

    Article  CAS  PubMed  Google Scholar 

  3. Colao A., Marzullo P., Di Somma C., Lombardi G. Growth hormone and the heart. Clin. Endocrinol. (Oxf.) 2001, 54: 137–154.

    Article  CAS  Google Scholar 

  4. Fazio S., Cittadini A., Biondi B. et al. Cardiovascular effects of short-term growth hormone hypersecretion. J. Clin. Endocrinol. Metab. 2000, 85: 179–182.

    Article  CAS  PubMed  Google Scholar 

  5. McGuffin W.L. Jr., Sherman B.M., Roth J. et al. Acromegaly and cardiovascular disorders: a prospective study. Ann. Intern. Med. 1974, 81: 11–18.

    Article  PubMed  Google Scholar 

  6. Morvan D., Komajda M., Grimaldi A., Turpin G., Grosgogeat Y. Cardiac hypertrophy and function in asymptomatic acromegaly. Eur. Heart J. 1991, 12: 666–672.

    CAS  PubMed  Google Scholar 

  7. Kahaly G., Olshausen K.V., Mohr-Kahaly S. et al. Arrhythmia profile in acromegaly. Eur. Heart J. 1992, 13: 51–56.

    CAS  PubMed  Google Scholar 

  8. Fazio S., Cittadini A., Sabatini D. et al. Evidence for biventricular involvement in acromegaly: a Doppler echocardiographic study. Eur. Heart J. 1993, 14: 26–33.

    Article  CAS  PubMed  Google Scholar 

  9. Sicolo N., Bui F., Sicolo M. et al. Acromegalic cardiopathy: a left ventricular scintigraphic study. J. Endocrinol. Invest. 1993, 16: 123–127.

    CAS  PubMed  Google Scholar 

  10. Fazio S., Cittadini A., Cuocolo A. et al. Impaired cardiac performance is a distinct feature of uncomplicated acromegaly. J. Clin. Endocrinol. Metab. 1994, 79: 441–446.

    CAS  PubMed  Google Scholar 

  11. López-Velasco R., Escobar-Morreale H.F., Vega B. et al. Cardiac involvement in acromegaly: specific cardiopathy or consequence of systemic hypertension. J. Clin. Endocrinol. Metab. 1997, 82: 1047–1053.

    PubMed  Google Scholar 

  12. Colao A., Cuocolo A., Marzullo P. et al. Impact of patient’s age and disease duration on cardiac performance in acromegaly: A radionuclide angiography study. J. Clin. Endocrinol. Metab. 1999, 84: 1518–1523.

    CAS  PubMed  Google Scholar 

  13. Colao A., Baldelli R., Marzullo P. et al. Systemic hypertension and impaired glucose tolerance are independently correlated to the severity of the acromegalic cardiomyopathy. J. Clin. Endocrinol. Metab. 2000, 85: 193–199.

    CAS  PubMed  Google Scholar 

  14. Thuesen L., Christensen S.E., Weeke J., Orskov H., Henningsen P. The cardiovascular effects of octreotide treatment in acromegaly: an echocardiographic study. Clin. Endocrinol. (Oxf.) 1989, 30: 619–625.

    Article  CAS  Google Scholar 

  15. Pereira J., Rodriguez-Puras M.J., Leal-Cerro A. et al. Acromegalic cardiopathy improves after treatment with increasing doses of octreotide. J. Endocrinol. Invest. 1991, 14: 17–23.

    CAS  PubMed  Google Scholar 

  16. Lim M.J., Barkan A.L., Buda A.J. Rapid reduction of left ventricular hypertrophy in acromegaly after suppression of growth hormone hypersecretion. Ann. Intern. Med. 1992, 117: 719–726.

    Article  CAS  PubMed  Google Scholar 

  17. Merola B., Cittadini A., Colao A. et al. Chronic treatment with the somatostatin analog octreotide improves cardiac abnormalities in acromegaly. J. Clin. Endocrinol. Metab. 1993, 77: 790–793.

    CAS  PubMed  Google Scholar 

  18. Tokgözoglu S.L., Erbas T., Aytemir K., Akalin S., Kes S., Oram E. Effects of octreotide on left ventricular mass in acromegaly. Am. J. Cardiol. 1994, 74: 1072–1074.

    Article  PubMed  Google Scholar 

  19. Hradec J., Kral J., Janota T. et al. Regression of acromegalic left ventricular hypertrophy after lanreotide (a slow-release somatostatin analog). Am. J. Cardiol. 1999, 83: 1506–1509.

    Article  CAS  PubMed  Google Scholar 

  20. Baldelli R., Ferretti E., Jaffrain-Rea M.L. et al. Cardiac effects of lanreotide, a slow release somatostatin analog, in acromegalic patients. J. Clin. Endocrinol. Metab. 1999, 84: 527–532.

    CAS  PubMed  Google Scholar 

  21. Colao A., Marzullo P., Ferone D. et al. Cardiovascular effects of depot long-acting somatostatin analog Sandostatin LAR(r) in acromegaly. J. Clin. Endocrinol. Metab. 2000, 86: 3132–3140.

    Google Scholar 

  22. Colao A., Merola B., Ferone D., Lombardi G. Acromegaly. J. Clin. Endocrinol. Metab. 1997, 82: 2777–2781.

    Article  CAS  Google Scholar 

  23. Colao A., Lombardi G. Growth hormone and prolactin excess. Lancet 1998, 352: 1455–1461.

    Article  CAS  PubMed  Google Scholar 

  24. Giustina A., Barkan A., Casanueva F.F. et al. Criteria for cure of acromegaly: a consensus statement. J. Clin. Endocrinol. Metab. 2000, 85: 526–529.

    CAS  PubMed  Google Scholar 

  25. Sahn D.J., De Maria A., Kissio J., Weyman A. The committee on M-mode standardization of the American Society of Echocardiography. Recommendations regarding quantification in M-mode echocardiography: results of a survey of echocardiography measurements. Circulation 1978, 58: 1072–1083.

    Article  CAS  PubMed  Google Scholar 

  26. Colao A., Cuocolo A., Marzullo P. et al. Effects of one-year treatment with octreotide on cardiac performance in patients with acromegaly. J. Clin. Endocrinol. Metab. 1999, 84: 17–23.

    Article  CAS  PubMed  Google Scholar 

  27. Colao A., Cuocolo A., Marzullo P. et al. Is the acromegalic cardiomyopathy reversible? Effect of 5 year normalization of growth hormone and insulin-like growth factor-I levels on cardiac performance. J. Clin. Endocrinol. Metab. 2001, 86: 1551–1557.

    CAS  PubMed  Google Scholar 

  28. Haider A.W., Larson M.G., Benjamin E.S., Levy D. Increased left ventricular mass and hypertrophy are associated with increased risk for sudden death. J. Am. Coll. Cardiol. 1998, 32: 1454–1459.

    Article  CAS  PubMed  Google Scholar 

  29. Leong K.S., Mann P., Wallymahmed M., MacFarlane J.A., Wilding J.P. Abnormal heart rate variability in adults with growth hormone deficiency. J. Clin. Endocrinol. Metab. 2000, 85: 628–633.

    CAS  PubMed  Google Scholar 

  30. Bondanelli M., Ambrosio M.R., Franceschetti P., Margutti A., Trasforini G., Degli Uberti. Diurnal rhythm of plasma cathecolamines in acromegaly. J. Clin. Endocrinol. Metab. 1999, 84: 2458–2467.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Molecular and Clinical Endocrinology and Oncology, “Federico II” University, Naples, Italy

    Gaetano Lombardi, A. Colao, P. Marzullo, B. Biondi & S. Fazio

  2. Internal Medicine III, “Federico II” University, Naples, Italy

    E. Palmieri

  3. Dipartimento di Endocrinologia ed Oncologia Molecolare e Clinica, Università di Napoli “Federico II”, Via S. Pansini 5, 80131, Napoli, Italy

    Gaetano Lombardi

Authors
  1. Gaetano Lombardi
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  2. A. Colao
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  3. P. Marzullo
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  4. B. Biondi
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  5. E. Palmieri
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  6. S. Fazio
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Consortia

Multicenter Italian Study Group on Lanreotide

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Correspondence to Gaetano Lombardi.

Additional information

The Multicenter Italian Study on Lanreotide: V. Trischitta, C. Battista, S. Giovanni Rotondo (FG); R. Cozzi, M. Barausse, Milano; G. Faglia, M. Arosio, Milano; G. Giordano, M. Giusti, Genova; F. Mantero, G. Arnaldi, Ancona; E. Martino, M. Gasperi, Pisa; N. Sicolo, C. Martini, Padova; R. Valcavi, and M. Zini, Reggio Emilia, Italy

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Lombardi, G., Colao, A., Marzullo, P. et al. Improvement of left ventricular hypertrophy and arrhythmias after lanreotide-induced GH and IGF-I decrease in acromegaly. A prospective multi-center study. J Endocrinol Invest 25, 971–976 (2002). https://doi.org/10.1007/BF03344070

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