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.
Similar content being viewed by others
References
Saccà L., Cittadini A., Fazio S. Growth hormone and the heart. Endocr. Rev. 1994, 15: 555–573.
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.
Colao A., Marzullo P., Di Somma C., Lombardi G. Growth hormone and the heart. Clin. Endocrinol. (Oxf.) 2001, 54: 137–154.
Fazio S., Cittadini A., Biondi B. et al. Cardiovascular effects of short-term growth hormone hypersecretion. J. Clin. Endocrinol. Metab. 2000, 85: 179–182.
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.
Morvan D., Komajda M., Grimaldi A., Turpin G., Grosgogeat Y. Cardiac hypertrophy and function in asymptomatic acromegaly. Eur. Heart J. 1991, 12: 666–672.
Kahaly G., Olshausen K.V., Mohr-Kahaly S. et al. Arrhythmia profile in acromegaly. Eur. Heart J. 1992, 13: 51–56.
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.
Sicolo N., Bui F., Sicolo M. et al. Acromegalic cardiopathy: a left ventricular scintigraphic study. J. Endocrinol. Invest. 1993, 16: 123–127.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Colao A., Merola B., Ferone D., Lombardi G. Acromegaly. J. Clin. Endocrinol. Metab. 1997, 82: 2777–2781.
Colao A., Lombardi G. Growth hormone and prolactin excess. Lancet 1998, 352: 1455–1461.
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.
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.
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.
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.
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.
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.
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.
Author information
Authors and Affiliations
Consortia
Corresponding author
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
Rights and permissions
About this article
Cite this article
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
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03344070