Skip to main content
SpringerLink
Log in

Cardiovascular Effects of a Single Slow Release Lanreotide Injection in Patients with Acromegaly and Left Ventricular Hypertrophy

  • Published:
Pituitary Aims and scope Submit manuscript

Abstract

In our study we assessed the effects of a single i.m. injection of slow-release Lanreotide (30 mg) (SR-L), a new long-acting somatostain analog, on circulating GH levels, baseline cardiac function (M-mode, 2D guided, doppler-echocardiographic study) and cardiopulmonary response to exercise (cycloergometric test, performed using a computer drived, electrically braked cycle ergometer), tested at baseline, after 7 and 14 days from the injection in 10 acromegalic patients (5 M, 5 F, mean age 57.7 ± 3.1 yrs, body mass index (BMI) 27 ± 0.8 kg/m2, blood pressure 141 ± 6.5/82 ± 3 mmHg). SR-L administration decreased GH levels in acromegalic patients (mean±SEM) from 16.1 ± 6.9 to 10.8 ± 5.1 µg/L (p = 0.045) after 7 days and to 11.9 ± 5 µg/L (p = 0.078) after 14 days from the injection. Moreover, we observed a significant (p<0.05) decrease in systolic blood pressure and heart rate at the 7th (135 ± 6.1 vs 141 ± 6.5 mmHg, and 68 ± 2.1 vs 74 ± 2.1 bpm) and 14th (137 ± 6.2 vs 141 ± 6.5 mmHg, and 72 ± 2 vs 74 ± 2.1 bpm) day of the study with respect to the baseline values. After SR-L administration we also found an increase in ejection fraction (69 ± 2 vs 63 ± 2.3% at 7th day, p = 0.006; 65 ± 2.3 vs 63 ± 2.3% at the 14th day, p = 0.027) and shortening fraction (40.8 ± 1.8 vs 36.6 ± 1.9% at 7th day, p = 0.005; 38.7 ± 1.8 vs 36.6 ± 1.9% at the 14th day, p = 0.045). The positive acute cardiac response to SR-L injection was also demonstrated by the increase in A/E velocity ratios at 7th (1.14 ± 0.1 vs 0.98 ± 0.07, p = 0.016) and 14th (1.04 ± 0.08 vs 0.98 ± 0.07, p = 0.008) day of the study. After SR-L injection, exercise capacity and VO2 at anaerobic thresold were also increased with respect to the baseline test: 61.1 ± 8.2 vs 38.9 ± 6.8 watts (p = 0.002) and 1012.4 ± 71.5 vs 915.3 ± 77.8 mL/min (p = 0.033) after 7 days, and 61.4 ± 7.2 vs 38.9 ± 6.8 watts (p = 0.002) and 1010.1 ± 62.5 vs 915.3 ± 77.8 mL/min (p = 0.010) after 14 days from the injection. In conclusion, these results suggest that in acromegalic patients: (1) SR-L causes a rapid improvement in baseline cardiac function and in cardiopulmonary performance during exercise in acromegaly; (2) the endocrine (decrease in GH levels) and echocardiographic responses to SR-L are maximal after 7 days from the injection, whereas the effect of SR-L on the exercise performance are longer lasting.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Melmed S. Acromegaly. N Engl J Med 1990;22:966–997.

    Google Scholar 

  2. Lim MJ, Barkan AL, Buda AJ. Rapid reduction of left ventricular hypertrophy in acromegaly after suppression of growth hormone hypersecretion. Ann Intern Med 1992; 117:719–726.

    Google Scholar 

  3. Martins JB, Kerber RE, Sherman BM, Marcus M L, Ehrardt JC. Cardiac size and functions in acromegaly. Circulation 1977;56:863–869.

    Google Scholar 

  4. Fazio S, Cittadini A, Sabatini D, Merola B, Colao AM, Biondi B, Lombardi G, Saccà L. Evidence for biventricular involvement in acromegaly: A Doppler echocardiographic study. Eur Heart J 1993;14:26–33.

    Google Scholar 

  5. Hayward RP, Emanuel RW, Nabarro JD. Acromegalic heart disease: Influence of the treatment of acromegaly on the heart. Q J Med 1987;237:41–58.

    Google Scholar 

  6. Bertoni PD, Morandi G. Impaired left ventricular diastolic function in acromegaly: An echocardiographic study. Acta Cardiol 1986;42:1–9.

    Google Scholar 

  7. Giustina A, Boni E, Romanelli G, Grassi V, Giustina G. Cardiopulmonary performance during exercise in acromegaly, and the effects of acute suppression of growth hormone hypersecretion with octreotide. Am J Cardiol 1995;75:1042–1047.

    Google Scholar 

  8. Vance ML, Harris AG. Long-term treatment of 189 acromegalic patients with the somatostatin analog octreotide. Arch Intern Med 1991;151:1573–1578.

    Google Scholar 

  9. Thuesen L, Christensen SE, Weeke J, Orskov H, Henningsen P. The cardiovascular effects of octreotide treatment in acromegaly: An echocardiographic study. Clin Endocrinol 1989;30:619–625.

    Google Scholar 

  10. Pereira JL, Rodriguez-Puras MJ, Leal-Cerro A, Martinez A, Garcia-Luna PP, Gavilan I, Pumar A, Astorga R. Acromegalic cardiopathy improves after treatment with increasing dose of octreotide. J Endocrinol Invest 1991;14:17–23.

    Google Scholar 

  11. Giustina A, Zaltieri G, Negrini F, Wehrenberg WB. The pharmacological aspects of the treatment of acromegaly. Pharmacol Res 1996;34:1–22.

    Google Scholar 

  12. Morange I, De Boisvilliers F, Chanson P, Lucas B, DeWailly D, Catus F, Thomas F, Jaquet P. Slow release lanreotide tretment in acromegalic patients previously normalized by octreotide. J Clin Endocrinol Metab 1994;79:145–151.

    Google Scholar 

  13. Kuhn JM, Legrand A, Ruiz JM, Obach R, De Ronzan J, Thomas F. Pharmacokinetic and pharmacodynamic properties of a long-acting formulation of the new somatostatin analogue, lanreotide, in normal healthy volunteers. Br J Clin Pharmac 1994;38:213–219.

    Google Scholar 

  14. Labovitz A, Pearson AC. Evaluation of left ventricular diastolic function: Clinical relevance and recent Doppler echocardiographic insights. Am Heart J 1987;114:836–851.

    Google Scholar 

  15. Sahn DJ, De Maria A, Kisslo J, Weyman A, the Committee on M-mode Standardization of Echocardiography. Recommendations regarding quantitation in M-mode echocardiography: Results of a survey of echocardiographic measurements. Circulation 1978;58:1072–1083.

    Google Scholar 

  16. Devereux RB, Reichek N. Echocardiographic determination of left ventricular mass in man-anatomical validation of the method. Circulation 1977;55:613–618.

    Google Scholar 

  17. Wilson J. Non invasive assessment of load reduction in patients with asymptomatic aortic regurgitation. Am J Med 1980;68:664–668.

    Google Scholar 

  18. Davis JA, Whipp BJ, Lamarra N, Huntsmann DJ, Frank NH, Wasserman K. Effect of ramp slope on measurement of aerobic parameters from the ramp exercise test. Med Sci Sports Exerc 1982;14:339–343.

    Google Scholar 

  19. McCuffin WL Jr, Sherman BM, Roth J, Gorden P, Kahn R, Roberts WC, Frommer PL. Acromegaly and cardiovascular disorders: A prospective study. Ann Intern Med 1974;81: 11–18.

    Google Scholar 

  20. Hirsh EZ, Sloman JG, Martin FI. Cardiac function in acromegaly. Am J Med Sci 1969;257:1–8.

    Google Scholar 

  21. Wasserman K. The anaerobic theshold: Definition, physiological significance and identification. Adv Cardiol 1986;35: 1–23.

    Google Scholar 

  22. Héron I, Thomas F, Dero M, Goscel A, Ruiz JM, Schantz B, Kuhn JM. Pharmacokinetics and efficacy of a long-acting formulation of the new somatostatin analog BIM 23014 in patients with acromegaly. J Clin Endocrinol Metab 1993; 76:721–727.

    Google Scholar 

  23. Christensen SE, Weeke J, Orskov H. Continuous subcutaneous pump infusion of somatostatin analogue SMS 201–995 versus subcutaneous injection schedule in acromegalic patients. Clin Endocrinol 1987;27:297–306.

    Google Scholar 

  24. Morange-Ramos PCI, Cogne M, Jaquet P. Three years follow-up of acromegalic patients treated with intramuscular slow-release lanreotide. J Clin Endocrinol Metab 1997;82: 18–22.

    Google Scholar 

  25. Padayatty SJ, Perrins EJ, Belchetz PE. Octreotide treatment increases exercise capacity in patients with acromegaly. Eur J Endocrinol 1996;134:554–559.

    Google Scholar 

  26. Yang R, Bunting S, Gillet N, Clark R, Jin H. Growth hormone improves cardiac perforance in experimental heart failure. Circulation 1995;92:262–267.

    Google Scholar 

  27. Volterrani M, Desenzani P, Lorusso R, D'Aloia A, Manelli F, Giustina A. Haemodynamic effects of intravenous growth hormone in congestive heart failure. Lancet 1997;349:1667–1668.

    Google Scholar 

  28. Giustina A, Lorusso R, Borghetti V, Bugari G, Misitano V, Alfieri O. Impaired spontaneous growth hormone secretion in severe dilated cardiomyopathy.AmHeart J 1996;131:620–622.

    Google Scholar 

  29. Lundergan C, Foegh ML, Vargas R, Eufemio M, Barnes GW, Kot P, Romwell P. Inhibition of myointimal proliferation of the rat carotid artery by peptides angiopeptin and BIM 23034. Atherosclerosis 1989;80:49–55.

    Google Scholar 

  30. Menozzi R, Del Rio G, Zaltieri G, Milani G, Velardo A, Papi G, Venneri MG, Maramma P. Symphathetic activity in acromegaly. Effect of acute octretide administration. J Endocrinol Invest 1997;20(Suppl. 4).

Download references

Author information

Authors and Affiliations

  1. Endocrinology, University of Brescia, Italy

    F. Manelli, P. Desenzani, F. Negrini & A. Giustina

  2. Internal Medicine, University of Brescia, Italy

    E. Boni & G. Romanelli

  3. Chemistry, University of Brescia, Italy

    G. Bugari & V. Grassi

Authors
  1. F. Manelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P. Desenzani
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. E. Boni
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. G. Bugari
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. F. Negrini
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. G. Romanelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. V. Grassi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. A. Giustina
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Manelli, F., Desenzani, P., Boni, E. et al. Cardiovascular Effects of a Single Slow Release Lanreotide Injection in Patients with Acromegaly and Left Ventricular Hypertrophy. Pituitary 2, 205–210 (1999). https://doi.org/10.1023/A:1009997011064

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1009997011064

Search

Navigation