Cardiovascular effects of depot long-acting somatostatin analog sandostatin LAR in acromegaly

Annamaria Colao, Paolo Marzullo, Diego Ferone, Letizia Spinelli, Alberto Cuocolo, Domenico Bonaduce, Marco Salvatore, Viktor Boerlin, Ioana Lancranjan, Gaetano Lombardi

Research output: Contribution to journalArticle

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Abstract

Cardiovascular disease is the most severe complication of acromegaly accounting for the increased mortality of these patients. Recently, the slow-release form of octreotide (OCT; Sandostatin LAR, OCT-LAR), for im injection every 28 days, was reported to induce suppression of GH levels below 7.5 mU/L (2.5 μg/L) in 39-75% of patients, and normalization of insulin-like growth factor (IGF)-I levels for age in 64-88% of patients, with an excellent patients' compliance. The aim of the present study was to investigate the early effect of OCT-LAR treatment on the left ventricular (LV) structure and performance in 15 somatostatin analog-naive patients with acromegaly (GH, 94.8 ± 24.9 mU/L; IGF-I, 757.9 ± 66.6 μg/L), focusing on the early effect of GH and IGF-I suppression on the heart. Cardiac structure was investigated by echocardiography, whereas LV performance was investigated by gated-blood-pool scintigraphy, before and after 3 and 6 months of treatment with OCT-LAR. OCT-LAR was initially administered im, at a dose of 20 mg every 28 days, for 3 months. In six patients, the dose was then increased to 30 mg every 28 days to achieve disease control, which was considered when fasting and/or glucose-suppressed GH values were below 7.5 and 3.0 mU/L, respectively, together with IGF-I values within the normal range for age. The treatment with OCT-LAR for 6 months induced a significant decrease of GH (to 12.9 ± 3.0 mU/L) and IGF-I levels (to 340.3 ± 40.2 μg/L) in all 15 patients. After 6 months of treatment, the percent IGF-I suppression was 52.8 ± 4.4%, and serum GH/IGF-I levels were normalized in 9 patients. A significant decrease of LV mass index (LVMi), interventricular septum thickness, and LV posterior wall thickness was observed in all 15 patients after 3 and 6 months of OCT-LAR treatment: LVMi was decreased by 19.1 ± 2.0% without any difference in patients with (19.9 ± 2.7%) or without disease control (17.8 ± 3.3%). Among the 11 patients with LV hypertrophy, 6 normalized their LVMi after treatment. At study entry, an inadequate LV ejection fraction (LVEF) at rest (

Original languageEnglish
Pages (from-to)3132-3140
Number of pages9
JournalJournal of Clinical Endocrinology and Metabolism
Volume85
Issue number9
Publication statusPublished - 2000

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Acromegaly
Octreotide
Somatostatin
Insulin-Like Growth Factor I
Disease control
Echocardiography
Therapeutics
Gated Blood-Pool Imaging
Blood
Left Ventricular Hypertrophy
Patient Compliance
Stroke Volume
Glucose
Fasting
Reference Values
Cardiovascular Diseases
Injections

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology, Diabetes and Metabolism

Cite this

Cardiovascular effects of depot long-acting somatostatin analog sandostatin LAR in acromegaly. / Colao, Annamaria; Marzullo, Paolo; Ferone, Diego; Spinelli, Letizia; Cuocolo, Alberto; Bonaduce, Domenico; Salvatore, Marco; Boerlin, Viktor; Lancranjan, Ioana; Lombardi, Gaetano.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 85, No. 9, 2000, p. 3132-3140.

Research output: Contribution to journalArticle

Colao, A, Marzullo, P, Ferone, D, Spinelli, L, Cuocolo, A, Bonaduce, D, Salvatore, M, Boerlin, V, Lancranjan, I & Lombardi, G 2000, 'Cardiovascular effects of depot long-acting somatostatin analog sandostatin LAR in acromegaly', Journal of Clinical Endocrinology and Metabolism, vol. 85, no. 9, pp. 3132-3140.
Colao, Annamaria ; Marzullo, Paolo ; Ferone, Diego ; Spinelli, Letizia ; Cuocolo, Alberto ; Bonaduce, Domenico ; Salvatore, Marco ; Boerlin, Viktor ; Lancranjan, Ioana ; Lombardi, Gaetano. / Cardiovascular effects of depot long-acting somatostatin analog sandostatin LAR in acromegaly. In: Journal of Clinical Endocrinology and Metabolism. 2000 ; Vol. 85, No. 9. pp. 3132-3140.
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AU - Cuocolo, Alberto

AU - Bonaduce, Domenico

AU - Salvatore, Marco

AU - Boerlin, Viktor

AU - Lancranjan, Ioana

AU - Lombardi, Gaetano

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