Impact of successful transsphenoidal surgery on cardiovascular risk factors in acromegaly

Marie Lise Jaffrain-Rea, Giuseppe Minniti, Carlo Moroni, Vincenzo Esposito, Elisabetta Ferretti, Antonio Santoro, Tommaso Infusino, Guido Tamburrano, Giampaolo Cantore, Rosario Cassone

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Abstract

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.

Original languageEnglish
Pages (from-to)193-201
Number of pages9
JournalEuropean Journal of Endocrinology
Volume148
Issue number2
DOIs
Publication statusPublished - Feb 1 2003

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ASJC Scopus subject areas

  • Endocrinology

Cite this

Jaffrain-Rea, M. L., Minniti, G., Moroni, C., Esposito, V., Ferretti, E., Santoro, A., Infusino, T., Tamburrano, G., Cantore, G., & Cassone, R. (2003). Impact of successful transsphenoidal surgery on cardiovascular risk factors in acromegaly. European Journal of Endocrinology, 148(2), 193-201. https://doi.org/10.1530/eje.0.1480193