RESUMO
BACKGROUND: The patients with acromegaly have an increased propensity to develop cardiovascular complications. The aim of this study was to evaluate the most relevant clinic, echocardiographic and Holter recording findings in acromegaly and its correlation with the growth hormone (GH) levels and duration of the disease. PATIENTS AND METHODS: 27 patients with acromegaly were evaluated. The basal levels of GH and insulin-like growth factor 1 (IGF-1) were measured at the time of cardiological study and compared with the spontaneous GH secretion during 12-24 hours previously studied. Echocardiogram was made using complete M-mode, two dimensional and spectral Doppler ultrasound mechanical system. Additionally an standard EKG and a Holter recording were performed during 24 hours. RESULTS: There was a strong correlation between basal levels of GH and integrated concentration of GH during the study of spontaneous secretion (r = 0.92; p < 0.01). The prevalence of symptomatic cardiovascular complications in this study was 49%, including 3 patients who died for cardiovascular events. The echocardiographic study showed a high prevalence of left ventricular hypertrophy (66.7%), diastolic dysfunction (63%) and impaired systolic function (18.5%). There was no correlation between GH and IGF-1 levels and echocardiographic findings. Conversely the degree of hypertrophy was related to the duration of the disease and the presence of arterial hypertension. The diastolic function only was related with the presence of hypertension. We found supraventricular arrhythmic events and malignant premature ventricular complexes in 6 and 6 patients, respectively. The EKG showed a high fiability to detect ventricular hypertrophy but no rhythm events. CONCLUSIONS: The high prevalence of cardiovascular complications in acromegaly, most of them asymptomatic, and its clinical relevance, advise the necessity to perform systematic cardiovascular evaluation in these patients.
