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Marked improvement in cardiovascular function after successful transsphenoidal surgery in acromegalic patients
Author(s) -
Minniti Giuseppe,
Moroni Carlo,
JaffrainRea MarieLise,
Esposito Vincenzo,
Santoro Antonio,
Affricano Cesare,
Cantore Giampaolo,
Tamburrano Guido,
Cassone Rosario
Publication year - 2001
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1046/j.1365-2265.2001.01343.x
Subject(s) - acromegaly , medicine , transsphenoidal surgery , diastole , blood pressure , prospective cohort study , ambulatory , cardiology , isovolumic relaxation time , endocrinology , ejection fraction , ambulatory blood pressure , doppler echocardiography , urology , heart failure , adenoma , pituitary adenoma , growth hormone , hormone
OBJECTIVE Transsphenoidal surgery results in biochemical remission of acromegaly in 45–80% of patients; however, few studies have addressed the impact of transsphenoidal surgery on cardiovascular function in acromegalic patients. The aim of this prospective study was to investigate the effects of postoperative GH/IGF‐I normalization on echocardiographic parameters and blood pressure (BP) in a series of patients with active acromegaly. DESIGN An open prospective study. PATIENTS Thirty newly diagnosed acromegalic patients undergoing transsphenoidal surgery. MEASUREMENTS Doppler echocardiography and 24‐h ambulatory blood pressure monitoring were performed before and 6 months after transsphenoidal surgery. RESULTS Fifteen patients were considered to be well controlled postoperatively (group A), as defined by normal age‐corrected IGF‐I levels and glucose‐suppressed GH levels less than 2 mU/l, the remaining 15 patients being considered as poorly controlled (group B). In group A, a postoperative decrease of left ventricular mass index was observed (104·4 ± 6·6 vs. 127·1 ± 7·7 g/m 2 ; P < 0·001), associated with an improvement of some indices of diastolic function, such as an increase of the early/late transmitral peak flow velocity ( P < 0·05) and a decrease of isovolumic relaxation time ( P < 0·01). No significant change was observed in group B. A significant decrease of 24‐h systolic BP was also observed in group A ( P < 0·05) and five of six patients normalized their BP circadian rythm. In contrast, a nonsignificant increase in BP values, with a persistent blunted BP profile where present, was observed in group B. CONCLUSIONS We conclude that successful transsphenoidal surgery is able to induce a significant improvement in some cardiac parameters and a slight reduction in systolic blood pressure in acromegalic patients.