title: Octreotide improved ventricular arrhythmia in an acromegalic patient.
abstract: We saw a remarkable effect of octreotide, the long-acting somatostatin analogue, in reducing the number of ventricular premature complexes (VPCs) in a 59-year-old woman with acromegaly. Her basal GH and IGF-1 levels were up to 22.9 ng/ml and 934.9 ng/ml respectively. MRI revealed a 14 x 12 x 10 mm mass lesion in the pituitary gland. She had hypertension and echocardiography showed an increase in left ventricular wall thickness. Electric cardiography showed the presence of frequent VPCs and 24-h Holter monitoring revealed 24,277 beats of multifocal VPCs/24 h. She was treated with 300 microg/day of octreotide for four weeks before transsphenoidal surgery. After octreotide treatment, GH and IGF-1 were suppressed to 1.8 ng/ml and 145.3 ng/ml respectively, and the tumor size was remarkably reduced. Furthermore, the number of VPCs was also dramatically reduced to 2062 VPCs/24-h (8.5% of pretreatment) with 24-h Holter monitoring. This case shows that VPCs of acromegalic patients can be controlled by suppressing GH and IGF-1 with octreotide, and this agent is useful for reducing both tumor size and frequency of VPCs prior to surgery.
authors.affiliation: Second Department of Internal Medicine, Chiba University School of Medicine, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Suyama
authors.forename: D
authors.initials: D
authors.lastname: Uchida
authors.forename: T
authors.initials: T
authors.lastname: Tanaka
authors.forename: J
authors.initials: J
authors.lastname: Saito
authors.forename: Y
authors.initials: Y
authors.lastname: Noguchi
authors.forename: S
authors.initials: S
authors.lastname: Nakamura
authors.forename: I
authors.initials: I
authors.lastname: Tatsuno
authors.forename: Y
authors.initials: Y
authors.lastname: Saito
authors.forename: N
authors.initials: N
authors.lastname: Saeki
mesh_terms: D000172:Acromegaly / Q000097:blood / Q000150:complications* / Q000209:etiology; D000236:Adenoma / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D005117:Cardiac Complexes, Premature / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D006728:Hormones / Q000627:therapeutic use*; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use*; D010911:Pituitary Neoplasms / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery
chemical_list: D006728:Hormones; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D015282:Octreotide