Marked improvement in cardiovascular function after successful transsphenoidal surgery in acromegalic patients.
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.


METHODS
An open prospective study.


METHODS
Thirty newly diagnosed acromegalic patients undergoing transsphenoidal surgery.


METHODS
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/m2; 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.
Minniti
G
G
Neuromed, IRCCS (Pozzilli), Rome, Italy.
Moroni
C
C
Jaffrain-Rea
M L
ML
Esposito
V
V
Santoro
A
A
Affricano
C
C
Cantore
G
G
Tamburrano
G
G
Cassone
R
R
D000172:Acromegaly / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery*; D000236:Adenoma / Q000601:surgery; D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D018660:Blood Pressure Monitoring, Ambulatory; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000473:pathology; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000601:surgery; D011184:Postoperative Period; D011446:Prospective Studies; D016896:Treatment Outcome