A case and review of acromegaly-induced cardiomyopathy and the relationship between growth hormone and heart failure: cause or cure or neither or both?
Growth hormone plays an integral role in the development and maintenance of structure and function of the heart. Specific involvement of the heart in acromegaly is termed acromegalic cardiomyopathy, manifested as concentric left ventricular hypertrophy and diastolic dys-function. Left untreated, it ultimately progresses to systolic heart failure. Heart failure from acromegalic cardiomyopathy is one of the most common causes of death in acromegaly. Current treatment options include different approaches to lower elevated growth hormone levels with improvement in symptoms, exercise tolerance, and echocardiographic improvement in regression of left ventricular hypertrophy and indices of diastolic dysfunction. On the other hand, growth hormone is essential for cardiac growth and function and exerts beneficial and protective effects on the cardiovascular system. Its potential role as adjunctive therapy in the treatment of heart failure as derived from experimental studies and clinical trials is discussed.
Schwarz
Ernst R
ER
Division of Cardiology, Department of Medicine, Cedars Sinai Medical Center, Los Angeles, California 90048, USA. ernst.schwarz@cshs.org
Jammula
Praveen
P
Gupta
Rajiv
R
Rosanio
Salvatore
S
D000172:Acromegaly / Q000097:blood / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D000236:Adenoma / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D000818:Animals; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D002303:Cardiac Output, Low / Q000097:blood / Q000209:etiology*; D006332:Cardiomegaly / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology*; D002319:Cardiovascular System / Q000187:drug effects / Q000378:metabolism; D018450:Disease Progression; D054439:Ghrelin; D013007:Growth Hormone-Releasing Hormone / Q000378:metabolism; D049912:Growth Hormone-Secreting Pituitary Adenoma / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D019382:Human Growth Hormone / Q000097:blood* / Q000172:deficiency / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use; D036361:Peptide Hormones / Q000494:pharmacology / Q000627:therapeutic use; D014463:Ultrasonography
D018931:Antineoplastic Agents, Hormonal; D054439:Ghrelin; D036361:Peptide Hormones; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D013007:Growth Hormone-Releasing Hormone; D015282:Octreotide