Normalisation of plasma growth hormone levels improved cardiac dysfunction due to acromegalic cardiomyopathy with severe fibrosis.
A 51-year-old man was referred to the Department of Cardiology in our hospital due to severe congestive heart failure and ventricular arrhythmias in March 2008. He had repeated ventricular tachycardia for years and the left ventricular ejection fraction (EF) was 11% on admission. A myocardial biopsy revealed that over 50% cardiomyocytes were replaced by fibrosis. Due to the typical acromegalic features, he was referred to the endocrinology department and diagnosed as acromegaly. He was treated with octreotide for 8 months followed by trans-sphenoidal surgery. The plasma levels of growth hormone (GH) and insulin-like growth factor-1 (IGF-1) decreased by octreotide and normalised by surgery after which the cardiac function improved drastically. The current case demonstrates that cardiac dysfunction in acromegaly could be recovered by normalisation of GH and IGF-1 even in the presence of severe fibrosis in the myocardium.
Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Fumiko
F
Yokota
Hiroshi
H
Arima
Miho
M
Hirano
Tomohiro
T
Uchikawa
Yasuya
Y
Inden
Tetsuya
T
Nagatani
Yutaka
Y
Oiso
D000172:Acromegaly / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D000236:Adenoma / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D009202:Cardiomyopathies / Q000097:blood / Q000209:etiology* / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D005355:Fibrosis; D049912:Growth Hormone-Secreting Pituitary Adenoma / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D006333:Heart Failure / Q000097:blood / Q000209:etiology* / Q000473:pathology; D019382:Human Growth Hormone / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use; D010902:Pituitary Gland / Q000601:surgery
D018931:Antineoplastic Agents, Hormonal; D015415:Biomarkers; D019382:Human Growth Hormone; D015282:Octreotide