title: Congestive heart failure in acromegaly: A review of 6 cases.
abstract: BACKGROUND
  Though cardiac involvement is common in acromegaly, overt congestive heart failure is uncommon.
  
  
  METHODS
  This is retrospective analysis of hospital record between 1996 and 2007. We analyzed records of 150 consecutive patients with acromegaly. We included the patients with acromegaly those who had overt congestive heart failure either at presentation or during the course of illness for the present analysis. The diagnosis of acromegaly and congestive cardiac failure were based on standard criteria.
  
  
  RESULTS
  Out of 150 patients with acromegaly, 6 patients had overt CHF (4.0%), of which 4 presented with the features of CHF and 2 developed during the course of illness. Three patients had hypertension and 1 had diabetes. Baseline echocardiography showed severe biventricular dysfunction and global hypokinesia in all. Angiography showed dilated hypokinetic left ventricle with normal coronaries in 3, it was confirmed at autopsy in 1. Three underwent trans-sphenoidal surgery, 1 received somatostatin analogue as primary treatment modality. Normalization of growth hormone and IGF-1 led to improvement in cardiac function in 1, 1 patient lost to follow up, and 4 died during the course of illness. In 1 patient, autopsy was performed and cardiac specimen revealed normal coronaries, concentric ventricular hypertrophy, and dilatation with myofibrolysis and interfascicular fibrosis.
  
  
  CONCLUSIONS
  Prevalence of overt CHF is 4% in present series. Overt CHF carries poor prognosis and hence, this complication should be recognized at earliest, and medical management to normalized cardiac function should be given utmost priority.
authors.affiliation: Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: P
authors.initials: P
authors.lastname: Dutta
authors.forename: S
authors.initials: S
authors.lastname: Das
authors.forename: A
authors.initials: A
authors.lastname: Bhansali
authors.forename: S K
authors.initials: SK
authors.lastname: Bhadada
authors.forename: B V
authors.initials: BV
authors.lastname: Rajesh
authors.forename: K S
authors.initials: KS
authors.lastname: Reddy
authors.forename: K
authors.initials: K
authors.lastname: Vaiphei
authors.forename: K K
authors.initials: KK
authors.lastname: Mukherjee
authors.forename: A
authors.initials: A
authors.lastname: Pathak
authors.forename: V N
authors.initials: VN
authors.lastname: Shah