title: Low frequency of cardniac arrhythmias and lack of structural heart disease in medically-naïve acromegaly patients: a prospective study at baseline and after 1 year of somatostatin analogs treatment.
abstract: BACKGROUND
  The incidence of arrhythmias may be increased in acromegaly, but the pathophysiologic mechanisms involved are still unclear, and it has never been correlated with structural heart changes analyzed by the gold-standard method cardiac magnetic resonance (CMR).
  
  
  OBJECTIVE
  Evaluate the frequency of arrhythmias in drug-naïve acromegaly patients at baseline and after 1 year of somatostatin analogs (SA) treatment and to correlate the occurrence of arrhythmias with the presence of structural heart changes.
  
  
  METHODS
  Consecutive drug-naïve acromegaly patients were recruited. The occurrence of arrhythmias and structural heart changes were studied through 24-h Holter and CMR, respectively, at baseline and after 1-year SA treatment.
  
  
  RESULTS
  Thirty-six patients were studied at baseline and 28 were re-evaluated after 1 year of SA treatment. There were 13 females and median age was 48 years (20-73 years). Nine patients (32 %) were controlled after treatment. No sustained arrhythmias were reported in the 24-h Holter. No arrhythmia-related symptoms were observed. Only two patients presented left ventricular hypertrophy and three patients presented fibrosis at baseline. There was no correlation of the left ventricular mass with the number of episodes of arrhythmias and they were not more prevalent in the patients presenting cardiac fibrosis.
  
  
  CONCLUSIONS
  We found no sustained arrhythmias and a lack of arrhythmia-related symptoms at baseline and after 1 year of SA treatment in a contemporary cohort of acromegaly patients that also present a low frequency of structural heart changes, indicating that these patients may have a lower frequency of heart disease than previously reported.
authors: Neuroendocrinology Research Center - Endocrine Section, Medical School and Hospital Universitário Clementino Fraga Filho - Universidade Federal do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 255, sala 9F, Ilha do Fundão, Rio de Janeiro, 21941-913, Brazil.|Endocrine Unit, Instituto Estadual de Diabetes e Endocrinologia Luiz Capriglione (IEDE), Rio de Janeiro, Brazil.
authors: Leila
authors: L
authors: Warszawski
authors: Neuroendocrinology Research Center - Endocrine Section, Medical School and Hospital Universitário Clementino Fraga Filho - Universidade Federal do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 255, sala 9F, Ilha do Fundão, Rio de Janeiro, 21941-913, Brazil.|Neuroendocrine Section - Instituto Estadual do Cérebro Paulo Niemeyer, Secretaria Estadual de Saúde do Rio de Janeiro, Rio de Janeiro, Brazil.|Endocrine Unit, Hospital Federal de Bonsucesso, Rio de Janeiro, Brazil.
authors: Leandro
authors: L
authors: Kasuki
authors: Cardiology Section, Medical School and Hospital Universitário Clementino Fraga Filho - Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors: Rodrigo
authors: R
authors: Sá
authors: Neuroendocrinology Research Center - Endocrine Section, Medical School and Hospital Universitário Clementino Fraga Filho - Universidade Federal do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 255, sala 9F, Ilha do Fundão, Rio de Janeiro, 21941-913, Brazil.
authors: Cintia Marques
authors: CM
authors: Dos Santos Silva
authors: Cardiology Section, Medical School and Hospital Universitário Clementino Fraga Filho - Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors: Isabela
authors: I
authors: Volschan
authors: Clínica de Diagnóstico por Imagem/Multi-Imagem, Rio de Janeiro, Brazil.|Radiology Department, Casa de Saúde São Jose, Rio de Janeiro, Brazil.
authors: Ilan
authors: I
authors: Gottlieb
authors: Cardiology Section, Medical School and Hospital Universitário Clementino Fraga Filho - Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors: Roberto Coury
authors: RC
authors: Pedrosa
authors: Neuroendocrinology Research Center - Endocrine Section, Medical School and Hospital Universitário Clementino Fraga Filho - Universidade Federal do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 255, sala 9F, Ilha do Fundão, Rio de Janeiro, 21941-913, Brazil. mgadelha@hucff.ufrj.br.|Neuroendocrine Section - Instituto Estadual do Cérebro Paulo Niemeyer, Secretaria Estadual de Saúde do Rio de Janeiro, Rio de Janeiro, Brazil. mgadelha@hucff.ufrj.br.
authors: Mônica R
authors: MR
authors: Gadelha
mesh_terms: D000172:Acromegaly / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D001938:Brazil / Q000453:epidemiology; D015716:Electrocardiography, Ambulatory; D005260:Female; D005355:Fibrosis; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013004:Somatostatin / Q000031:analogs & derivatives / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D013004:Somatostatin
keywords: Acromegaly; Cardiac arrhythmia; Cardiac magnetic resonance imaging; Somatostatin analogs