title: Cardiovascular comorbidities in acromegaly: an update on their diagnosis and management.
abstract: Comorbidities related to the cardiovascular system are one of the most prevalent in patients with acromegaly, and contribute to an increased risk of morbidity and all-cause mortality. Specifically, hypertension, cardiomyopathy, heart valve disease, arrhythmias, atherosclerosis, coronary artery disease, and cardiac dysfunction may be frequent findings. Although the underlying physiopathology for each comorbidity may not be fully elucidated, uncontrolled growth hormone/insulin-like growth factor 1 excess, age, prolonged disease duration, and coexistence of other cardio-vascular risk factors are significant influencing variables. A simple diagnostic approach to screen for the presence of these comorbidities may allow prompt treatment and arrest the progression of cardiac abnormalities. In this article, we revise the most prevalent cardiovascular comorbidities and their pathophysiology in acromegalic patients, and we address some recommendations for their prompt diagnosis, management and treatment. Strengths and pitfalls of different diagnostic techniques that are currently being used and how different treatments can affect these complications will be further discussed.
authors.affiliation: Department of Endocrinology, Hospital Universitario La Princesa, Instituto de Investigación Princesa, Universidad Autónoma, Madrid, Spain.
authors.forename: Ana M
authors.initials: AM
authors.lastname: Ramos-Leví
authors.affiliation: Department of Endocrinology, Hospital Universitario La Princesa, Instituto de Investigación Princesa, Universidad Autónoma, Madrid, Spain. monica.marazuela@salud.madrid.org.
authors.forename: Mónica
authors.initials: M
authors.lastname: Marazuela
mesh_terms: D000172:Acromegaly / Q000097:blood / Q000150:complications*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D019468:Disease Management; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D012307:Risk Factors
chemical_list: D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I
keywords: acromegalic cardiomyopathy; acromegaly; acromegaly cardiovascular comorbidities; hypertension; pegvisomant; radiotherapy; somatostatin analogs; valve disease