Renin-Angiotensin System Blockade Improves Cardiac Indices in Acromegaly Patients.
Blockade of the angiotensin-renin system, with angiotensin converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARBs), has been shown to improve cardiac outcomes following myocardial infarction and delay progression of heart failure. Acromegaly is associated with a disease-specific cardiomyopathy, the pathogenesis of which is poorly understood.The cardiac indices of patients with active acromegaly with no hypertension (Group A, n=4), established hypertension not taking ACEi/ARBs (Group B, n=4) and established hypertension taking ACEi/ARBs (Group C, n=4) were compared using cardiac magnetic imaging.Patients taking ACEi/ARBs had lower end diastolic volume index (EDVi) and end systolic volume index (ESVi) than the other 2 groups ([C] 73.24 vs. [A] 97.92 vs. [B] 101.03 ml/m2, ANOVA p=0.034, B vs. C p<0.01). Groups A and B had EDVi and ESVi values at the top of published reference range values; Group C had values in the middle of the range.Acromegaly patients on ACEi/ARBs for hypertension demonstrate improved cardiac indices compared to acromegaly patients with hypertension not taking these medications. Further studies are needed to determine if these drugs have a beneficial cardiac effect in acromegaly in the absence of demonstrable hypertension.
Centre for Endocrinology, WHRI, Barts & the London School of Medicine and Dentistry, Queen Mary University of London.
Julia D J
JDJ
Thomas
Centre for Endocrinology, WHRI, Barts & the London School of Medicine and Dentistry, Queen Mary University of London.|NIHR Cardiovascular Biomedical Research Unit, St Bartholomew's Hospital, London.
Abhishek
A
Dattani
NIHR Cardiovascular Biomedical Research Unit, St Bartholomew's Hospital, London.
Filip
F
Zemrak
NIHR Cardiovascular Biomedical Research Unit, St Bartholomew's Hospital, London.
Thomas
T
Burchell
Department of Endocrinology, St Bartholomew's Hospital, London.
Scott A
SA
Akker
Department of Endocrinology, Lister Hospital, Stevenage, Herts.
Felicity J L
FJL
Kaplan
Department of Endocrinology, Royal Free Campus, UCL Medical School, London.
Bernard
B
Khoo
Department of Endocrinology, King's College Hospital, London.
Simon
S
Aylwin
Oxford Centre for Endocrinology, Diabetes and Metabolism, University of Oxford.
Ashley B
AB
Grossman
NIHR Cardiovascular Biomedical Research Unit, St Bartholomew's Hospital, London.
L Ceri
LC
Davies
Centre for Endocrinology, WHRI, Barts & the London School of Medicine and Dentistry, Queen Mary University of London.
Márta
M
Korbonits
D000172:Acromegaly / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology; D000328:Adult; D000368:Aged; D057911:Angiotensin Receptor Antagonists / Q000008:administration & dosage*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage*; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012084:Renin-Angiotensin System / Q000187:drug effects*
D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors