International Clinical Neuroscience Journal

Vol. 7 No. 1 (2020)

The Therapeutic Effect of Endoscopic Tumor Resection on Acromegalic Cardiomegaly in Patients With Pituitary Adenoma

International Clinical Neuroscience Journal, Vol. 7 No. 1 (2020), 23 December 2019 , Page 31-34

Abstract

Background: Acromegaly defines as chronic elevations of insulin-like growth factor-1 (IGF-1) and growth hormone (GH), which results in enlargement of organs and soft tissues. Cardiovascular complications of acromegaly such as cardiomegaly, hypertension contributing to a high risk of cardiovascular events. This study aimed to identify the determinants of the prevalence of cardiomegaly as cardiovascular comorbidity of acromegaly and the potential effect of the curative intervention.
Methods: A total of 160 patients with acromegaly due to pituitary adenoma participated in this study. Acromegaly diagnosed was based on clinical manifestations, age-adjusted plasma IGF-I, and elevated plasma GH levels, not suppressible during an oral glucose tolerance test (75 g). Electrocardiogram and chest X-ray obtained in all patients. Treatment approaches included transsphenoidal surgery and hormonal evaluation performed before and six months after surgery.
Results: The GH serum level was elevated in all patients before surgery, with a mean of 33.7 ng/mL that reached 5.7 ng/mL after surgery. Mean IGF-1 was 794.1 ng/mL that reached 395.6 ng/mL postoperatively. The prevalence of cardiomegaly was 15% that improved in 5% of patients after trans sphenoidal surgery.
Conclusion: Appropriate surgical intervention in acromegaly that complicated by cardiomegaly may result in significant improvement of the cardiac structure.

Keywords:
  • Acromegaly
  • pituitary adenoma
  • Transsphenoidal surgery
  • Cardiomegaly.

How to Cite

1.
Ebrahimzadeh K, Mojtabavi K, Mohammadi S, Farahani M, Gholizadeh Ghozloujeh Z, Asaadi S, Sharifi G, Joshaghanian MA, Rezaei O. The Therapeutic Effect of Endoscopic Tumor Resection on Acromegalic Cardiomegaly in Patients With Pituitary Adenoma. Int Clin Neurosci J [Internet]. 2019 Dec. 23 [cited 2025 Jul. 10];7(1):31-4. Available from: https://journals.sbmu.ac.ir/neuroscience/article/view/27303

References

Bedogni G, Giannone G, Maghnie M, Giacomozzi C, Di Iorgi N, Pedicelli S, et al. Serum insulin-like growth factor-I (IGF-I) reference ranges for chemiluminescence assay in childhood and adolescence. Data from a population of in- and out-patients. Growth Horm IGF Res. 2012;22(3-4):134-8. doi: 10.1016/j.ghir.2012.04.005.

Berg C, Petersenn S, Lahner H, Herrmann BL, Buchfelder M, Droste M, et al. Cardiovascular risk factors in patients with uncontrolled and long-term acromegaly: comparison with matched data from the general population and the effect of disease control. J Clin Endocrinol Metab. 2010;95(8):3648- 56. doi: 10.1210/jc.2009-2570.

Colao A, Ferone D, Marzullo P, Lombardi G. Systemic complications of acromegaly: epidemiology, pathogenesis, and management. Endocr Rev. 2004;25(1):102-52. doi: 10.1210/er.2002-0022.

Mosca S, Paolillo S, Colao A, Bossone E, Cittadini A, Iudice FL, et al. Cardiovascular involvement in patients affected by acromegaly: an appraisal. Int J Cardiol. 2013;167(5):1712-8. doi: 10.1016/j.ijcard.2012.11.109.

Colao A, Ferone D, Marzullo P, Lombardi G. Systemic complications of acromegaly: epidemiology, pathogenesis, and management. Endocr Rev. 2004;25(1):102-52. doi: 10.1210/er.2002-0022.

Jaffrain-Rea ML, Minniti G, Moroni C, Esposito V, Ferretti E, Santoro A, et al. Impact of successful transsphenoidal surgery on cardiovascular risk factors in acromegaly. Eur J Endocrinol. 2003;148(2):193-201. doi: 10.1530/eje.0.1480193.

Annamalai AK, Webb A, Kandasamy N, Elkhawad M, Moir S, Khan F, et al. A comprehensive study of clinical, biochemical, radiological, vascular, cardiac, and sleep parameters in an unselected cohort of patients with acromegaly undergoing presurgical somatostatin receptor ligand therapy. J Clin Endocrinol Metab. 2013;98(3):1040-50. doi: 10.1210/ jc.2012-3072.

Minniti G, Moroni C, Jaffrain-Rea ML, Esposito V, Santoro A, Affricano C, et al. Marked improvement in cardiovascular function after successful transsphenoidal surgery in acromegalic patients. Clin Endocrinol (Oxf). 2001;55(3):307- 13. doi: 10.1046/j.1365-2265.2001.01343.x.

Reyes-Vidal C, Fernandez JC, Bruce JN, Crisman C, Conwell IM, Kostadinov J, et al. Prospective study of surgical treatment of acromegaly: effects on ghrelin, weight, adiposity, and markers of CV risk. J Clin Endocrinol Metab. 2014;99(11):4124-32. doi: 10.1210/jc.2014-2259.

Sarkar S, Rajaratnam S, Chacko G, Chacko AG. Endocrinological outcomes following endoscopic and microscopic transsphenoidal surgery in 113 patients with acromegaly. Clin Neurol Neurosurg. 2014;126:190-5. doi: 10.1016/j.clineuro.2014.09.004.

Chanson P, Raverot G, Castinetti F, Cortet-Rudelli C, Galland F, Salenave S. Management of clinically non-functioning pituitary adenoma. Ann Endocrinol (Paris). 2015;76(3):239- 47. doi: 10.1016/j.ando.2015.04.002.

Carmichael JD, Broder MS, Cherepanov D, Chang E, Mamelak A, Said Q, et al. The association between biochemical control and cardiovascular risk factors in acromegaly. BMC Endocr Disord. 2017;17(1):15. doi: 10.1186/s12902-017-0166-6.

Mendoza E, Malong CL, Tanchee-Ngo MJ, Mercado-Asis L. Acromegaly with cardiomyopathy, cardiac thrombus and hemorrhagic cerebral infarct: a case report of therapeutic dilemma with review of literature. Int J Endocrinol Metab. 2015;13(2):e18841. doi: 10.5812/ijem.18841.

Kiseljak-Vassiliades K, Carlson NE, Borges MT, Kleinschmidt- DeMasters BK, Lillehei KO, Kerr JM, et al. Growth hormone tumor histological subtypes predict response to surgical and medical therapy. Endocrine. 2015;49(1):231-41. doi: 10.1007/s12020-014-0383-y.

van Varsseveld NC, van Bunderen CC, Franken AA, Koppeschaar HP, van der Lely AJ, Drent ML. Fractures in pituitary adenoma patients from the Dutch National Registry of Growth Hormone Treatment in Adults. Pituitary. 2016;19(4):381-90. doi: 10.1007/s11102-016-0716-3.

Kopchick JJ, List EO, Kelder B, Gosney ES, Berryman DE. Evaluation of growth hormone (GH) action in mice: discovery of GH receptor antagonists and clinical indications. Mol Cell Endocrinol. 2014;386(1-2):34-45. doi: 10.1016/j. mce.2013.09.004.

Beckers A, Aaltonen LA, Daly AF, Karhu A. Familial isolated pituitary adenomas (FIPA) and the pituitary adenoma predisposition due to mutations in the aryl hydrocarbon receptor interacting protein (AIP) gene. Endocr Rev. 2013;34(2):239-77. doi: 10.1210/er.2012-1013.

Oki Y. Medical management of functioning pituitary adenoma: an update. Neurol Med Chir (Tokyo). 2014;54(12):958-65.

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