Lombardi Gaetano, Galdiero Mariano, Auriemma Renata S, Pivonello Rosario, Colao Annamaria
Department of Molecular and Clinical Endocrinology and Oncology, Federico II University of Naples, Naples, Italy.
Neuroendocrinology. 2006;83(3-4):211-7. doi: 10.1159/000095530.
Acromegaly is characterized by an increased cardiovascular morbidity and mortality. In fact, growth hormone and insulin-like growth factor-I excess induces a specific cardiomyopathy. The heart is involved from the very early stages of the disease in which the hyperkinetic syndrome (high heart rate and increased systolic output) takes place. Frequently, if the disease is untreated for many years or unsuccessfully treated, concentric biventricular hypertrophy and diastolic dysfunction can develop and, at least, lead to diastolic congestive heart failure. Rhythm disturbances and valve dysfunction are also frequently described in acromegaly. The coexistence of other complications, such as diabetes and arterial hypertension, can induce the worsening of acromegalic cardiomyopathy. Control of acromegaly by surgery or pharmacotherapy could improve cardiovascular morbidity thanks to decreasing left ventricular mass and reducing cardiac dysfunction. In conclusion, an early diagnosis and a careful evaluation of cardiac function, morphology and activity seem to be mandatory in acromegaly.
肢端肥大症的特征是心血管发病率和死亡率增加。事实上，生长激素和胰岛素样生长因子-I过多会诱发特定的心肌病。在疾病的早期阶段，心脏就会受累，此时会出现高动力综合征（心率加快和收缩输出增加）。通常，如果疾病多年未得到治疗或治疗不成功，可能会发展为双心室同心性肥厚和舒张功能障碍，至少会导致舒张性充血性心力衰竭。肢端肥大症患者也经常出现心律失常和瓣膜功能障碍。其他并发症，如糖尿病和动脉高血压的共存，可导致肢端肥大性心肌病恶化。通过手术或药物治疗控制肢端肥大症，由于左心室质量的减少和心脏功能障碍的减轻，可改善心血管发病率。总之，早期诊断以及对心脏功能、形态和活动进行仔细评估在肢端肥大症中似乎是必不可少的。
