Remba-Shapiro Ilan, Okui Cyntholia H, Murphy Sean P, Eliott Dean, Scott Nandita, Nachtigall Lisa B
Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Department of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Case Rep Endocrinol. 2025 Jul 15;2025:3522275. doi: 10.1155/crie/3522275. eCollection 2025.
Acromegaly is a rare disease that is caused by a growth hormone (GH) secreting pituitary tumor. This is a case of a 62-year-old man who presented with hypertrophic cardiomyopathy more than 25 years after surgical remission without other known etiologies of left ventricular hypertrophy. The patient initially presented at age 28 with symptoms of acromegaly and diagnosed himself, while several physicians dismissed the diagnosis. He underwent transsphenoidal surgery associated with long-term remission. At age 53, he developed palpitations, light headedness, dizziness, and chest tightness, and an echocardiogram demonstrated left ventricular hypertrophy. At age 60, cardiac magnetic resonance imaging (MRI) suggested hypertrophic cardiomyopathy, which continues to be followed. This case raises the question of whether cardiac morphological changes occur in patients with acromegaly who have GH and insulin-like growth factor-1 (IGF-1) levels well controlled. Cardiac MRI is the most accurate imaging modality for assessment of cardiomyopathy. However, more research is needed to inform clinical guidelines on screening for cardiac functional and morphological changes in patients with acromegaly.
肢端肥大症是一种由分泌生长激素（GH）的垂体瘤引起的罕见疾病。这是一例62岁男性患者，在手术缓解25年多后出现肥厚型心肌病，且无其他已知的左心室肥厚病因。该患者最初在28岁时出现肢端肥大症症状并自行诊断，然而几位医生都否定了这一诊断。他接受了经蝶窦手术，实现了长期缓解。53岁时，他出现心悸、头晕、眩晕和胸闷，超声心动图显示左心室肥厚。60岁时，心脏磁共振成像（MRI）提示肥厚型心肌病，目前仍在持续监测。该病例引发了一个问题，即在生长激素（GH）和胰岛素样生长因子-1（IGF-1）水平得到良好控制的肢端肥大症患者中是否会发生心脏形态学改变。心脏MRI是评估心肌病最准确的成像方式。然而，需要更多研究来为肢端肥大症患者心脏功能和形态学改变的筛查临床指南提供依据。
