Skip to main content
Erschienen in: Pituitary 6/2016

03.09.2016

Low frequency of cardniac arrhythmias and lack of structural heart disease in medically-naïve acromegaly patients: a prospective study at baseline and after 1 year of somatostatin analogs treatment

verfasst von: Leila Warszawski, Leandro Kasuki, Rodrigo Sá, Cintia Marques dos Santos Silva, Isabela Volschan, Ilan Gottlieb, Roberto Coury Pedrosa, Mônica R. Gadelha

Erschienen in: Pituitary | Ausgabe 6/2016

Einloggen, um Zugang zu erhalten

Abstract

Background

The incidence of arrhythmias may be increased in acromegaly, but the pathophysiologic mechanisms involved are still unclear, and it has never been correlated with structural heart changes analyzed by the gold-standard method cardiac magnetic resonance (CMR).

Aim

Evaluate the frequency of arrhythmias in drug-naïve acromegaly patients at baseline and after 1 year of somatostatin analogs (SA) treatment and to correlate the occurrence of arrhythmias with the presence of structural heart changes.

Patients and methods

Consecutive drug-naïve acromegaly patients were recruited. The occurrence of arrhythmias and structural heart changes were studied through 24-h Holter and CMR, respectively, at baseline and after 1-year SA treatment.

Results

Thirty-six patients were studied at baseline and 28 were re-evaluated after 1 year of SA treatment. There were 13 females and median age was 48 years (20–73 years). Nine patients (32 %) were controlled after treatment. No sustained arrhythmias were reported in the 24-h Holter. No arrhythmia-related symptoms were observed. Only two patients presented left ventricular hypertrophy and three patients presented fibrosis at baseline. There was no correlation of the left ventricular mass with the number of episodes of arrhythmias and they were not more prevalent in the patients presenting cardiac fibrosis.

Conclusion

We found no sustained arrhythmias and a lack of arrhythmia-related symptoms at baseline and after 1 year of SA treatment in a contemporary cohort of acromegaly patients that also present a low frequency of structural heart changes, indicating that these patients may have a lower frequency of heart disease than previously reported.
Literatur
1.
Zurück zum Zitat Colao A, Ferone D, Marzullo P, Lombardi G (2004) Systemic complications of acromegaly: epidemiology, pathogenesis, and management. Endocr Rev 25:102–152CrossRefPubMed Colao A, Ferone D, Marzullo P, Lombardi G (2004) Systemic complications of acromegaly: epidemiology, pathogenesis, and management. Endocr Rev 25:102–152CrossRefPubMed
2.
Zurück zum Zitat Lie JT (1980) Pathology of the heart in acromegaly: anatomic findings in 27 autopsied patients. Am Heart J 100:41–52CrossRefPubMed Lie JT (1980) Pathology of the heart in acromegaly: anatomic findings in 27 autopsied patients. Am Heart J 100:41–52CrossRefPubMed
3.
Zurück zum Zitat Rossi L, Thiene G, Caragaro L, Giordano R, Lauro S (1977) Dysrhythmias and sudden death in acromegalic heart disease. A clinicopathologic study. Chest 72:495–498CrossRefPubMed Rossi L, Thiene G, Caragaro L, Giordano R, Lauro S (1977) Dysrhythmias and sudden death in acromegalic heart disease. A clinicopathologic study. Chest 72:495–498CrossRefPubMed
4.
Zurück zum Zitat Vitale G, Pivonello R, Lombardi G, Colao A (2004) Cardiac abnormalities in acromegaly. Pathophysiology and implications for management. Treat Endocrinol 3:309–318CrossRefPubMed Vitale G, Pivonello R, Lombardi G, Colao A (2004) Cardiac abnormalities in acromegaly. Pathophysiology and implications for management. Treat Endocrinol 3:309–318CrossRefPubMed
5.
Zurück zum Zitat Kahaly G, Olshausen KV, Mohr-Kahaly S, Erbel R, Boor S, Beyer J, Meyer J (1992) Arrhythmia profile in acromegaly. Eur Heart J 13:51–56PubMed Kahaly G, Olshausen KV, Mohr-Kahaly S, Erbel R, Boor S, Beyer J, Meyer J (1992) Arrhythmia profile in acromegaly. Eur Heart J 13:51–56PubMed
6.
Zurück zum Zitat Huikuri HV, Castellanos A, Myerburg RJ (2001) Sudden death due to cardiac arrhythmias. N Engl J Med 345:1473–1482CrossRefPubMed Huikuri HV, Castellanos A, Myerburg RJ (2001) Sudden death due to cardiac arrhythmias. N Engl J Med 345:1473–1482CrossRefPubMed
7.
Zurück zum Zitat Colao A (2001) Are patients with acromegaly at high risk for dysrhythmias? Clin Endocrinol (Oxf). 55:305–306CrossRefPubMed Colao A (2001) Are patients with acromegaly at high risk for dysrhythmias? Clin Endocrinol (Oxf). 55:305–306CrossRefPubMed
8.
Zurück zum Zitat Ijiri H, Kohno I, Yin D, Iwasaki H, Takusagawa M, Iida T, Osada M, Umetani K, Ishihara T, Sawanobori T, Ishii H, Komori S, Tamura K (2000) Cardiac arrhythmias and left ventricular hypertrophy in dipper and nondipper patients with essential hypertension. Jpn Circ J 64:499–504CrossRefPubMed Ijiri H, Kohno I, Yin D, Iwasaki H, Takusagawa M, Iida T, Osada M, Umetani K, Ishihara T, Sawanobori T, Ishii H, Komori S, Tamura K (2000) Cardiac arrhythmias and left ventricular hypertrophy in dipper and nondipper patients with essential hypertension. Jpn Circ J 64:499–504CrossRefPubMed
9.
Zurück zum Zitat Morita N, Mandel WJ, Kobayashi Y, Karagueuzian HS (2014) Cardiac fibrosis as a determinant of ventricular tachyarrhythmias. J Arrhythm. 30:389–394CrossRefPubMedPubMedCentral Morita N, Mandel WJ, Kobayashi Y, Karagueuzian HS (2014) Cardiac fibrosis as a determinant of ventricular tachyarrhythmias. J Arrhythm. 30:389–394CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Bogazzi F, Lombardi M, Strata E, Aquaro G, Di Bello V, Cosci C, Sardella C, Talini E, Martino E (2008) High prevalence of cardiac hypertophy without detectable signs of fibrosis in patients with untreated active acromegaly: an in vivo study using magnetic resonance imaging. Clin Endocrinol (Oxf). 68:361–368CrossRefPubMed Bogazzi F, Lombardi M, Strata E, Aquaro G, Di Bello V, Cosci C, Sardella C, Talini E, Martino E (2008) High prevalence of cardiac hypertophy without detectable signs of fibrosis in patients with untreated active acromegaly: an in vivo study using magnetic resonance imaging. Clin Endocrinol (Oxf). 68:361–368CrossRefPubMed
11.
Zurück zum Zitat Bogazzi F, Lombardi M, Strata E, Aquaro G, Lombardi M, Urbani C, Di Bello V, Cosci C, Sardella C, Talini E, Martino E (2010) Effects of somatostatin analogues on acromegalic cardiomyopathy: results from a prospective study using cardiac magnetic resonance. J Endocrinol Invest 33:103–108CrossRefPubMed Bogazzi F, Lombardi M, Strata E, Aquaro G, Lombardi M, Urbani C, Di Bello V, Cosci C, Sardella C, Talini E, Martino E (2010) Effects of somatostatin analogues on acromegalic cardiomyopathy: results from a prospective study using cardiac magnetic resonance. J Endocrinol Invest 33:103–108CrossRefPubMed
12.
Zurück zum Zitat Andreassen M, Faber J, Kjaer A, Petersen CL, Kristensen LO (2010) Cardiac effects of 3 months treatment of acromegaly evaluated by magnetic resonance imaging and B-type natriuretic peptides. Pituitary 13:329–336CrossRefPubMed Andreassen M, Faber J, Kjaer A, Petersen CL, Kristensen LO (2010) Cardiac effects of 3 months treatment of acromegaly evaluated by magnetic resonance imaging and B-type natriuretic peptides. Pituitary 13:329–336CrossRefPubMed
13.
Zurück zum Zitat Gouya H, Vignaux O, Le Roux P, Chanson P, Bertherat J, Bertagna X, Legmann P (2008) Rapidly reversible myocardial edema in patients with acromegaly: assessment with ultrafast T2 mapping in a single-breath-hold MRI sequence. AJR Am J Roentgenol 190:1576–1582CrossRefPubMed Gouya H, Vignaux O, Le Roux P, Chanson P, Bertherat J, Bertagna X, Legmann P (2008) Rapidly reversible myocardial edema in patients with acromegaly: assessment with ultrafast T2 mapping in a single-breath-hold MRI sequence. AJR Am J Roentgenol 190:1576–1582CrossRefPubMed
14.
Zurück zum Zitat Winhofer Y, Wolf P, Krssak M, Wolfsberger S, Tura A, Pacini G, Gessl A, Raber W, Kukurova IJ, Kautzky-Willer A, Knosp E, Trattnig S, Krebs M, Luger A (2014) No evidence of ectopic lipid accumulation in the pathophysiology of the acromegalic cardiomyopathy. J Clin Endocrinol Metab 99:4299–4306CrossRefPubMed Winhofer Y, Wolf P, Krssak M, Wolfsberger S, Tura A, Pacini G, Gessl A, Raber W, Kukurova IJ, Kautzky-Willer A, Knosp E, Trattnig S, Krebs M, Luger A (2014) No evidence of ectopic lipid accumulation in the pathophysiology of the acromegalic cardiomyopathy. J Clin Endocrinol Metab 99:4299–4306CrossRefPubMed
15.
Zurück zum Zitat dos Santos Silva CM, Gottlieb I, Volschan ICM, Kasuki L, Warszawski L, Lima GA, Pedrosa RC, Vieira Neto L, Gadelha MR (2015) Low frequency of cardiomyopathy using cardiac magnetic resonance imaging in an acromegaly contemporary cohort. J Clin Endocrinol Metab 100:4447–4455CrossRefPubMed dos Santos Silva CM, Gottlieb I, Volschan ICM, Kasuki L, Warszawski L, Lima GA, Pedrosa RC, Vieira Neto L, Gadelha MR (2015) Low frequency of cardiomyopathy using cardiac magnetic resonance imaging in an acromegaly contemporary cohort. J Clin Endocrinol Metab 100:4447–4455CrossRefPubMed
16.
Zurück zum Zitat Pennell DJ, Sechtem UP, Higgins CB, Manning WJ, Pohost GM, Rademakers FE, van Rossum AC, Shaw LJ, Yucel EK (2004) Society for Cardiovascular Magnetic, R., Working Group on Cardiovascular Magnetic Resonance of the European Society of, C.: clinical indications for cardiovascular magnetic resonance (CMR): Consensus Panel report. Eur Heart J 25:1940–1965CrossRefPubMed Pennell DJ, Sechtem UP, Higgins CB, Manning WJ, Pohost GM, Rademakers FE, van Rossum AC, Shaw LJ, Yucel EK (2004) Society for Cardiovascular Magnetic, R., Working Group on Cardiovascular Magnetic Resonance of the European Society of, C.: clinical indications for cardiovascular magnetic resonance (CMR): Consensus Panel report. Eur Heart J 25:1940–1965CrossRefPubMed
17.
Zurück zum Zitat Katznelson L, Laws ER Jr, Melmed S, Molitch ME, Murad MH, Utz A, Wass JA, Endocrine S (2014) Acromegaly: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 99:3933–3951CrossRefPubMed Katznelson L, Laws ER Jr, Melmed S, Molitch ME, Murad MH, Utz A, Wass JA, Endocrine S (2014) Acromegaly: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 99:3933–3951CrossRefPubMed
18.
Zurück zum Zitat Maison P, Tropeano AI, Macquin-Mavier I, Giustina A, Chanson P (2007) Impact of somatostatin analogs on the heart in acromegaly: a metaanalysis. J Clin Endocrinol Metab 92:1743–1747CrossRefPubMed Maison P, Tropeano AI, Macquin-Mavier I, Giustina A, Chanson P (2007) Impact of somatostatin analogs on the heart in acromegaly: a metaanalysis. J Clin Endocrinol Metab 92:1743–1747CrossRefPubMed
19.
Zurück zum Zitat Granata R, Trovato L, Destefanis S, Settanni F, Ghigo E (2004) H9c2 cardiac muscle cells express all somatostatin receptor subtypes. J Endocrinol Invest 27:RC24–27 Granata R, Trovato L, Destefanis S, Settanni F, Ghigo E (2004) H9c2 cardiac muscle cells express all somatostatin receptor subtypes. J Endocrinol Invest 27:RC24–27
20.
Zurück zum Zitat Smith WH, Nair RU, Adamson D, Kearney MT, Ball SG, Balmforth AJ (2005) Somatostatin receptor subtype expression in the human heart: differential expression by myocytes and fibroblasts. J Endocrinol 187:379–386CrossRefPubMed Smith WH, Nair RU, Adamson D, Kearney MT, Ball SG, Balmforth AJ (2005) Somatostatin receptor subtype expression in the human heart: differential expression by myocytes and fibroblasts. J Endocrinol 187:379–386CrossRefPubMed
21.
Zurück zum Zitat Colao A, Pivonello R, Galderisi M, Cappabianca P, Auriemma RS, Galdiero M, Cavallo LM, Esposito F, Lombardi G (2008) Impact of treating acromegaly first with surgery or somatostatin analogs on cardiomyopathy. J Clin Endocrinol Metab 93:2639–2646CrossRefPubMed Colao A, Pivonello R, Galderisi M, Cappabianca P, Auriemma RS, Galdiero M, Cavallo LM, Esposito F, Lombardi G (2008) Impact of treating acromegaly first with surgery or somatostatin analogs on cardiomyopathy. J Clin Endocrinol Metab 93:2639–2646CrossRefPubMed
22.
Zurück zum Zitat Lombardi G, Colao A, Marzullo P, Biondi B, Palmieri E, Fazio S (2002) Multicenter Italian Study Group on, L.: improvement of left ventricular hypertrophy and arrhythmias after lanreotide-induced GH and IGF-I decrease in acromegaly. A prospective multi-center study. J Endocrinol Invest 25:971–976CrossRefPubMed Lombardi G, Colao A, Marzullo P, Biondi B, Palmieri E, Fazio S (2002) Multicenter Italian Study Group on, L.: improvement of left ventricular hypertrophy and arrhythmias after lanreotide-induced GH and IGF-I decrease in acromegaly. A prospective multi-center study. J Endocrinol Invest 25:971–976CrossRefPubMed
23.
Zurück zum Zitat Dickstein K, Cohen-Solal A, Filippatos G, McMurray JJ, Ponikowski P, Poole-Wilson PA, Stromberg A, van Veldhuisen DJ, Atar D, Hoes AW, Keren A, Mebazaa A, Nieminen M, Priori SG, Swedberg K (2008) Guidelines, E.S.C.C.f.P.: eSC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur Heart J 29:2388–2442CrossRefPubMed Dickstein K, Cohen-Solal A, Filippatos G, McMurray JJ, Ponikowski P, Poole-Wilson PA, Stromberg A, van Veldhuisen DJ, Atar D, Hoes AW, Keren A, Mebazaa A, Nieminen M, Priori SG, Swedberg K (2008) Guidelines, E.S.C.C.f.P.: eSC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur Heart J 29:2388–2442CrossRefPubMed
24.
Zurück zum Zitat Myerburg RJ, Kessler KM, Luceri RM, Zaman L, Trohman RG, Estes D, Castellanos A (1984) Classification of ventricular arrhythmias based on parallel hierarchies of frequency and form. Am J Cardiol 54:1355–1358CrossRefPubMed Myerburg RJ, Kessler KM, Luceri RM, Zaman L, Trohman RG, Estes D, Castellanos A (1984) Classification of ventricular arrhythmias based on parallel hierarchies of frequency and form. Am J Cardiol 54:1355–1358CrossRefPubMed
25.
Zurück zum Zitat Marcu CB, Nijveldt R, Beek AM, Van Rossum AC (2007) Delayed contrast enhancement magnetic resonance imaging for the assessment of cardiac disease. Heart Lung Circ. 16:70–78CrossRefPubMed Marcu CB, Nijveldt R, Beek AM, Van Rossum AC (2007) Delayed contrast enhancement magnetic resonance imaging for the assessment of cardiac disease. Heart Lung Circ. 16:70–78CrossRefPubMed
26.
Zurück zum Zitat Messroghli DR, Greiser A, Frohlich M, Dietz R, Schulz-Menger J (2007) Optimization and validation of a fully-integrated pulse sequence for modified look-locker inversion-recovery (MOLLI) T1 mapping of the heart. J Magn Reson Imaging 26:1081–1086CrossRefPubMed Messroghli DR, Greiser A, Frohlich M, Dietz R, Schulz-Menger J (2007) Optimization and validation of a fully-integrated pulse sequence for modified look-locker inversion-recovery (MOLLI) T1 mapping of the heart. J Magn Reson Imaging 26:1081–1086CrossRefPubMed
27.
Zurück zum Zitat Moon JC, Messroghli DR, Kellman P, Piechnik SK, Robson MD, Ugander M, Gatehouse PD, Arai AE, Friedrich MG, Neubauer S, Schulz-Menger J, Schelbert EB (2013) Society for Cardiovascular Magnetic Resonance, I., Cardiovascular Magnetic Resonance Working Group of the European Society of, C.: myocardial T1 mapping and extracellular volume quantification: a Society for Cardiovascular Magnetic Resonance (SCMR) and CMR Working Group of the European Society of Cardiology consensus statement. J Cardiovasc Magn Reson 15:92CrossRefPubMedPubMedCentral Moon JC, Messroghli DR, Kellman P, Piechnik SK, Robson MD, Ugander M, Gatehouse PD, Arai AE, Friedrich MG, Neubauer S, Schulz-Menger J, Schelbert EB (2013) Society for Cardiovascular Magnetic Resonance, I., Cardiovascular Magnetic Resonance Working Group of the European Society of, C.: myocardial T1 mapping and extracellular volume quantification: a Society for Cardiovascular Magnetic Resonance (SCMR) and CMR Working Group of the European Society of Cardiology consensus statement. J Cardiovasc Magn Reson 15:92CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Colao A, Auriemma RS, Galdiero M, Lombardi G, Pivonello R (2009) Effects of initial therapy for five years with somatostatin analogs for acromegaly on growth hormone and insulin-like growth factor-I levels, tumor shrinkage, and cardiovascular disease: a prospective study. J Clin Endocrinol Metab 94:3746–3756CrossRefPubMed Colao A, Auriemma RS, Galdiero M, Lombardi G, Pivonello R (2009) Effects of initial therapy for five years with somatostatin analogs for acromegaly on growth hormone and insulin-like growth factor-I levels, tumor shrinkage, and cardiovascular disease: a prospective study. J Clin Endocrinol Metab 94:3746–3756CrossRefPubMed
29.
Zurück zum Zitat Casini AF, Araujo PB, Fontes R, Xavier SS, Gadelha MR (2006) Cardiac morphology and performance alterations and analysis of determinant factors of left ventricular hypertrophy in 40 patients with acromegaly. Arq Bras Endocrinol Metabol. 50:82–90CrossRefPubMed Casini AF, Araujo PB, Fontes R, Xavier SS, Gadelha MR (2006) Cardiac morphology and performance alterations and analysis of determinant factors of left ventricular hypertrophy in 40 patients with acromegaly. Arq Bras Endocrinol Metabol. 50:82–90CrossRefPubMed
30.
Zurück zum Zitat Just H, Nieschlag E, Nicolescu RF, Kroger FJ, Overzier C (1974) Cardiac function in acromegaly. A clinical and hemodynamic study. Acta Cardiol 29:89–103PubMed Just H, Nieschlag E, Nicolescu RF, Kroger FJ, Overzier C (1974) Cardiac function in acromegaly. A clinical and hemodynamic study. Acta Cardiol 29:89–103PubMed
31.
Zurück zum Zitat Hayward RP, Emanuel RW, Nabarro JD (1987) Acromegalic heart disease: influence of treatment of the acromegaly on the heart. Q J Med. 62:41–58PubMed Hayward RP, Emanuel RW, Nabarro JD (1987) Acromegalic heart disease: influence of treatment of the acromegaly on the heart. Q J Med. 62:41–58PubMed
32.
Zurück zum Zitat Kostis JB, McCrone K, Moreyra AE, Gotzoyannis S, Aglitz NM, Natarajan N, Kuo PT (1981) Premature ventricular complexes in the absence of identifiable heart disease. Circulation 63:1351–1356CrossRefPubMed Kostis JB, McCrone K, Moreyra AE, Gotzoyannis S, Aglitz NM, Natarajan N, Kuo PT (1981) Premature ventricular complexes in the absence of identifiable heart disease. Circulation 63:1351–1356CrossRefPubMed
33.
Zurück zum Zitat Mercado M, Gonzalez B, Vargas G, Ramirez C, de los Monteros AL, Sosa E, Jervis P, Roldan P, Mendoza V, Lopez-Felix B, Guinto G (2014) Successful mortality reduction and control of comorbidities in patients with acromegaly followed at a highly specialized multidisciplinary clinic. J Clin Endocrinol Metab 99:4438–4446CrossRefPubMed Mercado M, Gonzalez B, Vargas G, Ramirez C, de los Monteros AL, Sosa E, Jervis P, Roldan P, Mendoza V, Lopez-Felix B, Guinto G (2014) Successful mortality reduction and control of comorbidities in patients with acromegaly followed at a highly specialized multidisciplinary clinic. J Clin Endocrinol Metab 99:4438–4446CrossRefPubMed
34.
Zurück zum Zitat Mestron A, Webb SM, Astorga R, Benito P, Catala M, Gaztambide S, Gomez JM, Halperin I, Lucas-Morante T, Moreno B, Obiols G, de Pablos P, Paramo C, Pico A, Torres E, Varela C, Vazquez JA, Zamora J, Albareda M, Gilabert M (2004) Epidemiology, clinical characteristics, outcome, morbidity and mortality in acromegaly based on the Spanish Acromegaly Registry (Registro Espanol de Acromegalia, REA). Eur J Endocrinol 151:439–446CrossRefPubMed Mestron A, Webb SM, Astorga R, Benito P, Catala M, Gaztambide S, Gomez JM, Halperin I, Lucas-Morante T, Moreno B, Obiols G, de Pablos P, Paramo C, Pico A, Torres E, Varela C, Vazquez JA, Zamora J, Albareda M, Gilabert M (2004) Epidemiology, clinical characteristics, outcome, morbidity and mortality in acromegaly based on the Spanish Acromegaly Registry (Registro Espanol de Acromegalia, REA). Eur J Endocrinol 151:439–446CrossRefPubMed
35.
Zurück zum Zitat Report of the expert committee on the diagnosis, classification of diabetes mellitus (1997) Diabetes Care 20:1183–1197CrossRef Report of the expert committee on the diagnosis, classification of diabetes mellitus (1997) Diabetes Care 20:1183–1197CrossRef
36.
Zurück zum Zitat Frohlich ED (1993) The fifth Joint National Committee report on the detection, evaluation and treatment of high blood pressure. J Am Coll Cardiol 22:621–622CrossRefPubMed Frohlich ED (1993) The fifth Joint National Committee report on the detection, evaluation and treatment of high blood pressure. J Am Coll Cardiol 22:621–622CrossRefPubMed
37.
Zurück zum Zitat Arosio M, Reimondo G, Malchiodi E, Berchialla P, Borraccino A, De Marinis L, Pivonello R, Grottoli S, Losa M, Cannavo S, Minuto F, Montini M, Bondanelli M, De Menis E, Martini C, Angeletti G, Velardo A, Peri A, Faustini-Fustini M, Tita P, Pigliaru F, Borretta G, Scaroni C, Bazzoni N, Bianchi A, Appetecchia M, Cavagnini F, Lombardi G, Ghigo E, Beck-Peccoz P, Colao A, Terzolo M (2012) Italian Study Group of, A.: predictors of morbidity and mortality in acromegaly: an Italian survey. Eur J Endocrinol 167:189–198PubMed Arosio M, Reimondo G, Malchiodi E, Berchialla P, Borraccino A, De Marinis L, Pivonello R, Grottoli S, Losa M, Cannavo S, Minuto F, Montini M, Bondanelli M, De Menis E, Martini C, Angeletti G, Velardo A, Peri A, Faustini-Fustini M, Tita P, Pigliaru F, Borretta G, Scaroni C, Bazzoni N, Bianchi A, Appetecchia M, Cavagnini F, Lombardi G, Ghigo E, Beck-Peccoz P, Colao A, Terzolo M (2012) Italian Study Group of, A.: predictors of morbidity and mortality in acromegaly: an Italian survey. Eur J Endocrinol 167:189–198PubMed
38.
Zurück zum Zitat Webb SC, Krikler DM, Hendry WG, Adrian TE, Bloom SR (1986) Electrophysiological actions of somatostatin on the atrioventricular junction in sinus rhythm and reentry tachycardia. Br Heart J 56:236–241CrossRefPubMedPubMedCentral Webb SC, Krikler DM, Hendry WG, Adrian TE, Bloom SR (1986) Electrophysiological actions of somatostatin on the atrioventricular junction in sinus rhythm and reentry tachycardia. Br Heart J 56:236–241CrossRefPubMedPubMedCentral
39.
Zurück zum Zitat Ohmura T, Nishio M, Kigoshi S, Muramatsu I (1990) Somatostatin decreases the calcium inward current in guinea-pig atria. Br J Pharmacol 99:587–591CrossRefPubMedPubMedCentral Ohmura T, Nishio M, Kigoshi S, Muramatsu I (1990) Somatostatin decreases the calcium inward current in guinea-pig atria. Br J Pharmacol 99:587–591CrossRefPubMedPubMedCentral
40.
Zurück zum Zitat Yang LP, Keating GM (2010) Octreotide long-acting release (LAR): a review of its use in the management of acromegaly. Drugs. 70:1745–1769CrossRefPubMed Yang LP, Keating GM (2010) Octreotide long-acting release (LAR): a review of its use in the management of acromegaly. Drugs. 70:1745–1769CrossRefPubMed
41.
Zurück zum Zitat Colao A, Ferone D, Cappabianca P, del Basso De Caro ML, Marzullo P, Monticelli A, Alfieri A, Merola B, Cali A, de Divitiis E, Lombardi G (1997) Effect of octreotide pretreatment on surgical outcome in acromegaly. J Clin Endocrinol Metab 82:3308–3314CrossRefPubMed Colao A, Ferone D, Cappabianca P, del Basso De Caro ML, Marzullo P, Monticelli A, Alfieri A, Merola B, Cali A, de Divitiis E, Lombardi G (1997) Effect of octreotide pretreatment on surgical outcome in acromegaly. J Clin Endocrinol Metab 82:3308–3314CrossRefPubMed
42.
Zurück zum Zitat Auriemma RS, Pivonello R, De Martino MC, Cudemo G, Grasso LF, Galdiero M, Perone Y, Colao A (2013) Treatment with GH receptor antagonist in acromegaly: effect on cardiac arrhythmias. Eur J Endocrinol 168:15–22CrossRefPubMed Auriemma RS, Pivonello R, De Martino MC, Cudemo G, Grasso LF, Galdiero M, Perone Y, Colao A (2013) Treatment with GH receptor antagonist in acromegaly: effect on cardiac arrhythmias. Eur J Endocrinol 168:15–22CrossRefPubMed
Metadaten
Titel
Low frequency of cardniac arrhythmias and lack of structural heart disease in medically-naïve acromegaly patients: a prospective study at baseline and after 1 year of somatostatin analogs treatment
verfasst von
Leila Warszawski
Leandro Kasuki
Rodrigo Sá
Cintia Marques dos Santos Silva
Isabela Volschan
Ilan Gottlieb
Roberto Coury Pedrosa
Mônica R. Gadelha
Publikationsdatum
03.09.2016
Verlag
Springer US
Erschienen in
Pituitary / Ausgabe 6/2016
Print ISSN: 1386-341X
Elektronische ISSN: 1573-7403
DOI
https://doi.org/10.1007/s11102-016-0749-7

Weitere Artikel der Ausgabe 6/2016

Pituitary 6/2016 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.