Clinical and biochemical features in patients. Medicine ; Melmed S. In: Melmed S, Malden M. The Pituitary. Oxford: Blackwell Science Inc, ;
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Cardiovascular disturbances in acromegaly. Acromegaly causes a number of disorders in the cardiovascular system, resulting from chronic exposure to high levels of GH and IGF Such disorders are the main responsible for increased mortality rates among acromegalic patients.
Among several forms of cardiovascular impairment is acromegalic cardiomyopathy, an entity that is initially characterized by a hyperdynamic state, followed by concentric left ventricular hypertrophy and diastolic dysfunction due to relaxation deficit, culminating in systolic dysfunction and sometimes heart failure. In addition, arrhythmias and heart valve diseases are also relevant, especially mitral and aortic, ischemic heart disease, hypertension, and glucose and lipid metabolism disorders.
This review approaches the main clinical and prognostic aspects of these entities, the effects of acromegaly treatment on them, and the respective consequences on patient survival. Keywords: Acromegaly; Acromegalic cardiomyopathy; Secondary hypertension; Cardiovascular risk. Os efeitos do excesso de GH e IGF-1 sobre o crescimento acral e visceral e sobre o metabolismo ocorrem insidiosamente. No recente estudo do Registro Espanhol de Acromegalia ocorreram 56 mortes em 1.
Mesmo entre pacientes tratados com cirurgia transesfenoidal, a mortalidade persiste elevada Casini e cols. Lopez-Velasco e cols. Colao e cols. Fatti e cols. Hermann e cols. Ohtsuka e cols. Pereira e cols. Chanson e cols. Del Rio e cols. Todos os pacientes desse estudo eram normotensos. Bondanelli e cols. Vilar e cols. Colao, citando Sonksen e cols. Baldelli e cols. Van der Lely e cols.
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2015, Número 5
Em , foram publicadas diretrizes para o manejo da acromegalia, o qual envolve, muitas vezes, uma abordagem multidisciplinar. Acromegaly is a disabling and disfiguring illness, which, if not adequately controlled, decreases life expectancy. Cardiovascular and respiratory complications represent the main causes of death in acromegalic patients. Progress in all therapeutic modalities has been made, allowing biochemical disease control in more patients. In , the guidelines for management of acromegaly were published which encompass, many times, a multidisciplinary approach. In this article, we critically evaluate what is available in Brazil that allows us to follow the guidelines established in the diagnosis and treatment consensus.