GH hypersecretion has a direct detrimental effect on the heart: a specific cardiomyopathy is a well-known consequence of acromegaly. The most common features of the acromegalic cardiomyopathy include concentric biventric-ular hypertrophy, left ventricular systolic and diastolic dysfunction, rhythm disturbances, and an increased prevalence of valve abnormalities 1. Cardiac hypertrophy is present in about 20 of young normotensive patients with short duration of the disease and in up to 90 of hypertensive patients with long-term duration of the disease 2. This evidence lends support to the concept that cardiac hypertrophy is an early event strongly worsening with the disease duration, and aggravated by hypertension. These cardiac complications are a major determinant of the shortened life expectancy of acromegalic patients. Indeed, patients with acromegaly display about 30 enhanced mortality rate, in particular, cardiovascular disease represents the cause of death in 60 of cases 3. Ageing and long duration of GH/IGF-I excess are main determinants of cardiac derangement and early diagnosis and effective treatment are essential to reserved the acromegalic cardiomyopathy 4. In fact, younger patients respond better to treatment in terms of cardiac improvement than middle-aged patients, provided that all had controlled GH and IGF-I levels 5.
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