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Complications of acromegaly: cardiovascular, respiratory and metabolic comorbidities
- Source :
- Pituitary. 20:46-62
- Publication Year :
- 2017
- Publisher :
- Springer Science and Business Media LLC, 2017.
-
Abstract
- Acromegaly is associated with an enhanced mortality, with cardiovascular and respiratory complications representing not only the most frequent comorbidities but also two of the main causes of deaths, whereas a minor role is played by metabolic complications, and particularly diabetes mellitus. The most prevalent cardiovascular complications of acromegaly include a cardiomyopathy, characterized by cardiac hypertrophy and diastolic and systolic dysfunction together with arterial hypertension, cardiac rhythm disorders and valve diseases, as well as vascular endothelial dysfunction. Biochemical control of acromegaly significantly improves cardiovascular disease, albeit completely recovering to normal mainly in young patients with short disease duration. Respiratory complications, represented mainly by sleep-breathing disorders, particularly sleep apnea, and respiratory insufficiency, frequently occur at the early stage of the disease and, although their severity decreases with disease control, this improvement does not often change the indication for a specific therapy directed to improve respiratory function. Metabolic complications, including glucose and lipid disorders, are variably reported in acromegaly. Treatments of acromegaly may influence glucose metabolism, and the presence of diabetes mellitus in acromegaly may affect the choice of treatments, so that glucose homeostasis is worth being monitored during the entire course of the disease. Early diagnosis and prompt treatment of acromegaly, aimed at obtaining a strict control of hormone excess, are the best strategy to limit the development or reverse the complications and prevent the premature mortality.
- Subjects :
- medicine.medical_specialty
Medical therapy
Cardiomyopathy
Endocrinology, Diabetes and Metabolism
030209 endocrinology & metabolism
Comorbidity
Disease
030204 cardiovascular system & hematology
03 medical and health sciences
Sleep Apnea Syndromes
0302 clinical medicine
Endocrinology
Internal medicine
Diabetes mellitus
Acromegaly
medicine
Humans
Glucose homeostasis
Respiratory function
Metabolic Syndrome
Human Growth Hormone
business.industry
Sleep apnea
Pituitary surgery
medicine.disease
Surgery
Cardiovascular Diseases
Cardiology
Metabolic syndrome
business
Subjects
Details
- ISSN :
- 15737403 and 1386341X
- Volume :
- 20
- Database :
- OpenAIRE
- Journal :
- Pituitary
- Accession number :
- edsair.doi.dedup.....fcbc386a8adf632b37bf26d7c9825ca3