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Exp Clin Endocrinol Diabetes 2017; 125(06): 365-367
DOI: 10.1055/s-0042-123710
Article
© Georg Thieme Verlag KG Stuttgart · New York

Renin-Angiotensin System Blockade Improves Cardiac Indices in Acromegaly Patients

Julia D. J. Thomas
1   Centre for Endocrinology, WHRI, Barts & the London School of Medicine and Dentistry, Queen Mary University of London
,
Abhishek Dattani
1   Centre for Endocrinology, WHRI, Barts & the London School of Medicine and Dentistry, Queen Mary University of London
2   NIHR Cardiovascular Biomedical Research Unit, St Bartholomew’s Hospital, London
,
Filip Zemrak
2   NIHR Cardiovascular Biomedical Research Unit, St Bartholomew’s Hospital, London
,
Thomas Burchell
2   NIHR Cardiovascular Biomedical Research Unit, St Bartholomew’s Hospital, London
,
Scott A. Akker
3   Department of Endocrinology, St Bartholomew’s Hospital, London
,
Felicity J. L. Kaplan
4   Department of Endocrinology, Lister Hospital, Stevenage, Herts
,
Bernard Khoo
5   Department of Endocrinology, Royal Free Campus, UCL Medical School, London
,
Simon Aylwin
6   Department of Endocrinology, King’s College Hospital, London
,
Ashley B. Grossman
7   Oxford Centre for Endocrinology, Diabetes and Metabolism, University of Oxford
,
L. Ceri Davies
2   NIHR Cardiovascular Biomedical Research Unit, St Bartholomew’s Hospital, London
,
Márta Korbonits
1   Centre for Endocrinology, WHRI, Barts & the London School of Medicine and Dentistry, Queen Mary University of London
› Author Affiliations
Further Information

Publication History

received 23 July 2016
revised 07 December 2016

accepted 12 December 2016

Publication Date:
06 February 2017 (online)

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Abstract

Purpose:

Blockade of the angiotensin-renin system, with angiotensin converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARBs), has been shown to improve cardiac outcomes following myocardial infarction and delay progression of heart failure. Acromegaly is associated with a disease-specific cardiomyopathy, the pathogenesis of which is poorly understood.

Methods:

The cardiac indices of patients with active acromegaly with no hypertension (Group A, n=4), established hypertension not taking ACEi/ARBs (Group B, n=4) and established hypertension taking ACEi/ARBs (Group C, n=4) were compared using cardiac magnetic imaging.

Results:

Patients taking ACEi/ARBs had lower end diastolic volume index (EDVi) and end systolic volume index (ESVi) than the other 2 groups ([C] 73.24 vs. [A] 97.92 vs. [B] 101.03 ml/m2, ANOVA p=0.034, B vs. C p<0.01). Groups A and B had EDVi and ESVi values at the top of published reference range values; Group C had values in the middle of the range.

Conclusion:

Acromegaly patients on ACEi/ARBs for hypertension demonstrate improved cardiac indices compared to acromegaly patients with hypertension not taking these medications. Further studies are needed to determine if these drugs have a beneficial cardiac effect in acromegaly in the absence of demonstrable hypertension.

Key words

pituitary - acromegaly - cardiac magnetic resonance - renin-angiotensin
 

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