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Cardiovascular comorbidities in acromegaly: an update on their diagnosis and management

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Abstract

Comorbidities related to the cardiovascular system are one of the most prevalent in patients with acromegaly, and contribute to an increased risk of morbidity and all-cause mortality. Specifically, hypertension, cardiomyopathy, heart valve disease, arrhythmias, atherosclerosis, coronary artery disease, and cardiac dysfunction may be frequent findings. Although the underlying physiopathology for each comorbidity may not be fully elucidated, uncontrolled growth hormone/insulin-like growth factor 1 excess, age, prolonged disease duration, and coexistence of other cardio-vascular risk factors are significant influencing variables. A simple diagnostic approach to screen for the presence of these comorbidities may allow prompt treatment and arrest the progression of cardiac abnormalities. In this article, we revise the most prevalent cardiovascular comorbidities and their pathophysiology in acromegalic patients, and we address some recommendations for their prompt diagnosis, management and treatment. Strengths and pitfalls of different diagnostic techniques that are currently being used and how different treatments can affect these complications will be further discussed.

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  1. Department of Endocrinology, Hospital Universitario La Princesa, Instituto de Investigación Princesa, Universidad Autónoma, Madrid, Spain

    Ana M Ramos-Leví & Mónica Marazuela

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  1. Ana M Ramos-Leví
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ARL has received lecture fees from Ipsen and Novartis. MM has received lecture fees, advisor fees and research grants from Pfizer and lecture fees from Novartis and Ipsen. The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

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Ramos-Leví, A.M., Marazuela, M. Cardiovascular comorbidities in acromegaly: an update on their diagnosis and management. Endocrine 55, 346–359 (2017). https://doi.org/10.1007/s12020-016-1191-3

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