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A Case and Review of Acromegaly-Induced Cardiomyopathy and the Relationship Between Growth Hormone and Heart Failure: Cause or Cure or Neither or Both?

Division of Cardiology, Department of Medicine, Cedars Sinai Medical Center, Los Angeles, California; University of California, Los Angeles; Division of Cardiology, Department of Internal Medicine, The University of Texas Medical Branch, Galveston, ernst.schwarz{at}cshs.org

Praveen Jammula, MDM

Rajiv Gupta, MD

Salvatore Rosanio, MD, PhD

Division of Cardiology, Department of Internal Medicine, The University of Texas Medical Branch, Galveston

Growth hormone plays an integral role in the development and maintenance of structure and function of the heart. Specific involvement of the heart in acromegaly is termed acromegalic cardiomyopathy, manifested as concentric left ventricular hypertrophy and diastolic dys-function. Left untreated, it ultimately progresses to systolic heart failure. Heart failure from acromegalic cardiomyopathy is one of the most common causes of death in acromegaly. Current treatment options include different approaches to lower elevated growth hormone levels with improvement in symptoms, exercise tolerance, and echocardiographic improvement in regression of left ventricular hypertrophy and indices of diastolic dysfunction. On the other hand, growth hormone is essential for cardiac growth and function and exerts beneficial and protective effects on the cardiovascular system. Its potential role as adjunctive therapy in the treatment of heart failure as derived from experimental studies and clinical trials is discussed.

Key Words: acromegaly • cardiomyopathy • growth hormone • heart failure

Journal of Cardiovascular Pharmacology and Therapeutics, Vol. 11, No. 4, 232-244 (2006)
DOI: 10.1177/1074248406296676


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