Objective Transsphenoidal surgery results in biochemical remission of acrom
egaly in 45-80% of patients; however, few studies have addressed the impact
of transsphenoidal surgery on cardiovascular function in acromegalic patie
nts. The aim of this prospective study was to investigate the effects of po
stoperative GH/IGF-I normalization on echocardiographic parameters and bloo
d pressure (BP) in a series of patients with active acromegaly.
Design An open prospective study.
Patients Thirty newly diagnosed acromegalic patients undergoing transspheno
Measurements Doppler echocardiography and 24-h ambulatory blood pressure mo
nitoring were performed before and 6 months after transsphenoidal surgery.
Results Fifteen patients were considered to be well controlled postoperativ
ely (group A), as defined by normal age-corrected IGF-I levels and glucose-
suppressed GH levels less than 2 mU/I, the remaining 15 patients being cons
idered as poorly controlled (group B). In group A, a postoperative decrease
of left ventricular mass index was observed (104.4 +/-6.6 vs. 127.1 +/-7.7
g/m(2); P<0.001), associated with an improvement of some indices of diasto
lic function, such as an increase of the early/late transmitral peak flow v
elocity (P<0.05) and a decrease of isovolumic relaxation time (P<0.01). No
significant change was observed in group B. A significant decrease of 24-h
systolic BP was also observed in group A (P<0.05) and five of six patients
normalized their BP circadian rythm. In contrast, a nonsignificant increase
in BP values, with a persistent blunted BP profile where present, was obse
rved in group B.
Conclusions We conclude that successful transsphenoidal surgery is able to
induce a significant improvement in some cardiac parameters and a slight re
duction in systolic blood pressure in acromegalic patients.