Assessment of Cardiavascular Changes following Trans-sphenoidal Surgery in Acromegalic Patients.

Abstract

Cardiovascular disease represents the most prevalent comorbidity in acromegaly, accounting for up to 80% of complications and it has been reported to importantly contribute to death.[1] In this issue of Neurology India, Srinivasan et al., aimed to evaluate the effect of transsphenoidal surgery (TSS) on the echocardiographic parameters of patients with acromegaly. They also evaluated the possible impact of postoperative normalization of growth hormone (GH) and insulin-like growth factor type 1 (IGF-1) on the echocardiographic parameters of these patients. Few publications have attempted to address the changes in echocardiographic parameters related to TSS as well as the impact of acromegaly control on these changes. The authors showed that a reduction in GH and IGF-1 levels following surgery for acromegaly is accompanied by an increase in the left ventricular ejection fraction (EF) in patients who were cured. Furthermore, a decrease was also observed in the cardiac left ventricular mass (LVM), which might contribute to the improvement of diastolic function of the heart.[2] These findings could eventually be related to a decrease in the morbidity and mortality associated with acromegalic cardiomyopathy. Indeed, the control of acromegaly has been shown to reduce mortality, including that from cardiovascular and neoplastic causes.