{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T23:50:50Z","timestamp":1790380250785,"version":"4.1.0"},"reference-count":54,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T00:00:00Z","timestamp":1738108800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Cardiovascular disease in acromegaly patients remains a major cause of morbidity and all-cause mortality. This systematic review investigates the effect of the first growth hormone-lowering intervention on cardiac parameters.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Systematic review.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Studies evaluating cardiac parameters following the first intervention in acromegaly published up to February, 25, 2022 were included in this systematic review. Risk of bias was assessed using a modified Newcastle\u2013Ottawa Scale and Joanna Briggs Institute Critical Appraisal Checklist. Primary treatment modalities included (transsphenoidal) surgery and medical treatment with first-generation somatostatin receptor ligands. Cardiac outcome measures were divided into cardiac structure (left ventricular hypertrophy [LVH], [indexed] left ventricular mass [LVM\/LVMi]) and cardiac function (left ventricular ejection fraction [LVEF] and E\/A ratio).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Twenty-six studies (17 cohort studies and 9 case reports) were included out of 2541 potential studies. The risk of bias analysis categorized, 24 studies as low risk and 2 studies as intermediate risk. Disease-associated changes in cardiac structure and function generally improved in most studies following primary treatment. Left ventricular mass\/left ventricular mass index significantly decreased in 9\/15 studies and the prevalence of LVH in 3\/13 studies. Left ventricular ejection fraction significantly increased in 9\/14 studies and the E\/A ratio in 6\/7 studies. Despite the limited number of studies, cardiac structure improved more in patients achieving biochemical remission than in those failing to achieve biochemical remission.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Acromegaly associated structural and functional myocardial changes improve with both medical and surgical treatment. Normalizing or even reducing growth hormone\/insulin-like growth factor 1 levels may be key in the prevention of further progression of cardiac involvement in acromegaly and adverse cardiac outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejendo\/lvaf009","type":"journal-article","created":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T00:15:04Z","timestamp":1738196104000},"page":"S1-S14","source":"Crossref","is-referenced-by-count":6,"title":["The effect of first intervention on cardiac parameters in patients with acromegaly: a systematic review"],"prefix":"10.1093","volume":"192","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7137-1074","authenticated-orcid":false,"given":"Kevin A","family":"Huynh","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Leiden University Medical Center , 2333 ZA Leiden ,","place":["The Netherlands"]},{"name":"Center for Endocrine Tumors Leiden (CETL), Center for Pituitary Care, Leiden University Medical Center , 2333 ZA Leiden ,","place":["The Netherlands"]},{"name":"Department of Neurosurgery, Leiden University Medical Center , 2333 ZA Leiden ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Al-Gully","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Leiden University Medical Center , 2333 ZA Leiden ,","place":["The Netherlands"]},{"name":"Center for Endocrine Tumors Leiden (CETL), Center for Pituitary Care, Leiden University Medical Center , 2333 ZA Leiden ,","place":["The Netherlands"]},{"name":"Department of Cardiology, Leiden University Medical Center , 2333 ZA Leiden ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 M","family":"Montero-Cabezas","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leiden University Medical Center , 2333 ZA Leiden ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda E","family":"Scheffers","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Erasmus Medical Center\u2014Sophia Children's Hospital , 3015 GD Rotterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco J T","family":"Verstegen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Leiden University Medical Center , 2333 ZA Leiden ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5817-3594","authenticated-orcid":false,"given":"Nienke R","family":"Biermasz","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Leiden University Medical Center , 2333 ZA Leiden ,","place":["The Netherlands"]},{"name":"Center for Endocrine Tumors Leiden (CETL), Center for Pituitary Care, Leiden University Medical Center , 2333 ZA Leiden ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4780-2468","authenticated-orcid":false,"given":"Eva C","family":"Coopmans","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Leiden University Medical Center , 2333 ZA Leiden ,","place":["The Netherlands"]},{"name":"Center for Endocrine Tumors Leiden (CETL), Center for Pituitary Care, Leiden University Medical Center , 2333 ZA Leiden ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,1,29]]},"reference":[{"issue":"11","key":"2025022114484328800_lvaf009-B1","doi-asserted-by":"publisher","first-page":"3189","DOI":"10.1172\/jci39375","article-title":"Acromegaly pathogenesis and treatment","volume":"119","author":"Melmed","year":"2009","journal-title":"J Clin 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