{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T15:38:15Z","timestamp":1777217895908,"version":"3.51.4"},"reference-count":79,"publisher":"IMR Press","issue":"4","license":[{"start":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T00:00:00Z","timestamp":1679529600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Cardiovasc. Med."],"abstract":"<jats:p>Patients with acromegaly carry a high risk of developing cardiovascular diseases (CVD). In fact, CVD is the leading cause of mortality among this group of patients. The most frequent cardiovascular complications are heart failure (HF), valvular disease, hypertension, arrhythmias, and coronary artery disease (CAD). The pathophysiology centers on the family of growth hormone (GH). These hormones are involved in normal cardiac development and function; however, excess of insulin-like growth factor-1 (IGF-1), the principally active hormone, can also cause negative effects on the cardiovascular system. HF in acromegaly usually presents with biventricular enlargement and diastolic dysfunction and is strongly associated with the duration of GH excess rather than the degree of hormone elevation. There is a high prevalence of valvular disease affecting aortic and mitral valves among patients with longer disease duration. The development of hypertension in acromegaly may be attributed to the effects of chronic GH\/IGF-1 excess on different organ systems, which act via several mechanisms. The aspect of arrhythmia and CAD complicating acromegaly are currently not fully understood.<\/jats:p>","DOI":"10.31083\/j.rcm2404095","type":"journal-article","created":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T01:44:27Z","timestamp":1679622267000},"source":"Crossref","is-referenced-by-count":8,"title":["Cardiovascular Effects of Excess Growth Hormone: How Real is the Threat?"],"prefix":"10.31083","volume":"24","author":[{"given":"Frederick Berro","family":"Rivera","sequence":"first","affiliation":[{"name":"Department of Medicine, Lincoln Medical and Mental Health Center, Bronx, NY 10451, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianne Katharina","family":"Tali\u00f1o","sequence":"first","affiliation":[{"name":"Ateneo de Manila School of Medicine and Public Health, 1604 Pasig City, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie Francesca","family":"Ansay","sequence":"first","affiliation":[{"name":"Ateneo de Manila School of Medicine and Public Health, 1604 Pasig City, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerard Francis","family":"Mangubat","sequence":"first","affiliation":[{"name":"Department of Medicine, Southern Philippines Medical Center, 8000 Davao City, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mer Lorraine","family":"Mahilum","sequence":"first","affiliation":[{"name":"Department of Medicine, Southern Philippines Medical Center, 8000 Davao City, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajiv Hans","family":"Menghrajani","sequence":"first","affiliation":[{"name":"St. Luke\u2019s Medical Center College of Medicine - William H. Quasha Memorial, 1102 Manila, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siena","family":"Placino","sequence":"first","affiliation":[{"name":"St. Luke\u2019s Medical Center College of Medicine - William H. Quasha Memorial, 1102 Manila, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sung Whoy","family":"Cha","sequence":"first","affiliation":[{"name":"Cebu Institute of Medicine, 6000 Cebu City, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John Paul","family":"Aparece","sequence":"first","affiliation":[{"name":"Cebu Institute of Medicine, 6000 Cebu City, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc Gregory","family":"Yu","sequence":"first","affiliation":[{"name":"Section of Vascular Cell Biology, Joslin Diabetes Center and Harvard Medical School, Boston, MA 02215, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael Lawrenz","family":"Co","sequence":"first","affiliation":[{"name":"Section of Cardiology, Thomas Jefferson University, Philadelphia, PA 19107, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edgar","family":"Lerma","sequence":"first","affiliation":[{"name":"Section of Nephrology, University of Illinois at Chicago College of Medicine\/Advocate Christ Medical Center, Oak Lawn, IL 60612, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krishnaswami","family":"Vijayaraghavan","sequence":"first","affiliation":[{"name":"University of Arizona, Phoenix, AZ 85004, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter A.","family":"McCullough","sequence":"first","affiliation":[{"name":"Truth for Health Foundation, Tucson, AZ 85728, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"16242","published-online":{"date-parts":[[2023,3,23]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Delafontaine P, Song YH, Li Y. Expression, regulation, and function of IGF-1, IGF-1R, and IGF-1 binding proteins in blood vessels. Arteriosclerosis, Thrombosis, and Vascular Biology. 2004; 24: 435\u2013444.","DOI":"10.1161\/01.ATV.0000105902.89459.09"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Obradovic M, Zafirovic S, Soskic S, Stanimirovic J, Trpkovic A, Jevremovic D, et al. Effects of IGF-1 on the Cardiovascular System. Current Pharmaceutical Design. 2019; 25: 3715\u20133725.","DOI":"10.2174\/1381612825666191106091507"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Devesa J, Almengl\u00f3 C, Devesa P. Multiple Effects of Growth Hormone in the Body: Is it Really the Hormone for Growth? Clinical Medicine Insights. Endocrinology and Diabetes. 2016; 9: 47\u201371.","DOI":"10.4137\/CMED.S38201"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Bolfi F, Neves AF, Boguszewski CL, Nunes-Nogueira VS. Mortality in acromegaly decreased in the last decade: a systematic review and meta-analysis. European Journal of Endocrinology. 2018; 179: 59\u201371.","DOI":"10.1530\/EJE-18-0255"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Lugo G, Pena L, Cordido F. Clinical manifestations and diagnosis of acromegaly. International Journal of Endocrinology. 2012; 2012: 540398.","DOI":"10.1155\/2012\/540398"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Caron P, Brue T, Raverot G, Tabarin A, Cailleux A, Delemer B, et al. Signs and symptoms of acromegaly at diagnosis: the physician\u2019s and the patient\u2019s perspectives in the ACRO-POLIS study. Endocrine. 2019; 63: 120\u2013129.","DOI":"10.1007\/s12020-018-1764-4"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Esposito D, Ragnarsson O, Johannsson G, Olsson DS. Prolonged diagnostic delay in acromegaly is associated with increased morbidity and mortality. European Journal of Endocrinology. 2020; 182: 523\u2013531.","DOI":"10.1530\/EJE-20-0019"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Katznelson L, Laws ER, Jr, Melmed S, Molitch ME, Murad MH, Utz A, et al. Acromegaly: an endocrine society clinical practice guideline. The Journal of Clinical Endocrinology and Metabolism. 2014; 99: 3933\u20133951.","DOI":"10.1210\/jc.2014-2700"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Akirov A, Masri-Iraqi H, Dotan I, Shimon I. The Biochemical Diagnosis of Acromegaly. Journal of Clinical Medicine. 2021; 10: 1147.","DOI":"10.3390\/jcm10051147"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Sharma AN, Tan M, Amsterdam EA, Singh GD. Acromegalic cardiomyopathy: Epidemiology, diagnosis, and management. Clinical Cardiology. 2018; 41: 419\u2013425.","DOI":"10.1002\/clc.22867"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"AlDallal S. Acromegaly: a challenging condition to diagnose. International Journal of General Medicine. 2018; 11: 337\u2013343.","DOI":"10.2147\/IJGM.S169611"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"Colao A, Grasso LFS, Di Somma C, Pivonello R. Acromegaly and Heart Failure. Heart Failure Clinics. 2019; 15: 399\u2013408.","DOI":"10.1016\/j.hfc.2019.03.001"},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"Crisafulli S, Luxi N, Sultana J, Fontana A, Spagnolo F, Giuffrida G, et al. Global epidemiology of acromegaly: a systematic review and meta-analysis. European Journal of Endocrinology. 2021; 185: 251\u2013263.","DOI":"10.1530\/EJE-21-0216"},{"key":"ref14","doi-asserted-by":"crossref","unstructured":"Lavrentaki A, Paluzzi A, Wass JAH, Karavitaki N. Epidemiology of acromegaly: review of population studies. Pituitary. 2017; 20: 4\u20139.","DOI":"10.1007\/s11102-016-0754-x"},{"key":"ref15","doi-asserted-by":"crossref","unstructured":"Yun SJ, Lee JK, Park SY, Chin SO. Descriptive Epidemiology and Survival Analysis of Acromegaly in Korea. Journal of Korean Medical Science. 2021; 36: e159.","DOI":"10.3346\/jkms.2021.36.e159"},{"key":"ref16","doi-asserted-by":"crossref","unstructured":"Holdaway IM, Rajasoorya C. Epidemiology of acromegaly. Pituitary. 1999; 2: 29\u201341.","DOI":"10.1023\/A:1009965803750"},{"key":"ref17","doi-asserted-by":"crossref","unstructured":"Lieberman SA, Hoffman AR. Sequelae to acromegaly: reversibility with treatment of the primary disease. Hormone and Metabolic Research. 1990; 22: 313\u2013318.","DOI":"10.1055\/s-2007-1004910"},{"key":"ref18","doi-asserted-by":"crossref","unstructured":"Renehan AG, Brennan BM. Acromegaly, growth hormone and cancer risk. Best Practice & Research. Clinical Endocrinology & Metabolism. 2008; 22: 639\u2013657.","DOI":"10.1016\/j.beem.2008.08.011"},{"key":"ref19","doi-asserted-by":"crossref","unstructured":"van der Klaauw AA, Bax JJ, Smit JWA, Holman ER, Delgado V, Bleeker GB, et al. Increased aortic root diameters in patients with acromegaly. European Journal of Endocrinology. 2008; 159: 97\u2013103.","DOI":"10.1530\/EJE-08-0138"},{"key":"ref20","doi-asserted-by":"crossref","unstructured":"Topaloglu O, Sayki Arslan M, Turak O, Ginis Z, Sahin M, Cebeci M, et al. Three noninvasive methods in the evaluation of subclinical cardiovascular disease in patients with acromegaly: epicardial fat thickness, aortic stiffness and serum cell adhesion molecules. Clinical Endocrinology. 2014; 80: 726\u2013734.","DOI":"10.1111\/cen.12356"},{"key":"ref21","doi-asserted-by":"crossref","unstructured":"Wu JC, Huang WC, Chang HK, Ko CC, Lirng JF, Chen YC. Natural History of Acromegaly: Incidences, Re-operations, Cancers, and Mortality Rates in a National Cohort. Neuroendocrinology. 2020; 110: 977\u2013987.","DOI":"10.1159\/000505332"},{"key":"ref22","doi-asserted-by":"crossref","unstructured":"Colao A, Ferone D, Marzullo P, Lombardi G. Systemic complications of acromegaly: epidemiology, pathogenesis, and management. Endocrine Reviews. 2004; 25: 102\u2013152.","DOI":"10.1210\/er.2002-0022"},{"key":"ref23","doi-asserted-by":"crossref","unstructured":"Colao A, Vitale G, Pivonello R, Ciccarelli A, Di Somma C, Lombardi G. The heart: an end-organ of GH action. European Journal of Endocrinology. 2004; 151: S93\u2013101.","DOI":"10.1530\/eje.0.151s093"},{"key":"ref24","doi-asserted-by":"crossref","unstructured":"Hasdai D, Holmes DR, Jr, Richardson DM, Izhar U, Lerman A. Insulin and IGF-I attenuate the coronary vasoconstrictor effects of endothelin-1 but not of sarafotoxin 6c. Cardiovascular Research. 1998; 39: 644\u2013650.","DOI":"10.1016\/S0008-6363(98)00144-8"},{"key":"ref25","doi-asserted-by":"crossref","unstructured":"Song CL, Liu B, Diao HY, Shi YF, Zhang JC, Li YX, et al. Down-regulation of microRNA-320 suppresses cardiomyocyte apoptosis and protects against myocardial ischemia and reperfusion injury by targeting IGF-1. Oncotarget. 2016; 7: 39740\u201339757.","DOI":"10.18632\/oncotarget.9240"},{"key":"ref26","doi-asserted-by":"crossref","unstructured":"Gallego-Colon E, Sampson RD, Sattler S, Schneider MD, Rosenthal N, Tonkin J. Cardiac-Restricted IGF-1Ea Overexpression Reduces the Early Accumulation of Inflammatory Myeloid Cells and Mediates Expression of Extracellular Matrix Remodelling Genes after Myocardial Infarction. Mediators of Inflammation. 2015; 2015: 484357.","DOI":"10.1155\/2015\/484357"},{"key":"ref27","doi-asserted-by":"crossref","unstructured":"Urbanek K, Rota M, Cascapera S, Bearzi C, Nascimbene A, De Angelis A, et al. Cardiac stem cells possess growth factor-receptor systems that after activation regenerate the infarcted myocardium, improving ventricular function and long-term survival. Circulation Research. 2005; 97: 663\u2013673.","DOI":"10.1161\/01.RES.0000183733.53101.11"},{"key":"ref28","doi-asserted-by":"crossref","unstructured":"Xu X, Hueckstaedt LK, Ren J. Deficiency of insulin-like growth factor 1 attenuates aging-induced changes in hepatic function: role of autophagy. Journal of Hepatology. 2013; 59: 308\u2013317.","DOI":"10.1016\/j.jhep.2013.03.037"},{"key":"ref29","doi-asserted-by":"crossref","unstructured":"Sacc\u00e0 L, Napoli R, Cittadini A. Growth hormone, acromegaly, and heart failure: an intricate triangulation. Clinical Endocrinology. 2003; 59: 660\u2013671.","DOI":"10.1046\/j.1365-2265.2003.01780.x"},{"key":"ref30","doi-asserted-by":"crossref","unstructured":"AsghariHanjani N, Vafa M. The role of IGF-1 in obesity, cardiovascular disease, and cancer. Medical Journal of the Islamic Republic of Iran. 2019; 33: 56.","DOI":"10.47176\/mjiri.33.56"},{"key":"ref31","doi-asserted-by":"crossref","unstructured":"Higashi Y, Gautam S, Delafontaine P, Sukhanov S. IGF-1 and cardiovascular disease. Growth Hormone & IGF Research: Official Journal of the Growth Hormone Research Society and the International IGF Research Society. 2019; 45: 6\u201316.","DOI":"10.1016\/j.ghir.2019.01.002"},{"key":"ref32","doi-asserted-by":"crossref","unstructured":"Gadelha MR, Kasuki L, Lim DST, Fleseriu M. Systemic Complications of Acromegaly and the Impact of the Current Treatment Landscape: An Update. Endocrine Reviews. 2019; 40: 268\u2013332.","DOI":"10.1210\/er.2018-00115"},{"key":"ref33","doi-asserted-by":"crossref","unstructured":"Isgaard J, Arcopinto M, Karason K, Cittadini A. GH and the cardiovascular system: an update on a topic at heart. Endocrine. 2015; 48: 25\u201335.","DOI":"10.1007\/s12020-014-0327-6"},{"key":"ref34","doi-asserted-by":"crossref","unstructured":"Ito H, Hiroe M, Hirata Y, Tsujino M, Adachi S, Shichiri M, et al. Insulin-like growth factor-I induces hypertrophy with enhanced expression of muscle specific genes in cultured rat cardiomyocytes. Circulation. 1993; 87: 1715\u20131721.","DOI":"10.1161\/01.CIR.87.5.1715"},{"key":"ref35","doi-asserted-by":"crossref","unstructured":"Cansu GB, Y\u0131lmaz N, Yan\u0131ko\u011flu A, \u00d6zdem S, Y\u0131ld\u0131r\u0131m AB, S\u00fcleymanlar G, et al. Assessment of diastolic dysfunction, arterial stiffness, and carotid intima-media thickness in patients with acromegaly. Endocrine Practice. 2017; 23: 536\u2013545.","DOI":"10.4158\/EP161637.OR"},{"key":"ref36","doi-asserted-by":"crossref","unstructured":"Colao A. The GH-IGF-I axis and the cardiovascular system: clinical implications. Clinical Endocrinology. 2008; 69: 347\u2013358.","DOI":"10.1111\/j.1365-2265.2008.03292.x"},{"key":"ref37","unstructured":"Lombardi G, Di Somma C, Grasso LFS, Savanelli MC, Colao A, Pivonello R. The cardiovascular system in growth hormone excess and growth hormone deficiency. Journal of Endocrinological Investigation. 2012; 35: 1021\u20131029."},{"key":"ref38","doi-asserted-by":"crossref","unstructured":"Uzi\u0229b\u0142o-\u017byczkowska B, Jurek A, Witek P, Zieli\u0144ski G, Gielerak G, Krzesi\u0144ski P. Left Heart Dysfunction in Acromegaly Revealed by Novel Echocardiographic Methods. Frontiers in Endocrinology. 2020; 11: 418.","DOI":"10.3389\/fendo.2020.00418"},{"key":"ref39","doi-asserted-by":"crossref","unstructured":"Natchev E, Kundurdjiev A, Zlatareva N, Vandeva S, Kirilov G, Kundurzhiev T, et al. Echocardiographic myocardial changes in acromegaly: a cross-sectional analysis in a tertiary center in bulgaria. Acta Endocrinologica. 2019; -5: 52\u201361.","DOI":"10.4183\/aeb.2019.52"},{"key":"ref40","doi-asserted-by":"crossref","unstructured":"Yang H, Tan H, Huang H, Li J. Advances in Research on the Cardiovascular Complications of Acromegaly. Frontiers in Oncology. 2021; 11: 640999.","DOI":"10.3389\/fonc.2021.640999"},{"key":"ref41","doi-asserted-by":"crossref","unstructured":"Gadelha P, Santos ECL, Castillo J, Vilar L. Subclinical Ventricular Dysfunction in Long-Term Acromegaly Assessed by Speckle-Tracking Echocardiography. Frontiers in Endocrinology. 2022; 13: 812964.","DOI":"10.3389\/fendo.2022.812964"},{"key":"ref42","doi-asserted-by":"crossref","unstructured":"Korm\u00e1nyos \u00c1, Kalapos A, Domsik P, Gyenes N, Ambrus N, Valkusz Z, et al. The right atrium in acromegaly-a three-dimensional speckle-tracking echocardiographic analysis from the MAGYAR-Path Study. Quantitative Imaging in Medicine and Surgery. 2020; 10: 646\u2013656.","DOI":"10.21037\/qims.2020.02.05"},{"key":"ref43","doi-asserted-by":"crossref","unstructured":"Park KH, Lee EJ, Seo GH, Ku CR. Risk for Acromegaly-related Comorbidities by Sex in Korean Acromegaly. The Journal of Clinical Endocrinology and Metabolism. 2020; 105: dgz317.","DOI":"10.1210\/clinem\/dgz317"},{"key":"ref44","doi-asserted-by":"crossref","unstructured":"Hong S, Kim KS, Han K, Park CY. Acromegaly and cardiovascular outcomes: a cohort study. European Heart Journal. 2022; 43: 1491\u20131499.","DOI":"10.1093\/eurheartj\/ehab822"},{"key":"ref45","doi-asserted-by":"crossref","unstructured":"Ramos-Lev\u00ed AM, Marazuela M. Bringing Cardiovascular Comorbidities in Acromegaly to an Update. How Should We Diagnose and Manage Them? Frontiers in Endocrinology. 2019; 10: 120.","DOI":"10.3389\/fendo.2019.00120"},{"key":"ref46","doi-asserted-by":"crossref","unstructured":"Colao A, Spiezia S, Cerbone G, Pivonello R, Marzullo P, Ferone D, et al. Increased arterial intima-media thickness by B-M mode echodoppler ultrasonography in acromegaly. Clinical Endocrinology. 2001; 54: 515\u2013524.","DOI":"10.1046\/j.1365-2265.2001.01256.x"},{"key":"ref47","doi-asserted-by":"crossref","unstructured":"Paisley AN, Banerjee M, Rezai M, Schofield RE, Balakrishnannair S, Herbert A, et al. Changes in arterial stiffness but not carotid intimal thickness in acromegaly. The Journal of Clinical Endocrinology and Metabolism. 2011; 96: 1486\u20131492.","DOI":"10.1210\/jc.2010-2225"},{"key":"ref48","doi-asserted-by":"crossref","unstructured":"Berg C, Petersenn S, Lahner H, Herrmann BL, Buchfelder M, Droste M, et al. Cardiovascular risk factors in patients with uncontrolled and long-term acromegaly: comparison with matched data from the general population and the effect of disease control. The Journal of Clinical Endocrinology and Metabolism. 2010; 95: 3648\u20133656.","DOI":"10.1210\/jc.2009-2570"},{"key":"ref49","doi-asserted-by":"crossref","unstructured":"Pereira AM, van Thiel SW, Lindner JR, Roelfsema F, van der Wall EE, Morreau H, et al. Increased prevalence of regurgitant valvular heart disease in acromegaly. The Journal of Clinical Endocrinology and Metabolism. 2004; 89: 71\u201375.","DOI":"10.1210\/jc.2003-030849"},{"key":"ref50","doi-asserted-by":"crossref","unstructured":"Colao A, Spinelli L, Marzullo P, Pivonello R, Petretta M, Di Somma C, et al. High prevalence of cardiac valve disease in acromegaly: an observational, analytical, case-control study. The Journal of Clinical Endocrinology and Metabolism. 2003; 88: 3196\u20133201.","DOI":"10.1210\/jc.2002-021099"},{"key":"ref51","doi-asserted-by":"crossref","unstructured":"Khan SA, Ram N, Masood MQ, Islam N. Prevalence of Comorbidities among Patients with Acromegaly. Pakistan Journal of Medical Sciences. 2021; 37: 1758\u20131761.","DOI":"10.12669\/pjms.37.7.4277"},{"key":"ref52","doi-asserted-by":"crossref","unstructured":"Dreval AV, Trigolosova IV, Misnikova IV, Kovalyova YA, Tishenina RS, Barsukov IA, et al. Prevalence of diabetes mellitus in patients with acromegaly. Endocrine Connections. 2014; 3: 93\u201398.","DOI":"10.1530\/EC-14-0021"},{"key":"ref53","doi-asserted-by":"crossref","unstructured":"Espinosa-de-los-Monteros AL, Gonz\u00e1lez B, Vargas G, Sosa E, Mercado M. Clinical and biochemical characteristics of acromegalic patients with different abnormalities in glucose metabolism. Pituitary. 2011; 14: 231\u2013235.","DOI":"10.1007\/s11102-010-0284-x"},{"key":"ref54","doi-asserted-by":"crossref","unstructured":"Puglisi S, Terzolo M. Hypertension and Acromegaly. Endocrinology and Metabolism Clinics of North America. 2019; 48: 779\u2013793.","DOI":"10.1016\/j.ecl.2019.08.008"},{"key":"ref55","doi-asserted-by":"crossref","unstructured":"Ronconi V, Giacchetti G, Mariniello B, Camilletti A, Mantero F, Boscaro M, et al. Reduced nitric oxide levels in acromegaly: cardiovascular implications. Blood Pressure. 2005; 14: 227\u2013232.","DOI":"10.1080\/08037050510034293"},{"key":"ref56","doi-asserted-by":"crossref","unstructured":"Rizzoni D, Porteri E, Giustina A, De Ciuceis C, Sleiman I, Boari GEM, et al. Acromegalic patients show the presence of hypertrophic remodeling of subcutaneous small resistance arteries. Hypertension. 2004; 43: 561\u2013565.","DOI":"10.1161\/01.HYP.0000114604.52270.95"},{"key":"ref57","doi-asserted-by":"crossref","unstructured":"Vila G, Luger A, van der Lely AJ, Neggers SJCMM, Webb SM, Biller BMK, et al. Hypertension in Acromegaly in Relationship to Biochemical Control and Mortality: Global ACROSTUDY Outcomes. Frontiers in Endocrinology. 2020; 11: 577173.","DOI":"10.3389\/fendo.2020.577173"},{"key":"ref58","doi-asserted-by":"crossref","unstructured":"Bielohuby M, Roemmler J, Manolopoulou J, Johnsen I, Sawitzky M, Schopohl J, et al. Chronic growth hormone excess is associated with increased aldosterone: a study in patients with acromegaly and in growth hormone transgenic mice. Experimental Biology and Medicine. 2009; 234: 1002\u20131009.","DOI":"10.3181\/0901-RM-34"},{"key":"ref59","doi-asserted-by":"crossref","unstructured":"Sharma MD, Nguyen AV, Brown S, Robbins RJ. Cardiovascular Disease in Acromegaly. Methodist DeBakey Cardiovascular Journal. 2017; 13: 64\u201367.","DOI":"10.14797\/mdcj-13-2-64"},{"key":"ref60","doi-asserted-by":"crossref","unstructured":"Maffei P, Martini C, Milanesi A, Corfini A, Mioni R, de Carlo E, et al. Late potentials and ventricular arrhythmias in acromegaly. International Journal of Cardiology. 2005; 104: 197\u2013203.","DOI":"10.1016\/j.ijcard.2004.12.010"},{"key":"ref61","doi-asserted-by":"crossref","unstructured":"Dutta P, Das S, Bhansali A, Bhadada SK, Rajesh BV, Reddy KS, et al. Congestive heart failure in acromegaly: A review of 6 cases. Indian Journal of Endocrinology and Metabolism. 2012; 16: 987\u2013990.","DOI":"10.4103\/2230-8210.103007"},{"key":"ref62","doi-asserted-by":"crossref","unstructured":"Subramnaian M, Shah V, Saggu DK, Yalagudri S, Narasimhan C. Looking above the heart: A rare cause of ventricular tachycardia. Journal of Arrhythmia. 2021; 37: 1120\u20131122.","DOI":"10.1002\/joa3.12546"},{"key":"ref63","doi-asserted-by":"crossref","unstructured":"Orosz A, Csajb\u00f3k \u00c9, Cz\u00e9kus C, Gavall\u00e9r H, Magony S, Valkusz Z, et al. Increased Short-Term Beat-To-Beat Variability of QT Interval in Patients with Acromegaly. PLoS ONE. 2015; 10: e0125639.","DOI":"10.1371\/journal.pone.0125639"},{"key":"ref64","doi-asserted-by":"crossref","unstructured":"Kinugawa S, Tsutsui H, Ide T, Nakamura R, Arimura K, Egashira K, et al. Positive inotropic effect of insulin-like growth factor-1 on normal and failing cardiac myocytes. Cardiovascular Research. 1999; 43: 157\u2013164.","DOI":"10.1016\/S0008-6363(99)00058-9"},{"key":"ref65","doi-asserted-by":"crossref","unstructured":"Mizera \u0141, Elbaum M, Daroszewski J, Bolanowski M. Cardiovascular complications of acromegaly. Acta Endocrinologica. 2018; 14: 365\u2013374.","DOI":"10.4183\/aeb.2018.365"},{"key":"ref66","doi-asserted-by":"crossref","unstructured":"Giustina A, Barkan A, Beckers A, Biermasz N, Biller BMK, Boguszewski C, et al. A Consensus on the Diagnosis and Treatment of Acromegaly Comorbidities: An Update. The Journal of Clinical Endocrinology and Metabolism. 2020; 105: dgz096.","DOI":"10.1210\/clinem\/dgz096"},{"key":"ref67","unstructured":"Koca H, Koc M, Sumbul HE, Icen YK, Gulumsek E, Koca F, et al. Subclinical Left Atrial and Ventricular Dysfunction in Acromegaly Patients: A Speckle Tracking Echocardiography Study. Arquivos Brasileiros De Cardiologia. 2022; 118: 634\u2013645."},{"key":"ref68","doi-asserted-by":"crossref","unstructured":"Oliveira MM, Jorge Lara BH, Tom\u00e9 JM, Ferreira BP, Borges MCC, da Silva AP, et al. Cardiac Structural Alterations of Acromegalic, Without Alteration in Cardiac Function, Evaluated by Doppler Echocardiography with Speckle Tracking. Global Journal of Health Science. 2021; 13: 32.","DOI":"10.5539\/gjhs.v13n10p32"},{"key":"ref69","doi-asserted-by":"crossref","unstructured":"Muraru D, Niero A, Rodriguez-Zanella H, Cherata D, Badano L. Three-dimensional speckle-tracking echocardiography: benefits and limitations of integrating myocardial mechanics with three-dimensional imaging. Cardiovascular Diagnosis and Therapy. 2018; 8: 101\u2013117.","DOI":"10.21037\/cdt.2017.06.01"},{"key":"ref70","doi-asserted-by":"crossref","unstructured":"Korm\u00e1nyos \u00c1, Domsik P, Kalapos A, Valkusz Z, Lengyel C, Forster T, et al. Three-dimensional speckle tracking echocardiography-derived left atrial deformation analysis in acromegaly (Results from the MAGYAR-Path Study). Echocardiography. 2018; 35: 975\u2013984.","DOI":"10.1111\/echo.13860"},{"key":"ref71","doi-asserted-by":"crossref","unstructured":"Guo X, Cao J, Liu P, Cao Y, Li X, Gao L, et al. Cardiac Abnormalities in Acromegaly Patients: A Cardiac Magnetic Resonance Study. International Journal of Endocrinology. 2020; 2020: 2018464.","DOI":"10.1155\/2020\/2018464"},{"key":"ref72","doi-asserted-by":"crossref","unstructured":"Holdaway IM, Rajasoorya RC, Gamble GD. Factors influencing mortality in acromegaly. The Journal of Clinical Endocrinology and Metabolism. 2004; 89: 667\u2013674.","DOI":"10.1210\/jc.2003-031199"},{"key":"ref73","doi-asserted-by":"crossref","unstructured":"Tachibana H, Yamaguchi H, Abe S, Sato T, Inoue S, Abe S, et al. Improvement of ventricular arrhythmia by octreotide treatment in acromegalic cardiomyopathy. Japanese Heart Journal. 2003; 44: 1027\u20131031.","DOI":"10.1536\/jhj.44.1027"},{"key":"ref74","doi-asserted-by":"crossref","unstructured":"Suyama K, Uchida D, Tanaka T, Saito J, Noguchi Y, Nakamura S, et al. Octreotide improved ventricular arrhythmia in an acromegalic patient. Endocrine Journal. 2000; 47: S73\u2013S75.","DOI":"10.1507\/endocrj.47.SupplMarch_S73"},{"key":"ref75","doi-asserted-by":"crossref","unstructured":"Auriemma RS, Pivonello R, De Martino MC, Cudemo G, Grasso LFS, Galdiero M, et al. Treatment with GH receptor antagonist in acromegaly: effect on cardiac arrhythmias. European Journal of Endocrinology. 2012; 168: 15\u201322.","DOI":"10.1530\/EJE-12-0596"},{"key":"ref76","doi-asserted-by":"crossref","unstructured":"Maione L, Garcia C, Bouchachi A, Kallel N, Maison P, Salenave S, et al. No evidence of a detrimental effect of cabergoline therapy on cardiac valves in patients with acromegaly. The Journal of Clinical Endocrinology and Metabolism. 2012; 97: E1714\u2013E1719.","DOI":"10.1210\/jc.2012-1833"},{"key":"ref77","doi-asserted-by":"crossref","unstructured":"Antunes X, Kasuki L, Gadelha MR. New and emerging pharmacological treatment options for acromegaly. Expert Opinion on Pharmacotherapy. 2021; 22: 1615\u20131623.","DOI":"10.1080\/14656566.2021.1908998"},{"key":"ref78","doi-asserted-by":"crossref","unstructured":"Arshad MF, Ogunleye O, Ross R, Debono M. Surgically treated acromegaly patients have a similar quality of life whether controlled by surgery or requiring additional medical therapy (QuaLAT Study). Pituitary. 2021; 24: 768\u2013777.","DOI":"10.1007\/s11102-021-01153-4"},{"key":"ref79","doi-asserted-by":"crossref","unstructured":"Whittington MD, Munoz KA, Whalen JD, Ribeiro-Oliveira A, Campbell JD. Economic and clinical burden of comorbidities among patients with acromegaly. Growth Hormone & IGF Research: Official Journal of the Growth Hormone Research Society and the International IGF Research Society. 2021; 59: 101389.","DOI":"10.1016\/j.ghir.2021.101389"}],"container-title":["Reviews in Cardiovascular Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.imrpress.com\/journal\/RCM\/24\/4\/10.31083\/j.rcm2404095","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T18:32:35Z","timestamp":1732732355000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.imrpress.com\/journal\/RCM\/24\/4\/10.31083\/j.rcm2404095"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,23]]},"references-count":79,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023]]}},"alternative-id":["S1530-6550(23)00881-5"],"URL":"https:\/\/doi.org\/10.31083\/j.rcm2404095","relation":{},"ISSN":["1530-6550","2153-8174"],"issn-type":[{"value":"1530-6550","type":"print"},{"value":"2153-8174","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,23]]},"article-number":"95"}}