Overproduction of growth hormone in acromegaly can result in a cardiomyopathy. Control of the underlying disease results in control of the heart disease. Failure to control progression of the cardiac disease increases morbidity and mortality.


Risk factors for cardiomyopathy:

(1) long duration of disease

(2) active, uncontrolled disease


Clinical features:

(1) tachycardia

(2) hypertension

(3) left ventricular hypertrophy followed by biventricular dilatation (dilated cardiomyopathy)

(4) heart failure

Structural Changes

Cardiac Output

Functional Status


none apparent

high (increased contractility, low vascular resistance)


early hyperkinetic

myocardial hypertrophy, interstitial fibrosis, mucin deposits

diastolic dysfunction

dyspnea on exertion


ventricular dilatation

low with systolic dysfunction and heart failure

dyspnea at rest

late and end-stage


Additional cardiac disorders in acromegaly:

(1) valvular disease

(2) cardiac arrhythmias

(3) coronary artery disease with myocardial ischemia or infarction


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