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. 2012 Dec 10;168(1):15-22.
doi: 10.1530/EJE-12-0596. Print 2013 Jan.

Treatment with GH receptor antagonist in acromegaly: effect on cardiac arrhythmias

Renata S Auriemma  1 , Rosario Pivonello, Maria Cristina De Martino, Giuseppe Cudemo, Ludovica F S Grasso, Mariano Galdiero, Ylenia Perone, Annamaria Colao
Affiliations

Treatment with GH receptor antagonist in acromegaly: effect on cardiac arrhythmias

Renata S Auriemma et al. Eur J Endocrinol. .

Abstract

Objective: To evaluate the effects of short- and long-term treatment with pegvisomant (PEG) on arrhythmias in acromegalic patients resistant to long-term, high-dose therapy with somatostatin analogs (SA).

Materials and methods: Thirteen patients entered the study. all patients started peg at initial dose of 10MG daily and then titrated to 5MG every 6 weeks on the basis of IGF1. A standard 24-H electrocardiography registration was performed in all patients at baseline and after 6 AND 18 months of PEG to evaluate: mean (HR), maximum (MHR), and minimum (mHR) heart rate; pauses number (P) and duration (PD); supraventricular episodes (SEs) number and duration (SED); and ventricular ectopic beats (EB) number and duration (EBD). Left ventricular mass (LVM) was also evaluated by standard echocardiography.

Results: A slight but not significant decrease in HR, MHR, and mHR was observed after 6-month PEG, whereas a significant decrease in HR (P=0.03), MHR (P=0.05), and mHR (P=0.05) was found after 18-month PEG compared with baseline. LVM significantly (P=0.05) correlated with MRH (r=-0.50) after short-term treatment, and with HR (r=-0.54) and mHR (r=-0.55) after long-term treatment. Long-term PEG induced the complete recovery of arrhythmias recorded at baseline in one patient and the improvement of rhythm disorders developed after 6-month therapy in another patient. The prevalence of conduction disturbances passed from 15 to 7.7% after long-term PEG.

Conclusions: Long-term treatment with PEG reduces HR, MHR, and mHR and improves rhythm abnormalities in acromegaly.

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