Endocrinol Metab.  2015 Sep;30(3):395-401. 10.3803/EnM.2015.30.3.395.

Acromegaly with Normal Insulin-Like Growth Factor-1 Levels and Congestive Heart Failure as the First Clinical Manifestation

• Lee HM
• Lee SH
• Yang IH
• Hwang IK
• Hwang YC
• Ahn KJ
• Chung HY
• Hwang HJ
• Jeong IK

• KMID: 2407092
• DOI: http://doi.org/10.3803/EnM.2015.30.3.395

Abstract

The leading cause of morbidity and mortality in patients with acromegaly is cardiovascular complications. Myocardial exposure to excessive growth hormone can cause ventricular hypertrophy, hypertension, arrhythmia, and diastolic dysfunction. However, congestive heart failure as a result of systolic dysfunction is observed only rarely in patients with acromegaly. Most cases of acromegaly exhibit high levels of serum insulin-like growth factor-1 (IGF-1). Acromegaly with normal IGF-1 levels is rare and difficult to diagnose. Here, we report a rare case of an acromegalic patient whose first clinical manifestation was severe congestive heart failure, despite normal IGF-1 levels. We diagnosed acromegaly using a glucose-loading growth hormone suppression test. Cardiac function and myocardial hypertrophy improved 6 months after transsphenoidal resection of a pituitary adenoma.

Keyword

Acromegaly; Heart failure; Insulin-like growth factor I

MeSH Terms

Acromegaly*
Arrhythmias, Cardiac
Estrogens, Conjugated (USP)*
Growth Hormone
Heart Failure*
Humans
Hypertension
Hypertrophy
Insulin-Like Growth Factor I
Mortality
Pituitary Neoplasms
Estrogens, Conjugated (USP)
Growth Hormone
Insulin-Like Growth Factor I