Cardiac resynchronization therapy improves heart failure in one patient with acromegaly-induced cardiomyopathy: a case report
Abstract Background Congestive heart failure is rarely observed in patients with acromegaly. Excessive growth hormone secretion and elevation of insulin-like growth factor 1 contribute to pathological changes in myocyte growth and structure, cardiac contractility, vascular function, and in later sta...
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| Format: | Article |
| Language: | English |
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BMC
2019-04-01
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| Series: | Journal of Medical Case Reports |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13256-019-2030-y |
| _version_ | 1811223910194085888 |
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| author | Jun yi Wang Yong mei Hu Jian xiong Liu Xiao jia Luo |
| author_facet | Jun yi Wang Yong mei Hu Jian xiong Liu Xiao jia Luo |
| author_sort | Jun yi Wang |
| collection | DOAJ |
| description | Abstract Background Congestive heart failure is rarely observed in patients with acromegaly. Excessive growth hormone secretion and elevation of insulin-like growth factor 1 contribute to pathological changes in myocyte growth and structure, cardiac contractility, vascular function, and in later stage may progress to cardiac dysfunction. Early recognition of the condition is paramount, though the insidious progression of the disease commonly results in late diagnosis. Current standard regimens of pharmacological therapy, surgical treatment, radiotherapy are designed to normalize serum levels of both insulin-like growth factor 1 and growth hormone. In patients with late-stage heart failure due to acromegalic cardiomyopathy, cardiac resynchronization therapy might be a desirable treatment to help cardiac synchronization, improve symptoms, and eventually reduce hospital admissions together with mortality rates. Case presentation We describe a case of a 49-year-old man with a history of acromegaly who presented to our hospital with a diagnosis of decompensated systolic heart failure. Serial electrocardiograms showed wide (160–200 ms) QRS duration with left bundle branch block. Echocardiography showed severe left ventricular dysfunction that simultaneously achieved a left ventricular ejection fraction of 16%. Surgical indication was rarely assessed by neurosurgeons. Given that the stereotactic radiosurgery together with pharmacotherapy produced infinitesimal effects, cardiac resynchronization therapy was performed. Owing to biventricular synchronization and holding back reverse remodeling, the patient’s symptoms were successfully alleviated, and he was discharged from the hospital. Conclusions Congestive heart failure is a rare complication in acromegaly-induced cardiomyopathy (occurs in only 3% of patients). Early diagnosis and treatment with curative drugs more than cardiovascular implantable electronic devices might lead to better surgical outcomes in this group of patients. |
| first_indexed | 2024-04-12T08:41:36Z |
| format | Article |
| id | doaj.art-4d2f3a90a02047f19e92ae1a9e5e5aa7 |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-04-12T08:41:36Z |
| publishDate | 2019-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-4d2f3a90a02047f19e92ae1a9e5e5aa72022-12-22T03:39:52ZengBMCJournal of Medical Case Reports1752-19472019-04-011311610.1186/s13256-019-2030-yCardiac resynchronization therapy improves heart failure in one patient with acromegaly-induced cardiomyopathy: a case reportJun yi Wang0Yong mei Hu1Jian xiong Liu2Xiao jia Luo3Affiliated with Chengdu Second People’s HospitalAffiliated with Chengdu Second People’s HospitalAffiliated with Chengdu Second People’s HospitalAffiliated with Chengdu Second People’s HospitalAbstract Background Congestive heart failure is rarely observed in patients with acromegaly. Excessive growth hormone secretion and elevation of insulin-like growth factor 1 contribute to pathological changes in myocyte growth and structure, cardiac contractility, vascular function, and in later stage may progress to cardiac dysfunction. Early recognition of the condition is paramount, though the insidious progression of the disease commonly results in late diagnosis. Current standard regimens of pharmacological therapy, surgical treatment, radiotherapy are designed to normalize serum levels of both insulin-like growth factor 1 and growth hormone. In patients with late-stage heart failure due to acromegalic cardiomyopathy, cardiac resynchronization therapy might be a desirable treatment to help cardiac synchronization, improve symptoms, and eventually reduce hospital admissions together with mortality rates. Case presentation We describe a case of a 49-year-old man with a history of acromegaly who presented to our hospital with a diagnosis of decompensated systolic heart failure. Serial electrocardiograms showed wide (160–200 ms) QRS duration with left bundle branch block. Echocardiography showed severe left ventricular dysfunction that simultaneously achieved a left ventricular ejection fraction of 16%. Surgical indication was rarely assessed by neurosurgeons. Given that the stereotactic radiosurgery together with pharmacotherapy produced infinitesimal effects, cardiac resynchronization therapy was performed. Owing to biventricular synchronization and holding back reverse remodeling, the patient’s symptoms were successfully alleviated, and he was discharged from the hospital. Conclusions Congestive heart failure is a rare complication in acromegaly-induced cardiomyopathy (occurs in only 3% of patients). Early diagnosis and treatment with curative drugs more than cardiovascular implantable electronic devices might lead to better surgical outcomes in this group of patients.http://link.springer.com/article/10.1186/s13256-019-2030-yAcromegalic cardiomyopathyHeart failureCardiac resynchronization therapy |
| spellingShingle | Jun yi Wang Yong mei Hu Jian xiong Liu Xiao jia Luo Cardiac resynchronization therapy improves heart failure in one patient with acromegaly-induced cardiomyopathy: a case report Journal of Medical Case Reports Acromegalic cardiomyopathy Heart failure Cardiac resynchronization therapy |
| title | Cardiac resynchronization therapy improves heart failure in one patient with acromegaly-induced cardiomyopathy: a case report |
| title_full | Cardiac resynchronization therapy improves heart failure in one patient with acromegaly-induced cardiomyopathy: a case report |
| title_fullStr | Cardiac resynchronization therapy improves heart failure in one patient with acromegaly-induced cardiomyopathy: a case report |
| title_full_unstemmed | Cardiac resynchronization therapy improves heart failure in one patient with acromegaly-induced cardiomyopathy: a case report |
| title_short | Cardiac resynchronization therapy improves heart failure in one patient with acromegaly-induced cardiomyopathy: a case report |
| title_sort | cardiac resynchronization therapy improves heart failure in one patient with acromegaly induced cardiomyopathy a case report |
| topic | Acromegalic cardiomyopathy Heart failure Cardiac resynchronization therapy |
| url | http://link.springer.com/article/10.1186/s13256-019-2030-y |
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