The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Cardiovascular Effects of the Somatostatin Analog Octreotide in Acromegaly

Philippe Chanson, MD; José Timsit, MD; Christiane Masquet, MD; André Warnet, MD; Pierre-Jean Guillausseau, MD; Pascal Birman, MD; Alan G. Harris, MD; and Jean Lubetzki, MD
[+] Article, Author, and Disclosure Information

Requests for Reprints: Philippe Chanson, MD, Department of Internal Medicine and Endocrinology, Hôpital Lariboisière-2, rue Ambroise Paré, F. 75475 Paris Cedex 10, France.

Current Author Addresses: Dr. Chanson, Dr. Warnet, Dr. Guillausseau, Dr. Birman, and Dr. Lubetzki: Department of Internal Medicine and Endocrinology, Hôpital Lariboisière-2, rue Ambroise Paré, F. 75475 Paris Cedex 10, France.

Dr. Masquet: Department of Cardiology, Hôpital Lariboisière-2, rue Ambroise Paré, F. 75475 Paris Cedex 10, France.

Dr. Timsit: Department of Clinical Immunology and INSERM U25, Hôpital Necker, F. 75743 Paris Cedex 15, France.

Dr. Harris: Department of Neuroendocrinology, Sandoz Ltd., Clinical Research, CH-4002 Basel, Switzerland.

© 1990 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1990;113(12):921-925. doi:10.7326/0003-4819-113-12-921
Text Size: A A A

Objective: To determine the cardiovascular effects of the somatostatin analog octreotide in patients with acromegaly.

Design: Prospective nonrandomized study.

Setting: Referral-based endocrinology clinic.

Patients: Seven patients with active acromegaly, three of whom had refractory congestive heart failure. The other four patients were free of symptoms associated with heart failure.

Interventions: All patients were treated with octreotide, 100 to 500 μg subcutaneously three times daily. The three patients with heart failure continued to receive cardiovascular therapy (angio-tensin converting enzyme inhibitors, digitalis, diuretics).

Measurements and Main Results: During octreotide therapy, patients showed a rapid decrease in growth hormone and insulin-like growth factor 1 (IGF-1): Mean levels (± SD) fell from 28.1 ± 32.7 μg/L to 5.2 ± 8.3 μg/L and 740 ± 126 μg/L to 372 ± 64 ±g/L, respectively (P < 0.025). Plasma volume returned to normal and heart rate decreased significantly. In the four patients without heart failure, right-heart catheterization done before and after 3 months of octreotide therapy showed an 18.3% ± 11% reduction in stroke volume and a return to normal of the cardiac index. The three patients with congestive heart failure, evaluated before and after 40 days and up to 2 years of therapy, showed a dramatic clinical improvement that was associated with an increase in stroke volume (by 24% to 51%). In these patients, the cardiac index remained in the normal range, filling pressures were markedly decreased, and pulmonary wedge pressure returned to normal. This improvement was sustained for up to 3 years in the two patients with heart failure who were receiving long-term treatment.

Conclusion: The rapid and sustained cardiac improvement seen in our patients shows that octreotide therapy for patients with acromegaly may be highly beneficial, even in those patients with advanced cardiac failure.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.