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Acromegalia y sus implicaciones cardiovasculares

Diego Andrés Cadena-Obando, Ilan Remba-Shapiro, Coralys Germania Abreu-Rosario, Moisés Mercado

Resumen


La acromegalia es una enfermedad crónica lentamente progresiva causada por la hipersecreción de hormona de crecimiento (GH) y consecuentemente de factor de crecimiento insulinoide tipo 1 (IGF-1), originada en el 95-98% de las ocasiones por un adenoma hipofisario secretor de GH. Existen diversas complicaciones o comorbilidad asociadas a la acromegalia, de las cuales destacan las enfermedades cardiovasculares, metabólicas y neoplásicas. Las complicaciones cardiovasculares van desde la hipertensión arterial hasta la cardiomiopatía acromegálica, y resultan de la exposición crónica a valores elevados de GH y de IGF-1. La fisiopatología de estas complicaciones es compleja e incluye tanto un aumento en la reabsorción tubular de sodio como efectos directos de la GH y del IGF-1 sobre el endotelio vascular y las células cardiacas. Con frecuencia estas alteraciones cardiovasculares ocurren simultáneamente con trastornos metabólicos como la diabetes y trastornos respiratorios como la apnea del sueño, y son agravadas por ellos. En esta breve revisión se analizan la fisiopatología, las manifestaciones clínicas y el manejo de las complicaciones cardiovasculares de la acromegalia.


Palabras clave


Acromegalia; Hormona del Crecimiento; Factor I del Crecimiento Similar a la Insulina; Hipertensión; Cardiomiopatía

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Referencias


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DOI: https://doi.org/10.24875/RMIMSS.M21000054

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