Prevalence and Characteristics of Heart Disease in Patients with Acromegaly in Colombia (RAPACO HEART Study).

Introduction: Acromegaly is a chronic disorder characterized by excessive secretion of growth hormone (GH) and insulin-like growth factor type 1 (IGF-1), resulting in multisystem involvement. Cardiovascular complications affect up to 80% of cases and represent a major concern in advanced stages of the disease. This study aims to determine the prevalence of acromegalic heart disease (AHD) and identify factors associated with its development in a Colombian population.

Objective: To evaluate the characteristics of AHD in patients with acromegaly in Colombia.

Methods: A retrospective, multicenter case-control study was carried out using data from the national RAPACO registry. Patients aged 16 years or older with confirmed acromegaly and an available echocardiogram were included. AHD was defined by structural or functional cardiac abnormalities attributable to acromegaly.

Results: A total of 193 patients with acromegaly were analyzed; 61 (31.6%) had AHD. Compared with the non-AHD group, these patients were older, had a 4.5 cm larger abdominal perimeter, and a median time from disease onset to diagnosis of 8 years (versus 6 years in those without AHD). Among the 61 AHD cases, the most frequent finding was isolated left ventricular hypertrophy (n=32, 52.4%), followed by biventricular hypertrophy (n=12, 19.7%), valvulopathy (n=4, 6.6%), and combined LVH with valvulopathy (n=4, 6.6%). GH and IGF-1 levels were modestly higher in AHD patients. In multivariate analysis, arterial hypertension showed an odds ratio (OR) of 1.75 (95% CI 0.67-4.65) for AHD, while carpal tunnel syndrome significantly increased the odds of AHD (OR 3.81, p=0.01, 95% CI 1.36-11.14).

Conclusions: Despite therapeutic advances, AHD remains common in Colombian patients with acromegaly. Notably, carpal tunnel syndrome was independently associated with AHD, alongside hypertension, arrhythmias, and diabetes. These findings underscore the need for proactive cardiovascular screening and management strategies in this patient population.