Heart transplantation for terminal congestive heart failure in an acromegalic patient

Dilated hypokinetic cardiomyopathy in an acromegalic patientis an uncommon event. Specific hormonal therapy with octreotide(a somatostatin analogue) is now recognized as able to improvecardiac failure. A case of worsening of cardiac function undersuch a therapy is described in this report. Octreotide was finallydiscontinued and a cardiac transplantation performed. Soon aftersurgery, treatment with octreotide was started again and noother adverse reaction was noticed. Furthermore, no deleteriousor synergistic interaction between the somatostatin analogueand cyclosporine A was detected. A pharmacological hypothesisis given to explain the inability of octreotide to counteractcardiac failure. The patient died 6 months after surgery probablybecause of an acute episode of arrhythmia.