<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1405-9940</journal-id>
<journal-title><![CDATA[Archivos de cardiología de México]]></journal-title>
<abbrev-journal-title><![CDATA[Arch. Cardiol. Méx.]]></abbrev-journal-title>
<issn>1405-9940</issn>
<publisher>
<publisher-name><![CDATA[Instituto Nacional de Cardiología Ignacio Chávez]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1405-99402022000400513</article-id>
<article-id pub-id-type="doi">10.24875/acm.21000339</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Complicaciones cardiovasculares asociadas a la acromegalia. Estado del arte]]></article-title>
<article-title xml:lang="en"><![CDATA[Cardiovascular complications associated with acromegaly. A state-of-the-art]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Concepción-Zavaleta]]></surname>
<given-names><![CDATA[Marcio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Muñoz-Moreno]]></surname>
<given-names><![CDATA[Juan]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Quispe-Flores]]></surname>
<given-names><![CDATA[María]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rafael-Robles]]></surname>
<given-names><![CDATA[Luciana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lobato-Jeri]]></surname>
<given-names><![CDATA[Carlos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ramos-Yataco]]></surname>
<given-names><![CDATA[Anthony]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Concepción-Urteaga]]></surname>
<given-names><![CDATA[Luis]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Paz-Ibarra]]></surname>
<given-names><![CDATA[José]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Clínica Stella Maris Servicio de Endocrinología ]]></institution>
<addr-line><![CDATA[Lima ]]></addr-line>
<country>Perú</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Nacional Edgardo Rebagliati Martins Servicio de Cardiología ]]></institution>
<addr-line><![CDATA[Lima ]]></addr-line>
<country>Perú</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Nacional Guillermo Almenara Irigoyen Servicio de Endocrinología ]]></institution>
<addr-line><![CDATA[Lima ]]></addr-line>
<country>Perú</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital Nacional 2 de Mayo Servicio de Endocrinología ]]></institution>
<addr-line><![CDATA[Lima ]]></addr-line>
<country>Perú</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Instituto Nacional del Corazón Servicio de Cardiología ]]></institution>
<addr-line><![CDATA[Lima ]]></addr-line>
<country>Perú</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,Hospital Ricardo Cruzado Rivarola Servicio de Medicina ]]></institution>
<addr-line><![CDATA[Nasca ]]></addr-line>
<country>Perú</country>
</aff>
<aff id="Af7">
<institution><![CDATA[,Universidad Nacional de Trujillo Facultad de Medicina ]]></institution>
<addr-line><![CDATA[Trujillo ]]></addr-line>
<country>Perú</country>
</aff>
<aff id="Af8">
<institution><![CDATA[,Universidad Nacional Mayor de San Marcos Facultad de Medicina ]]></institution>
<addr-line><![CDATA[Lima ]]></addr-line>
<country>Perú</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2022</year>
</pub-date>
<volume>92</volume>
<numero>4</numero>
<fpage>513</fpage>
<lpage>521</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S1405-99402022000400513&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S1405-99402022000400513&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S1405-99402022000400513&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen La acromegalia es una enfermedad rara, causada principalmente por un tumor hipofisiario secretor de hormona de crecimiento (GH), se caracteriza por tener progresión lenta y asociarse a un compromiso multisistémico, siendo el aparato cardiovascular uno de los más comprometidos, llegando, incluso, desde hace más de 10 años a representar la principal causa de muerte. Las complicaciones cardiovasculares se desarrollan como resultado de las concentraciones sanguíneas elevadas de la GH y del factor de crecimiento similar a la insulina tipo 1 (IGF-1), los cuales ejercen efectos directos e indirectos sobre el endotelio, grandes vasos, riñón y los cardiomiocitos; produciendo hipertensión arterial, enfermedad valvular, arritmia cardiaca y una cardiopatía propia de la acromegalia denominada miocardiopatía acromegálica. Luego de la revisión bibliográfica actualizada relacionada con la fisiopatología, manifestaciones clínicas, diagnóstico y tratamiento del compromiso cardiovascular, encontramos que desde el punto de vista cardiovascular los pacientes con acromegalia pueden variar desde un estado asintomático hasta presentar disfunción cardiaca severa, siendo los marcadores bioquímicos y exámenes de imagen herramientas diagnósticas que permiten evaluar el grado de afección cardiovascular para poder brindar un tratamiento individualizado. La normalización de los valores de la GH y del IGF-1 mejora los parámetros cardiovasculares y, por tanto, su pronóstico.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Acromegaly is a rare disease, mainly caused by a pituitary tumor secreting growth hormone. It is characterized by slow progression and is associated with a multisystemic involvement, being the cardiovascular system, one of the most involved, even reaching, more than 10 years ago, to represent the main cause of death. Cardiovascular complications develop as a result of elevated blood concentrations of growth hormone and insulin-like growth factor 1, which exert direct and indirect effects on the endothelium, large vessels, kidney and cardiomyocytes; causing arterial hypertension, valve disease, cardiac arrhythmia and a specific heart disease called acromegalic cardiomyopathy. After the literature overview related to the pathophysiology, clinical manifestations, diagnosis and treatment of cardiovascular involvement, we found that from a cardiovascular point of view, patients with acromegaly can range from an asymptomatic state to severe cardiac dysfunction, being the biochemical markers and imaging studies diagnostic tools that allow assessment the degree of cardiovascular disease in order to provide individualized treatment. The normalization of growth hormone and insulin-like growth factor 1 levels improves cardiovascular parameters, and therefore its prognosis.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Acromegalia]]></kwd>
<kwd lng="es"><![CDATA[Corazón]]></kwd>
<kwd lng="es"><![CDATA[Cardiopatía]]></kwd>
<kwd lng="es"><![CDATA[Hipertensión]]></kwd>
<kwd lng="en"><![CDATA[Acromegaly]]></kwd>
<kwd lng="en"><![CDATA[Heart]]></kwd>
<kwd lng="en"><![CDATA[Heart diseases]]></kwd>
<kwd lng="en"><![CDATA[Hypertension]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Colao]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Grasso]]></surname>
<given-names><![CDATA[LFS]]></given-names>
</name>
<name>
<surname><![CDATA[Giustina]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Melmed]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Chanson]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Pereira]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acromegaly]]></article-title>
<source><![CDATA[Nat Rev Dis Primers]]></source>
<year>2019</year>
<volume>5</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>20</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Melmed]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acromegaly pathogenesis and treatment]]></article-title>
<source><![CDATA[J Clin Invest]]></source>
<year>2009</year>
<volume>119</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>3189-202</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Colao]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Ferone]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Marzullo]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Lombardi]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Systemic complications of acromegaly:epidemiology, pathogenesis, and management]]></article-title>
<source><![CDATA[Endocr Rev]]></source>
<year>2004</year>
<volume>25</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>102-52</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ramos-Leví]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Marazuela]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Bringing cardiovascular comorbidities in acromegaly to an update How should we diagnose and manage them?]]></article-title>
<source><![CDATA[Front Endocrinol (Lausanne)]]></source>
<year>2019</year>
<volume>10</volume>
<page-range>120</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gadelha]]></surname>
<given-names><![CDATA[MR]]></given-names>
</name>
<name>
<surname><![CDATA[Kasuki]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Lim]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Fleseriu]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Systemic complications of acromegaly and the impact of the current treatment landscape:An update]]></article-title>
<source><![CDATA[Endocr Rev]]></source>
<year>2019</year>
<volume>40</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>268-332</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Yang]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Tan]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Huang]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Li]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Advances in research on the cardiovascular complications of acromegaly]]></article-title>
<source><![CDATA[Front Oncol]]></source>
<year>2021</year>
<volume>11</volume>
<page-range>640999</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sharma]]></surname>
<given-names><![CDATA[AN]]></given-names>
</name>
<name>
<surname><![CDATA[Tan]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Amsterdam]]></surname>
<given-names><![CDATA[EA]]></given-names>
</name>
<name>
<surname><![CDATA[Singh]]></surname>
<given-names><![CDATA[GD]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acromegalic cardiomyopathy:Epidemiology, diagnosis, and management]]></article-title>
<source><![CDATA[Clin Cardiol]]></source>
<year>2018</year>
<volume>41</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>419-25</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lavrentaki]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Paluzzi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Wass]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Karavitaki]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Epidemiology of acromegaly:review of population studies]]></article-title>
<source><![CDATA[Pituitary]]></source>
<year>2017</year>
<volume>20</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>4-9</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Yun]]></surname>
<given-names><![CDATA[SJ]]></given-names>
</name>
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[JK]]></given-names>
</name>
<name>
<surname><![CDATA[Park]]></surname>
<given-names><![CDATA[SY]]></given-names>
</name>
<name>
<surname><![CDATA[Chin]]></surname>
<given-names><![CDATA[SO]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Descriptive epidemiology and survival analysis of acromegaly in Korea]]></article-title>
<source><![CDATA[J Korean Med Sci]]></source>
<year>2021</year>
<volume>36</volume>
<numero>23</numero>
<issue>23</issue>
</nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[López Gavilanez]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Guerrero Franco]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Solórzano Zambrano]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Navarro Chávez]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[López Estrella]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Vaca Burbano]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Epidemiology of acromegaly in Ecuador]]></article-title>
<source><![CDATA[Endocrinol Nutr]]></source>
<year>2016</year>
<volume>63</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>333-8</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cardenas Obando]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acromegaly and it's cardiovascular implications]]></article-title>
<source><![CDATA[Rev Med Inst Mex Seguro Soc]]></source>
<year>2021</year>
<volume>59</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>73-80</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vilar]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Vilar]]></surname>
<given-names><![CDATA[CF]]></given-names>
</name>
<name>
<surname><![CDATA[Lyra]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Naves]]></surname>
<given-names><![CDATA[LA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acromegaly:clinical features at diagnosis]]></article-title>
<source><![CDATA[Pituitary]]></source>
<year>2017</year>
<volume>20</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>22-32</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Holdaway]]></surname>
<given-names><![CDATA[IM]]></given-names>
</name>
<name>
<surname><![CDATA[Rajasoorya]]></surname>
<given-names><![CDATA[RC]]></given-names>
</name>
<name>
<surname><![CDATA[Gamble]]></surname>
<given-names><![CDATA[GD]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Factors influencing mortality in acromegaly]]></article-title>
<source><![CDATA[J Clin Endocrinol Metab]]></source>
<year>2004</year>
<volume>89</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>667-74</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Laszczak]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Moqbil]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Niedobylski]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Warcho&#322;]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cardiovascular comorbidities in acromegaly]]></article-title>
<source><![CDATA[J Educ Health Sport]]></source>
<year>2021</year>
<volume>11</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>283-9</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kasuki]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Rocha]]></surname>
<given-names><![CDATA[PDS]]></given-names>
</name>
<name>
<surname><![CDATA[Lamback]]></surname>
<given-names><![CDATA[EB]]></given-names>
</name>
<name>
<surname><![CDATA[Gadelha]]></surname>
<given-names><![CDATA[MR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Determinants of morbidities and mortality in acromegaly]]></article-title>
<source><![CDATA[Arch Endocrinol Metab]]></source>
<year>2019</year>
<volume>63</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>630-7</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rolla]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Jawiarczyk-Przyby&#322;owska]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Halupczok-&#379;y&#322;a]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Kaluzny]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Konopka]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[B&#322;oniecka]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Complications and comorbidities of acromegaly-retrospective study in Polish Center]]></article-title>
<source><![CDATA[Front Endocrinol (Lausanne)]]></source>
<year>2021</year>
<volume>12</volume>
<page-range>642131</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Palmeiro]]></surname>
<given-names><![CDATA[CR]]></given-names>
</name>
<name>
<surname><![CDATA[Anand]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Dardi]]></surname>
<given-names><![CDATA[IK]]></given-names>
</name>
<name>
<surname><![CDATA[Balasubramaniyam]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Schwarcz]]></surname>
<given-names><![CDATA[MD]]></given-names>
</name>
<name>
<surname><![CDATA[Weiss]]></surname>
<given-names><![CDATA[IA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Growth hormone and the cardiovascular system]]></article-title>
<source><![CDATA[Cardiol Rev]]></source>
<year>2012</year>
<volume>20</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>197-207</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Colao]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Grasso]]></surname>
<given-names><![CDATA[LFS]]></given-names>
</name>
<name>
<surname><![CDATA[Di Somma]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Pivonello]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acromegaly and heart failure]]></article-title>
<source><![CDATA[Heart Fail Clin]]></source>
<year>2019</year>
<volume>15</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>399-408</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lombardi]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Di Somma]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Grasso]]></surname>
<given-names><![CDATA[LFS]]></given-names>
</name>
<name>
<surname><![CDATA[Savanelli]]></surname>
<given-names><![CDATA[MC]]></given-names>
</name>
<name>
<surname><![CDATA[Colao]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Pivonello]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The cardiovascular system in growth hormone excess and growth hormone deficiency]]></article-title>
<source><![CDATA[J Endocrinol Invest]]></source>
<year>2012</year>
<volume>35</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>1021-9</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Arcopinto]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Bobbio]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Bossone]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Perrone-Filardi]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Napoli]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Sacca]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The GH/IGF-1 axis in chronic heart failure]]></article-title>
<source><![CDATA[Endocr Metab Immune Disord Drug Targets]]></source>
<year>2013</year>
<volume>13</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>76-91</page-range></nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Isgaard]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Arcopinto]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Karason]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Cittadini]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[GH and the cardiovascular system:an update on a topic at heart]]></article-title>
<source><![CDATA[Endocrine]]></source>
<year>2015</year>
<volume>48</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>25-35</page-range></nlm-citation>
</ref>
<ref id="B22">
<label>22</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vila]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Luger]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[van der Lely]]></surname>
<given-names><![CDATA[AJ]]></given-names>
</name>
<name>
<surname><![CDATA[Neggers]]></surname>
<given-names><![CDATA[SJCMM]]></given-names>
</name>
<name>
<surname><![CDATA[Webb]]></surname>
<given-names><![CDATA[SM]]></given-names>
</name>
<name>
<surname><![CDATA[Biller]]></surname>
<given-names><![CDATA[BMK]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hypertension in acromegaly in relationship to biochemical control and mortality:Global ACROSTUDY outcomes]]></article-title>
<source><![CDATA[Front Endocrinol (Lausanne)]]></source>
<year>2020</year>
<volume>11</volume>
<page-range>577173</page-range></nlm-citation>
</ref>
<ref id="B23">
<label>23</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pivonello]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Auriemma]]></surname>
<given-names><![CDATA[RS]]></given-names>
</name>
<name>
<surname><![CDATA[Grasso]]></surname>
<given-names><![CDATA[LF]]></given-names>
</name>
<name>
<surname><![CDATA[Pivonello]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Simeoli]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Patalano]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Complications of acromegaly:cardiovascular, respiratory and metabolic comorbidities]]></article-title>
<source><![CDATA[Pituitary]]></source>
<year>2017</year>
<volume>20</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>46-62</page-range></nlm-citation>
</ref>
<ref id="B24">
<label>24</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mosca]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Paolillo]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Colao]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Bossone]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Cittadini]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Iudice]]></surname>
<given-names><![CDATA[FL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cardiovascular involvement in patients affected by acromegaly:An appraisal]]></article-title>
<source><![CDATA[Int J Cardiol]]></source>
<year>2013</year>
<volume>167</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>1712-8</page-range></nlm-citation>
</ref>
<ref id="B25">
<label>25</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bihan]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Espinosa]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Valdes-Socin]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Salenave]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Young]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Levasseur]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Long-term outcome of patients with acromegaly and congestive heart failure]]></article-title>
<source><![CDATA[J Clin Endocrinol Metab]]></source>
<year>2004</year>
<volume>89</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>5308-13</page-range></nlm-citation>
</ref>
<ref id="B26">
<label>26</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nascimento]]></surname>
<given-names><![CDATA[GC]]></given-names>
</name>
<name>
<surname><![CDATA[Oliveira]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Torres de Oliveira]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Chaves Carvalho]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Cordeiro Lopes]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Guimarães Sá]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acromegalic cardiomyopathy in an extensively admixed population:is there a role for GH/IGF-I axis?]]></article-title>
<source><![CDATA[Clin Endocrinol (Oxf)]]></source>
<year>2013</year>
<volume>78</volume>
<page-range>94-101</page-range></nlm-citation>
</ref>
<ref id="B27">
<label>27</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sharma]]></surname>
<given-names><![CDATA[AN]]></given-names>
</name>
<name>
<surname><![CDATA[Tan]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Amsterdam]]></surname>
<given-names><![CDATA[EA]]></given-names>
</name>
<name>
<surname><![CDATA[Singh]]></surname>
<given-names><![CDATA[GD]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acromegalic cardiomyopathy:Epidemiology, diagnosis, and management]]></article-title>
<source><![CDATA[Clin Cardiol]]></source>
<year>2018</year>
<volume>41</volume>
<page-range>419-25</page-range></nlm-citation>
</ref>
<ref id="B28">
<label>28</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kamenicky]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Blanchard]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Frank]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Salenave]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Letierce]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Azizi]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Body fluid expansion in acromegaly is related to enhanced epithelial sodium channel (ENaC) activity]]></article-title>
<source><![CDATA[J Clin Endocrinol Metab]]></source>
<year>2011</year>
<volume>96</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>2127-35</page-range></nlm-citation>
</ref>
<ref id="B29">
<label>29</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Maffei]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Dassie]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Wennberg]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Parolin]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Vettor]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The endothelium in acromegaly]]></article-title>
<source><![CDATA[Front Endocrinol (Lausanne)]]></source>
<year>2019</year>
<volume>10</volume>
<page-range>437</page-range></nlm-citation>
</ref>
<ref id="B30">
<label>30</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Schöfl]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Petroff]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Tönjes]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Grussendorf]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Droste]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Stalla]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Incidence of myocardial infarction and stroke in acromegaly patients:results from the German Acromegaly Registry]]></article-title>
<source><![CDATA[Pituitary]]></source>
<year>2017</year>
<volume>20</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>635-42</page-range></nlm-citation>
</ref>
<ref id="B31">
<label>31</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Parolin]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Dassie]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Vettor]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Steeds]]></surname>
<given-names><![CDATA[RP]]></given-names>
</name>
<name>
<surname><![CDATA[Maffei]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Electrophysiological features in acromegaly:re-thinking the arrhythmic risk?]]></article-title>
<source><![CDATA[J Endocrinol Invest]]></source>
<year>2021</year>
<volume>44</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>209-21</page-range></nlm-citation>
</ref>
<ref id="B32">
<label>32</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Warszawski]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Kasuki]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Sá]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Dos Santos Silva]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
<name>
<surname><![CDATA[Volschan]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Gottlieb]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Low frequency of cardniac arrhythmias and lack of structural heart disease in medically-naïve acromegaly patients:a prospective study at baseline and after 1 year of somatostatin analogs treatment]]></article-title>
<source><![CDATA[Pituitary]]></source>
<year>2016</year>
<volume>19</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>582-9</page-range></nlm-citation>
</ref>
<ref id="B33">
<label>33</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kamenický]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Maione]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Chanson]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cardiovascular complications of acromegaly]]></article-title>
<source><![CDATA[Ann Endocrinol (Paris)]]></source>
<year>2021</year>
<volume>82</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>206-9</page-range></nlm-citation>
</ref>
<ref id="B34">
<label>34</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Colao]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Spinelli]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Marzullo]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Pivonello]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Petretta]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Di Somma]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[High prevalence of cardiac valve disease in acromegaly:an observational, analytical, case-control study]]></article-title>
<source><![CDATA[J Clin Endocrinol Metab]]></source>
<year>2003</year>
<volume>88</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>3196-201</page-range></nlm-citation>
</ref>
<ref id="B35">
<label>35</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dural]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Kabakci]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Çinar]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Erba&#351;]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Canpolat]]></surname>
<given-names><![CDATA[U]]></given-names>
</name>
<name>
<surname><![CDATA[Gürses]]></surname>
<given-names><![CDATA[KM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Assessment of cardiac autonomic functions by heart rate recovery, heart rate variability and QT dynamicity parameters in patients with acromegaly]]></article-title>
<source><![CDATA[Pituitary]]></source>
<year>2014</year>
<volume>17</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>163-70</page-range></nlm-citation>
</ref>
<ref id="B36">
<label>36</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Comunello]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Dassie]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Martini]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[De Carlo]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Mioni]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Battocchio]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Heart rate variability is reduced in acromegaly patients and improved by treatment with somatostatin analogues]]></article-title>
<source><![CDATA[Pituitary]]></source>
<year>2015</year>
<volume>18</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>525-34</page-range></nlm-citation>
</ref>
<ref id="B37">
<label>37</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ozkan]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Celik]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Hatipoglu]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Kantarci]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Kadioglu]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Procalcitonin can be used as a marker of premature atherosclerosis in acromegaly]]></article-title>
<source><![CDATA[Pituitary]]></source>
<year>2012</year>
<volume>15</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>358-64</page-range></nlm-citation>
</ref>
<ref id="B38">
<label>38</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Topaloglu]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Sayki Arslan]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Turak]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Ginis]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Sahin]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Cebeci]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Three noninvasive methods in the evaluation of subclinical cardiovascular disease in patients with acromegaly:Epicardial fat thickness, aortic stiffness and serum cell adhesion molecules]]></article-title>
<source><![CDATA[Clin Endocrinol (Oxf)]]></source>
<year>2014</year>
<volume>80</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>726-34</page-range></nlm-citation>
</ref>
<ref id="B39">
<label>39</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Aulinas]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Crespo]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Viladés]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Leta]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Urgell]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Biagetti]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cystatin-C and epicardial adipose tissue as noninvasive predictors of cardiovascular risk in acromegaly]]></article-title>
<source><![CDATA[Clin Endocrinol (Oxf)]]></source>
<year>2017</year>
<volume>86</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>214-22</page-range></nlm-citation>
</ref>
<ref id="B40">
<label>40</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Maffei]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Martini]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Milanesi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Corfini]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Mioni]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[de Carlo]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Late potentials and ventricular arrhythmias in acromegaly]]></article-title>
<source><![CDATA[Int J Cardiol]]></source>
<year>2005</year>
<volume>104</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>197-20</page-range></nlm-citation>
</ref>
<ref id="B41">
<label>41</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dereli]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Özer]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Özer]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Bayramo&#287;lu]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Kaya]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Association between fragmented QRS and left ventricular dysfunction in acromegaly patients]]></article-title>
<source><![CDATA[Acta Cardiol]]></source>
<year>2020</year>
<volume>75</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>435-41</page-range></nlm-citation>
</ref>
<ref id="B42">
<label>42</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Popielarz-Grygalewicz]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[G&#261;sior]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
<name>
<surname><![CDATA[Konwicka]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Grygalewicz]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Stelmachowska-Bana&#347;]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Zgliczy&#324;ski]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Heart in acromegaly:The echocardiographic characteristics of patients diagnosed with acromegaly in various stages of the disease]]></article-title>
<source><![CDATA[Int J Endocrinol]]></source>
<year>2018</year>
<volume>2018</volume>
<page-range>6935054</page-range></nlm-citation>
</ref>
<ref id="B43">
<label>43</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Natchev]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Kundurdjiev]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Zlatareva]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Vandeva]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Kirilov]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Kundurzhiev]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Echocardiographic myocardial changes in acromegaly:A cross-sectional analysis in a tertiary center in Bulgaria]]></article-title>
<source><![CDATA[Acta Endocrinol (Buchar)]]></source>
<year>2019</year>
<volume>5</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>52-61</page-range></nlm-citation>
</ref>
<ref id="B44">
<label>44</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kormányos]]></surname>
<given-names><![CDATA[Á]]></given-names>
</name>
<name>
<surname><![CDATA[Domsik]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Kalapos]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Gyenes]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Valkusz]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Lengyel]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Active acromegaly is associated with enhanced left ventricular contractility:Results from the three-dimensional speckle-tracking echocardiographic MAGYAR-Path Study]]></article-title>
<source><![CDATA[Rev Port Cardiol (Engl Ed)]]></source>
<year>2020</year>
<volume>39</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>189-96</page-range></nlm-citation>
</ref>
<ref id="B45">
<label>45</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Guo]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Cao]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Liu]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Cao]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Li]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Gao]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cardiac abnormalities in acromegaly patients:A cardiac magnetic resonance study]]></article-title>
<source><![CDATA[Int J Endocrinol]]></source>
<year>2020</year>
<volume>2020</volume>
<page-range>2018464</page-range></nlm-citation>
</ref>
<ref id="B46">
<label>46</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dassie]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Grillo]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Carretta]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Fabris]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Macaluso]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Bardelli]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Ambulatory arterial stiffness indexes in acromegaly]]></article-title>
<source><![CDATA[Eur J Endocrinol]]></source>
<year>2012</year>
<volume>166</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>199-205</page-range></nlm-citation>
</ref>
<ref id="B47">
<label>47</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ramos-Leví]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Marazuela]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Bringing cardiovascular comorbidities in acromegaly to an update How should we diagnose and manage them?]]></article-title>
<source><![CDATA[Front Endocrinol (Lausanne)]]></source>
<year>2019</year>
<volume>10</volume>
<page-range>1-11</page-range></nlm-citation>
</ref>
<ref id="B48">
<label>48</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Giustina]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Bevan]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
<name>
<surname><![CDATA[Bronstein]]></surname>
<given-names><![CDATA[MD]]></given-names>
</name>
<name>
<surname><![CDATA[Casanueva]]></surname>
<given-names><![CDATA[FF]]></given-names>
</name>
<name>
<surname><![CDATA[Chanson]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Petersenn]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[SAGIT Investigator Group SAGIT®:clinician-reported outcome instrument for managing acromegaly in clinical practice-development and results from a pilot study]]></article-title>
<source><![CDATA[Pituitary]]></source>
<year>2016</year>
<volume>19</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>39-49</page-range></nlm-citation>
</ref>
<ref id="B49">
<label>49</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Van der Lely]]></surname>
<given-names><![CDATA[AJ]]></given-names>
</name>
<name>
<surname><![CDATA[Gomez]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Pleil]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Badia]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Brue]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Buchfelder]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Development of ACRODAT®, a new software medical device to assess disease activity in patients with acromegaly]]></article-title>
<source><![CDATA[Pituitary]]></source>
<year>2017</year>
<volume>20</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>692-701</page-range></nlm-citation>
</ref>
<ref id="B50">
<label>50</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Heidarpour]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Shafie]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Aminorroaya]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Sarrafzadegan]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Farajzadegan]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Nouri]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Effects of somatostatin analog treatment on cardiovascular parameters in patients with acromegaly:A systematic review]]></article-title>
<source><![CDATA[J Res Med Sci]]></source>
<year>2019</year>
<volume>24</volume>
<page-range>29</page-range></nlm-citation>
</ref>
<ref id="B51">
<label>51</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jane]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Starke]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Elzoghby]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Reames]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Payne]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Thorner]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Endoscopic transsphenoidal surgery for acromegaly:remission using modern criteria, complications, and predictors of outcome]]></article-title>
<source><![CDATA[J Clin Endocrinol Metab]]></source>
<year>2011</year>
<volume>96</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>2732-40</page-range></nlm-citation>
</ref>
<ref id="B52">
<label>52</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Strasburger]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Buchfelder]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Droste]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Mann]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Stalla]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Saller]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Experience from the German pegvisomant observational study]]></article-title>
<source><![CDATA[Horm Res]]></source>
<year>2007</year>
<volume>68</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>70-3</page-range></nlm-citation>
</ref>
<ref id="B53">
<label>53</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Giustina]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Arnaldi]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Bogazzi]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Cannavó]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Colao]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[De Marinis]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pegvisomant in acromegaly:an update]]></article-title>
<source><![CDATA[J Endocrinol Invest]]></source>
<year>2017</year>
<volume>40</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>577-89</page-range></nlm-citation>
</ref>
<ref id="B54">
<label>54</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Berg]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Petersenn]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Lahner]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Herrmann]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Buchfelder]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Droste]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cardiovascular risk factors in patients with uncontrolled and long-term acromegaly:comparison with matched data from the general population and the effect of disease control]]></article-title>
<source><![CDATA[J Clin Endocrinol Metab]]></source>
<year>2010</year>
<volume>95</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>3648-56</page-range></nlm-citation>
</ref>
<ref id="B55">
<label>55</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Auriemma]]></surname>
<given-names><![CDATA[RS]]></given-names>
</name>
<name>
<surname><![CDATA[Pivonello]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[De Martino]]></surname>
<given-names><![CDATA[MC]]></given-names>
</name>
<name>
<surname><![CDATA[Cudemo]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Grasso]]></surname>
<given-names><![CDATA[LF]]></given-names>
</name>
<name>
<surname><![CDATA[Galdiero]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Treatment with GH receptor antagonist in acromegaly:effect on cardiac arrhythmias]]></article-title>
<source><![CDATA[Eur J Endocrinol]]></source>
<year>2012</year>
<volume>168</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>15-22</page-range></nlm-citation>
</ref>
<ref id="B56">
<label>56</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kasuki]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Rocha]]></surname>
<given-names><![CDATA[PDS]]></given-names>
</name>
<name>
<surname><![CDATA[Lamback]]></surname>
<given-names><![CDATA[EB]]></given-names>
</name>
<name>
<surname><![CDATA[Gadelha]]></surname>
<given-names><![CDATA[MR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Determinants of morbidities and mortality in acromegaly]]></article-title>
<source><![CDATA[Arch Endocrinol Metab]]></source>
<year>2019</year>
<volume>63</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>630-7</page-range></nlm-citation>
</ref>
<ref id="B57">
<label>57</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bihan]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Espinosa]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Valdes-Socin]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Salenave]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Young]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Levasseur]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Long-term outcome of patients with acromegaly and congestive heart failure]]></article-title>
<source><![CDATA[J Clin Endocrinol Metab]]></source>
<year>2004</year>
<volume>89</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>5308-13</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
