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(Hypertension. 2004;43:561.)
© 2004 American Heart Association, Inc.

Scientific Contributions

Acromegalic Patients Show the Presence of Hypertrophic Remodeling of Subcutaneous Small Resistance Arteries

Damiano Rizzoni; Enzo Porteri; Andrea Giustina; Carolina De Ciuceis; Intissar Sleiman; Gianluca E. M. Boari; Maurizio Castellano; Maria Lorenza Muiesan; Stefania Bonadonna; Anna Burattin; Bruno Cerudelli; Enrico Agabiti-Rosei

From the Department of Medical and Surgical Sciences, University of Brescia, Italy.

Correspondence to Dr Damiano Rizzoni, Department of Medical and Surgical Sciences, University of Brescia, Chair of Internal Medicine, c/o 2a Medicina, Spedali Civili., 25100 Brescia, Italy. E-mail rizzoni{at}med.unibs.it

Structural alterations of small resistance arteries in patients with essential hypertension (EH) are mostly characterized by inward eutrophic remodeling. However, we have observed the presence of hypertrophic remodeling in patients with renovascular hypertension, as well as in patients with noninsulin-dependent diabetes mellitus, suggesting a relevant effect of humoral growth factors on vascular structure. Growth hormone may stimulate in vitro proliferation of vascular smooth muscle cells. However, no data are presently available about small artery structure in acromegalic patients. Therefore, we have investigated the structure of subcutaneous small arteries in 12 normotensive (NT) subjects, in 12 EH subjects, and in 9 acromegalic patients (APs). All subjects underwent biopsy of the subcutaneous fat; then, small resistance arteries were dissected and mounted on a micromyograph. The normalized internal diameter, media thickness, media-to-lumen ratio, the media cross-sectional area together with remodeling, and growth indices were calculated. Demographic variables were similar in the three groups, except for blood pressure. The media-to-lumen ratio was significantly greater in EH and AP, compared with NT. No difference was observed between EH and AP. The media cross-sectional area was significantly greater in AP compared with EH and with NT. The calculation of remodeling and growth index suggests the presence of eutrophic remodeling in EH (growth index 0%) and of hypertrophic remodeling in AP (growth index 40%). In conclusion, our data suggest the presence of hypertrophic remodeling of subcutaneous small resistance arteries of AP, probably as a consequence of growth-stimulator properties of IGF-1.

Key Words: arteries • hypertrophy • remodeling • growth hormone

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