{"id":1638,"date":"2025-05-10T16:18:36","date_gmt":"2025-05-10T16:18:36","guid":{"rendered":"https:\/\/nutricardio.ro\/?p=1638"},"modified":"2025-05-10T16:18:36","modified_gmt":"2025-05-10T16:18:36","slug":"bolile-hipofizei-si-manifestarile-cardiovasculare","status":"publish","type":"post","link":"https:\/\/nutricardio.ro\/bolile-hipofizei-si-manifestarile-cardiovasculare\/","title":{"rendered":"Bolile hipofizei \u0219i manifest\u0103rile cardiovasculare"},"content":{"rendered":"<p class=\"\" data-start=\"261\" data-end=\"881\">Glanda hipofiz\u0103, \u00een special lobul anterior (adenohipofiza), este responsabil\u0103 pentru secre\u021bia a cel pu\u021bin \u0219apte hormoni, dintre care patru \u2013 ACTH, TSH, LH \u0219i FSH \u2013 ac\u021bioneaz\u0103 asupra glandelor \u021bint\u0103, precum corticosuprarenalele, tiroida \u0219i gonadele. Ace\u0219tia produc efecte indirecte asupra \u00eentregului organism. Melanocitostimulantul (MSH) \u0219i prolactina nu sunt asociate cu efecte cardiovasculare semnificative. Dintre toate bolile hipofizei \u0219i manifest\u0103rile cardiovasculare asociate, singura endocrinopatie hipofizar\u0103 cu implica\u021bii majore este excesul de hormon de cre\u0219tere (GH), care se manifest\u0103 clinic prin acromegalie.<\/p>\n<h2 data-start=\"261\" data-end=\"881\">Bolile hipofizei \u0219i manifest\u0103rile cardiovasculare<\/h2>\n<p class=\"\" data-start=\"883\" data-end=\"914\">\u00a0Acromegalia \u2013 baza endocrin\u0103<\/p>\n<p class=\"\" data-start=\"916\" data-end=\"1260\">Acromegalia este cauzat\u0103 \u00een majoritatea cazurilor de un adenom hipofizar secretant de GH, care determin\u0103 cre\u0219terea secundar\u0103 a IGF-1 (insulin-like growth factor 1). Afec\u021biunea are un debut lent, iar tabloul clinic este adesea tipic, incluz\u00e2nd tr\u0103s\u0103turi faciale grosiere, cre\u0219terea extremit\u0103\u021bilor, precum \u0219i modific\u0103ri tegumentare \u0219i articulare.<\/p>\n<p class=\"\" data-start=\"1262\" data-end=\"1311\"><strong>\u00a0Modific\u0103ri metabolice relevante cardiovascular<\/strong><\/p>\n<p class=\"\" data-start=\"1313\" data-end=\"1387\">Manifest\u0103rile metabolice contribuie semnificativ la riscul cardiovascular:<\/p>\n<ul data-start=\"1389\" data-end=\"1639\">\n<li class=\"\" data-start=\"1389\" data-end=\"1455\">\n<p class=\"\" data-start=\"1391\" data-end=\"1455\">rezisten\u021ba la insulin\u0103 apare la aproximativ 50% dintre pacien\u021bi;<\/p>\n<\/li>\n<li class=\"\" data-start=\"1456\" data-end=\"1524\">\n<p class=\"\" data-start=\"1458\" data-end=\"1524\">diabetul zaharat secundar este prezent \u00een circa 10% dintre cazuri;<\/p>\n<\/li>\n<li class=\"\" data-start=\"1525\" data-end=\"1639\">\n<p class=\"\" data-start=\"1527\" data-end=\"1639\">hiperlipidemia, \u00een special cre\u0219terea trigliceridelor \u0219i a LDL-colesterolului, accentueaz\u0103 riscul aterosclerotic.<\/p>\n<\/li>\n<\/ul>\n<h3 data-start=\"1641\" data-end=\"1686\">\u00a0Manifest\u0103ri cardiovasculare \u00een acromegalie<\/h3>\n<ol data-start=\"1688\" data-end=\"1715\">\n<li class=\"\" data-start=\"1688\" data-end=\"1715\">\n<p class=\"\" data-start=\"1691\" data-end=\"1715\"><strong>Hipertensiunea arterial\u0103<\/strong><\/p>\n<\/li>\n<\/ol>\n<p class=\"\" data-start=\"1717\" data-end=\"1995\">Este cea mai frecvent\u0103 manifestare cardiovascular\u0103, afect\u00e2nd \u00eentre 15 \u0219i 50% dintre pacien\u021bi. De obicei este u\u0219oar\u0103 sau moderat\u0103 \u0219i r\u0103spunde bine la tratamente conven\u021bionale. S-a constatat o corela\u021bie pozitiv\u0103 \u00eentre nivelurile de GH \u0219i IGF-1, v\u00e2rsta pacientului \u0219i durata bolii.<\/p>\n<p class=\"\" data-start=\"1997\" data-end=\"2053\"><strong>\u00a0Mecanisme fiziopatologice implicate \u00een hipertensiune:<\/strong><\/p>\n<ul data-start=\"2055\" data-end=\"2334\">\n<li class=\"\" data-start=\"2055\" data-end=\"2146\">\n<p class=\"\" data-start=\"2057\" data-end=\"2146\">reten\u021bie de sodiu \u0219i ap\u0103 prin activarea sistemului renin\u0103-angiotensin\u0103-aldosteron (SRAA);<\/p>\n<\/li>\n<li class=\"\" data-start=\"2147\" data-end=\"2202\">\n<p class=\"\" data-start=\"2149\" data-end=\"2202\">cre\u0219terea debitului cardiac \u0219i a volumului plasmatic;<\/p>\n<\/li>\n<li class=\"\" data-start=\"2203\" data-end=\"2282\">\n<p class=\"\" data-start=\"2205\" data-end=\"2282\">hipertrofia musculaturii netede vasculare cu reducerea complian\u021bei vasculare;<\/p>\n<\/li>\n<li class=\"\" data-start=\"2283\" data-end=\"2334\">\n<p class=\"\" data-start=\"2285\" data-end=\"2334\">posibil\u0103 disfunc\u021bie endotelial\u0103 mediat\u0103 de IGF-1.<\/p>\n<\/li>\n<\/ul>\n<ol start=\"2\" data-start=\"2336\" data-end=\"2352\">\n<li class=\"\" data-start=\"2336\" data-end=\"2352\">\n<p class=\"\" data-start=\"2339\" data-end=\"2352\"><strong>Ateroscleroza<\/strong><\/p>\n<\/li>\n<\/ol>\n<p class=\"\" data-start=\"2354\" data-end=\"2700\">Ateroscleroza se dezvolt\u0103 precoce la pacien\u021bii cu acromegalie, uneori chiar \u00eenainte de diagnostic. Factorii favorizan\u021bi includ hipertensiunea, insulinorezisten\u021ba, hiperinsulinismul, hiperlipidemia \u0219i inflama\u021bia cronic\u0103 de grad redus. Riscul de boal\u0103 coronarian\u0103 este crescut, iar mortalitatea cardiovascular\u0103 este mai mare la pacien\u021bii netrata\u021bi.<\/p>\n<ol start=\"3\" data-start=\"2702\" data-end=\"2732\">\n<li class=\"\" data-start=\"2702\" data-end=\"2732\">\n<p class=\"\" data-start=\"2705\" data-end=\"2732\"><strong>Cardiomiopatia acromegalic\u0103<\/strong><\/p>\n<\/li>\n<\/ol>\n<p class=\"\" data-start=\"2734\" data-end=\"2796\">Aceasta este o entitate clinic\u0103 specific\u0103, caracterizat\u0103 prin:<\/p>\n<ul data-start=\"2798\" data-end=\"3059\">\n<li class=\"\" data-start=\"2798\" data-end=\"2844\">\n<p class=\"\" data-start=\"2800\" data-end=\"2844\">hipertrofie ventricular\u0103 st\u00e2ng\u0103 concentric\u0103;<\/p>\n<\/li>\n<li class=\"\" data-start=\"2845\" data-end=\"2891\">\n<p class=\"\" data-start=\"2847\" data-end=\"2891\">dilatarea progresiv\u0103 a cavit\u0103\u021bilor cardiace;<\/p>\n<\/li>\n<li class=\"\" data-start=\"2892\" data-end=\"2979\">\n<p class=\"\" data-start=\"2894\" data-end=\"2979\">disfunc\u021bie diastolic\u0103 precoce, cu poten\u021bial de progresie spre insuficien\u021b\u0103 sistolic\u0103;<\/p>\n<\/li>\n<li class=\"\" data-start=\"2980\" data-end=\"3059\">\n<p class=\"\" data-start=\"2982\" data-end=\"3059\">tulbur\u0103ri de ritm, \u00een special tahiaritmii supraventriculare sau ventriculare.<\/p>\n<\/li>\n<\/ul>\n<p class=\"\" data-start=\"3061\" data-end=\"3211\">Aceast\u0103 form\u0103 de cardiomiopatie este independent\u0103 de hipertensiune \u0219i de alte comorbidit\u0103\u021bi, ap\u0103r\u00e2nd chiar \u0219i la pacien\u021bi tineri \u00een stadii incipiente.<\/p>\n<h4 data-start=\"3213\" data-end=\"3258\">\u00a0Tratamentul manifest\u0103rilor cardiovasculare<\/h4>\n<p class=\"\" data-start=\"3260\" data-end=\"3615\">Av\u00e2nd \u00een vedere complexitatea acestor manifest\u0103ri, este esen\u021bial ca fiecare pacient cu acromegalie sau suspiciune de boal\u0103 hipofizar\u0103 s\u0103 se adreseze medicului endocrinolog \u0219i cardiolog pentru evaluare \u0219i stabilirea unui plan terapeutic individualizat. Automedica\u021bia sau \u00eent\u00e2rzierea consultului medical pot duce la agravarea complica\u021biilor cardiovasculare.<\/p>\n<p class=\"\" data-start=\"3617\" data-end=\"3629\"><strong>Concluzie<\/strong><\/p>\n<p class=\"\" data-start=\"3631\" data-end=\"4022\">Manifest\u0103rile cardiovasculare \u00een acromegalie sunt frecvente, complexe \u0219i contribuie semnificativ la morbiditatea \u0219i mortalitatea pacien\u021bilor. Diagnosticul precoce \u0219i interven\u021bia terapeutic\u0103 eficient\u0103 sunt esen\u021biale pentru prevenirea complica\u021biilor majore. O abordare multidisciplinar\u0103 \u2013 endocrinologic\u0103, cardiologic\u0103 \u0219i nutri\u021bional\u0103 \u2013 este recomandat\u0103 pentru un management eficient al bolii.<\/p>\n<p data-start=\"2975\" data-end=\"3216\">Documentat din: Manual Fiziopatologie, vol. I<\/p>\n<p data-start=\"2975\" data-end=\"3216\">Citeste si:\u00a0<a href=\"https:\/\/nutricardio.ro\/glandele-suprarenale-centrale-energetice-ale-corpului\/\" target=\"_blank\" rel=\"noopener\">Glandele suprarenale: centrale energetice ale corpului<\/a><\/p>\n<p data-start=\"2975\" data-end=\"3216\"><a href=\"https:\/\/www.facebook.com\/profile.php?id=61572639073054\" target=\"_blank\" rel=\"noopener\">FACEBOOK NUTRICARDIO MAGAZINE<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Glanda hipofiz\u0103, \u00een special lobul anterior (adenohipofiza), este responsabil\u0103 pentru secre\u021bia a cel pu\u021bin \u0219apte hormoni, dintre care patru \u2013<\/p>\n","protected":false},"author":1,"featured_media":1647,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8,4],"tags":[505,509,503,508,513,375,507,514,127,506,512,511,504,515,510],"class_list":["post-1638","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-longevitate","category-nutritie","tag-acromegalie","tag-ateroscleroza","tag-bolile-hipofizei","tag-cardiomiopatie","tag-diabet-secundar","tag-endocrinologie","tag-gh","tag-glanda-hipofiza","tag-hipertensiune-arteriala","tag-hormon-de-crestere","tag-igf-1","tag-insulinorezistenta","tag-manifestari-cardiovasculare","tag-sistem-cardiovascular","tag-tulburari-metabolice"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.7 - 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