Biomedical subjects

C Bauters

Publications and source records attributed to C Bauters.

At least 145 records · Page 8Linked to original sources

PubMed1992

Dose-response curve of angiographically smooth human epicardial vessel segments to intracoronary injections of isosorbide dinitrate.

The coronary vasodilator properties of isosorbide dinitrate are well established but the doses generally used (1,000-2,000 micrograms) are still empirical. We studied, with the use of quantitative coronary arteriography (CAESAR System), the response of smooth vessel segments (greater than 1.85 mm diameter), preconstricted with methylergometrine (400 micrograms i.v.), to intracoronary injections of graded doses (5-100 micrograms) of isosorbide dinitrate and the effects of these injections on systemic hemodynamic parameters in 10 patients undergoing diagnostic coronary angiography. Six further patients, in whom the injections of isosorbide dinitrate were replaced by equivalent volumes of normal saline, served as controls. Relative to the diameter 5 min after injection of methylergometrine, the diameter increased by a mean +/- SD of 9 +/- 7, 26 +/- 12, 33 +/- 15, 38 +/- 14, and 39 +/- 16% after injections of 5, 15, 60, 240, and 1,000 micrograms, respectively, of isosorbide dinitrate. After a cumulative dose of 80 micrograms, subsequent doses did not cause further significant increases in diameter. Injection of saline in the control group did not alter the coronary diameter. A significant fall in systolic arterial pressure, compared to the control group, occurred at a cumulative dose of 320 micrograms. The mean arterial pressure and heart rate were unchanged. Significant coronary vasodilation occurs with intracoronary doses of isosorbide much smaller than those currently employed. Cumulative doses of 320 micrograms or more cause systemic hemodynamic changes without producing additional coronary vasodilation. During interventional cardiac procedures, where systemic hypotension is undesirable, the use of smaller doses of intracoronary isosorbide dinitrate than currently employed may be feasible and should be investigated further.

Adult↗

PubMed1992

Effect of ketanserin on proximal and distal coronary constrictor responses to intracoronary infusion of serotonin in patients with stable angina, patients with variant angina, and control patients.

BACKGROUND: Serotonin, released by aggregating platelets, may contribute to or cause myocardial ischemia by constricting epicardial vessels. Experimental studies suggest that this constriction is mediated by two distinct serotonin receptor subtypes: 5-hydroxytryptamine1-like (S1-like) and 5-hydroxytryptamine2 (S2). METHODS AND RESULTS: To determine the relative contribution of S1-like and S2 receptors to the vasoconstrictor effects of serotonin, we studied the effect of ketanserin (0.75 mg, intracoronary), a selective S2 receptor antagonist, on the constrictor response of human coronary vessels to intracoronary infusions of serotonin. In control patients (n = 7), serotonin (10(-4) mol/l) caused significant (p less than 0.05) constriction only in distal segments, which was significantly (p less than 0.05) inhibited by ketanserin. In stable angina patients (n = 8), serotonin (10(-4) mol/l) caused significant constriction in proximal (p less than 0.01) and distal (p less than 0.01) segments, which was significantly inhibited by ketanserin in proximal (p less than 0.05) but not distal (p = 0.30) segments. In patients with variant angina (n = 3), epicardial occlusion at the site of preexisting stenoses in proximal locations occurred at infused concentrations of 10(-6) (one patient) or 10(-5) (two patients) mol/l. The infusion of the same concentration of serotonin after ketanserin again caused epicardial occlusion. CONCLUSIONS: Our results suggest that functionally important S1-like receptors that mediate vasoconstriction exist in the epicardial vessels of patients with stable or variant angina. Their activation, either at hyperreactive sites in patients with variant angina or in the distal epicardial vessels of patients with chronic stable angina, may contribute to or cause myocardial ischemia when serotonin is released after the intracoronary activation of platelets.

Adult↗

PubMed1992

[Intravenous thrombolysis by recombinant plasminogen activator (rt-PA) in unstable angina. A randomized multicenter study versus placebo].

Fifty patients (38 men) with unstable angina pectoris defined by: pain lasting > 15 minutes+percritical electrocardiographic changes+significant coronary narrowing on coronary angiography (Coro 1) performed within 24 hours, were treated in a double blind protocol with rt-PA (n = 25) 100 mg/90 minutes (10 mg bolus + 90 mg/90 minutes or placebo (n = 25). All received effective intravenous heparin and intravenous nitrates. Calcium antagonists and betablockers were prescribed in half the cases. Aspirin (100 mg orally per day) was prescribed after control coronary angiography (Coro 2) performed 24 +/- 6 hours after starting treatment. Qualitative and quantitative analysis (CAESAR system) was centralised. There were no differences in the angiographic findings between the two groups. Intracoronary thrombosis was observed in 43% (rt-PA) and 44% (placebo) in Coro 1 and in 17% and 28% in Coro 2. The incidence of myocardial revascularisation procedures was similar in the two groups: angioplasty: 12 (rt-PA) and 13 (placebo); coronary bypass surgery: 5 (rt-PA) and 6 (placebo). Seven patients developed myocardial infarction (5 rt-PA, 2 placebo), one of whom died of cardiogenic shock (placebo). Eighteen patients had haemorrhagic complications (14 rt-PA, 4 placebo; p < 0.002) mainly at the puncture sites (12/14, 3/4). Spontaneous haemorrhage occurred in 7/25 (28%) of patients on rt-PA (haematuria 3, gastrointestinal haemorrhage 2, haematuria + gastrointestinal haemorrhage 1, epistaxis 1) and in 1/25 patients on placebo (gastrointestinal haemorrhage) This study shows that intravenous thrombolysis with rt-PA in severe unstable angina pectoris doe not modify the clinical outcome or the angiographic lesions but exposes patients to a high risk of haemorrhagic complications.

Adult↗

PubMed1992

[Treatment of first restenosis by recurrent angioplasty. Immediate results and angiographic follow-up after 6 months].

This report summarises the authors' experience of 421 patients treated for a first restenosis by repeat conventional balloon angioplasty with a high 6 months angiographic follow-up (84%). The immediate results were significantly less than those obtained during the same period with initial angioplasty procedures (94.5% success and 0.9% complications without any deaths during the hospital period). The 39.9% recurrent restenosis rate, on the other hand, is the same as observed after a first procedure. The risk factors of a second restenosis seem to be different from those of a first restenosis. A shorter interval between the first and second angioplasty (< 3 months) was associated with a 55% risk of restenosis compared with only 36% when the interval was > 3 months. Two operative factors were associated with a high risk of recurrent restenosis: a maximum inflation pressure > 7 atm and > or = 3 balloon inflations. These results seem to be important and should be taken into consideration when deciding on the management of patients presenting with a first restenosis.

Aged↗

PubMed1992

[Coronary angioplasty of multivessel coronary diseases. Apropos of 1664 procedures. Immediate results and results following 6 months].

Between 1980 and 1990, 1,664 coronary angioplasty procedures were performed in 1,307 patients (86.6% male) with multivessel disease. The average age was 57 +/- 3 years (range 29 to 83 years). There was a previous history of infarction in 40.1% of patients and 22.4% of the procedures were performed for unstable angina. Catheter and 58.2%, 1,220 double vessel and 444 triple vessel diseases. A total of 2,509 lesions were dilated (1.5 stenoses/patient). The primary success rate was 81.9% with 3.2% of infarcts and 3.5% emergency bypass procedures and a global mortality of 2%. The factors responsible for death in the acute and hospital phases were unstable angina, age > 70 years, and ejection fraction < 35%. Complete revascularisation was achieved in 14.3% of cases: the only predictive factor for complete revascularisation on multivariate analysis was double vessel disease. A 6 months clinical and angiographic control was obtained for 83.8% of controllable procedures (965 dilatations). The restenosis rate was 47.9%. Univariate analysis of the factors of restenosis identified clinical parameters (age > 58 years, triple vessel disease, diabetes and unstable angina), parameters related to the lesion (length of stenosis > 1 cm, percentage stenosis > 80%) and to the procedure (residual stenosis > 20%): 68.4% of patients with restenosis underwent repeat angioplasty with a significantly superior primary success rate 88.7% vs 81.9% of global successes (p < 0.001). With a 82% primary success rate with few major complications, coronary angioplasty is a safe and effective therapeutic alternative. The extent of the lesions and the presence of chronic occlusion are the main limitating factors of revascularisation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1992

[Abnormal origin of the left circumflex coronary artery: clinical, angiographic and prognostic aspects. Apropos of 30 cases].

The object of this study of 30 patients with an anomalous origin of the left circumflex coronary artery was to define the clinical and angiographic features of this condition and to assess its influence on morbidity and survival. The 30 patients were 24 men and 6 women with ages ranging from 29 to 76 years. An anomalous origin of the left circumflex coronary artery should be suspected when two angiographic signs are present: firstly, the visualisation of a spur of opacification in the 30 degrees LAO view of left ventriculography, present in 93% or our patients; secondly, during selective left coronary angiography in the transverse view, an ascular zone is observed where the normal left circumflex artery should be. Confirmation of the diagnosis depends on opacification of the left circumflex arising from the right anterior sinus of Valsalva with a separate (37%) or common (23%) orifice with the right coronary artery or arising from a proximal segment of the right coronary artery/(40%). Five patients (17%) had a significant stenosis of the anomalous left circumflex coronary artery but this was always associated with lesions of the other coronary narrowing was observed. Of these patients, one had electrocardiographic signs of myocardial ischaemia and no other cause apart from the anomalous origin of the left circumflex to explain this ischaemia. The 30 patients were followed up for an average of 6.1 +/- 3.9 years. During this period, 1 cardiac death, 1 infarction, 5 cases of angina, 4 coronary bypass procedures, and 6 coronary angioplasties were observed. Nine patients (30%) had no cardiac event during follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1992

[Nitrate derivatives and coronary vasomotricity].

The action of nitrate derivatives on the coronary arterioles is weak and very short lasting which avoids the phenomenon of a coronary steal syndrome. Investigations of the epicardial coronary vessels require vasoconstriction stress tests, usually using ergometrine, and vasodilatation tests, mainly using isosorbide dinitrate (ISDN). The combination of the two tests allows evaluation of global coronary vasomotricity which is less than 100% variation of diameter. In coronary spasm, ISDN relieves the stenosis in less than 2 minutes in nearly all cases. An infusion of ISDN also prevents most cases of arterial spasm. In effort angina, it has been possible to demonstrate paradoxal vasoconstriction during exercise due to endothelial dysfunction. The direct action of nitrate derivatives on smooth muscle which is not endothelium dependent, prevents the vasoconstriction and increases oxygen supply during exercise.

Coronary Artery Disease↗

PubMed1992

[Response of coronary arteries to the intracoronary injection of isosorbide dinitrate. Dose-response curve].

The coronary vasodilator properties of isosorbide dinitrate (ISDN) are well known but the dosage remains empirical. The aim of this study was to construct a dose-response curve to ISDN with respect to vasoconstriction induced by ergometrine. The heart rate, aortic pressure and coronary angiography were analysed before and 3 and 5 minutes after I.V. injection of 0.4 mg of methylergometrine and 3 minutes after intracoronary injection of 5, 15, 60, 240 and 1,000 micrograms of ISDN in 10 patients with an average age of 53.2 +/- 10.8 years (ISDN group). Six other patients with an average age of 56.5 +/- 12.8 years comprised the control group and only received ergometrine. The coronary diameters were measured by quantitative coronary angiography using the CAESAR system of automatic contour detection. Three coronary segments with angiographically normal appearances and a resting diameter greater than or equal to 1.85 mm were analysed in each patient. With respect to the maximal constriction observed 5 minutes after the injection of methylergometrine, the percentage increase in coronary diameter was 9 +/- 7%, 26 +/- 12%, 33 +/- 15%, 38 +/- 14% and 39 +/- 16% after 5, 15, 60, 240 and 1,000 micrograms of ISDN respectively (p less than 0.005 vs control). A plateau effect was observed after a cumulative dose of 80 micrograms and administration of higher doses of 240 and 1,000 micrograms only caused mild nonsignificant additional increase in vessel diameter. In comparison with the control group, the systolic blood pressure only fell significantly with doses greater than 240 micrograms of ISDN (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Coronary Angiography↗

PubMed1992

[Stenosis of the common trunk of the left coronary artery: an unusual complication of percutaneous coronary angioplasty].

The recurrence of angina-type pain within a few months of successful coronary angioplasty usually indicative of a diagnosis of coronary re-stenosis. A control coronary artery angiograph sometimes eliminates this diagnosis by detecting a fresh coronary stenosis. The authors report a case of a tight stenosis of the left major coronary trunk a few months after angioplasty of the circumflex artery. The onset of a stenosis of this type leads to the discussion of the possible role of a traumatic lesion of the wall of the major trunk by the catheter-guide.

Adult↗

PubMed1991

Morphological changes of coronary stenosis after repeated balloon angioplasties: a quantitative angiographic study.

To study the sequential changes of an atherosclerotic narrowing after repeated balloon dilatation, we reviewed the coronary angiograms of 11 patients who underwent at least 3 percutaneous transluminal coronary angioplasties of the same coronary segment for two restenoses. No significant changes in reference and stenosis diameters were found when comparing the three successive stenosis, but lesion length and stenosis area progressively increased. The identification of these morphological changes after repeated angioplasties may be of interest in the management of recurrent restenosis.

Angioplasty, Balloon, Coronary↗

PubMed1991

[Vasomotor activity and coronary insufficiency].

Provocative testing has provided a method of evaluating the important role of vasomotor tone in coronary artery disease. The most sensitive test is the ergonovine (Methergin) test. This is a specific and reliable method of defining the clinical situations in which coronary spasm is common: --focal coronary artery spasm is mainly observed in resting angina alone or in association with effort angina. The prognosis of spasm is excellent with calcium antagonist therapy provided there is no other associated pathology such as left ventricular failure or triple vessel disease; --in the six weeks following myocardial infarction, focal coronary artery spasm is a common event: 20% of coronary angiographies. After six weeks, spasm is much less frequent. It does not influence the prognosis. This type of spasm is probably related to the scarring process; --coronary artery spasm is frequently associated with restenosis after coronary angioplasty, a process which is histologically related to proliferation of smooth muscle; --diffuse increase in coronary vasomotor tone is a much rarer pathology, perhaps related to global changes in vascular tone as its association with the Raynaud syndrome and with migraine would suggest. It presents clinically with resting angina and sometimes by typical Prinzmetal angina; --finally, vosomotor tone plays an important role in the daily life of coronary patients. Holter recordings for the detection of silent myocardial ischemia have shown episodes of myocardial ischemia at lower myocardial oxygen consumption levels than those usually recorded during exercise stress testing, which suggests a reduction in oxygen supply, that is to say coronary vasoconstriction. Changes in coronary vasomotor tone can modify the diameter of healthy coronary arteries by 100%.(ABSTRACT TRUNCATED AT 250 WORDS)

Coronary Disease↗

PubMed1991

[Long-term prognosis after myocardial infarction. Value of exercise test compared to clinical features and coronarography].

The aim of this study was to identify the parameters of exercise stress testing with a predictive value of cardiac death after myocardial infarction and to determine their importance with respect to clinical and coronary angiographic data. Three hundred and three patients, average age 48.9 +/- 9.2 years, surviving primary myocardial infarction, underwent a symptoms-limited exercise stress test and coronary angiography four to seven weeks after infarction. The average follow-up period was 48 +/- 22 months. Eighteen patients (5.9%) were lost to follow-up. Global mortality was 11.6% (33/285) and cardiac mortality was 8.8% (25/285) including 14 sudden deaths (56%) and 17 deaths during the first three years of follow-up (68%). A univariable analysis identified the following parameters of exercise stress testing as predictive of cardiac mortality. The duration of exercise, the maximal rate-pressure product, inconclusive test, the maximal heart rate, and occurrence of supraventricular arrhythmias. Only the last two parameters remained significant after a discriminant analysis and their combination with clinical variables (age and ventricular fibrillation during the hospital phase) enabled accurate classification of 79% of patients, which was significantly better than when clinical features were used alone (p 0.01). On the other hand, adding the data of coronary angiography (number of diseases vessels, absence of an Ergometrine test) only moderately improved this score (82%, NS). This study suggests that the results of the post-infarction exercise stress test enables identification of patients with a low or, on the contrary, with a high risk of cardiac death. The prognostic value of this investigation is better than simple clinical evaluation, especially in stable or asymptomatic patients. In this selected group of patients, coronary angiography did not provide additional prognostic information.

Adult↗

PubMed1990

[Other techniques of arterial recanalization].

During the last few years several new instruments have been added to the armentarium of endovascular procedures. They are aimed at destroying atheromatous plaques and recalibrating the arteries. The plaque destruction techniques include atherectomy which may be directional (as with Simpson's Atherocath) and applicable only to very proximal vascular segments, or rotational, pulverizing the plaques with a bur. In this category are the flexible Auth's rotablator and Stack's transluminal extraction catheter (TEC) where planning is combined with extraction. To traverse complete occlusions, Kaltenbach's rotating guide increases the success rate, but its use must always be completed by conventional angioplasty. Vascular recalibration can be achieved by stents or heating balloons. Numerous types of stent are now available. The best known are the Medivent stent which is self-expansive and stents with expanding balloons, such as the Palmaz Schatz stent or the radio-opaque Wiktor stent made of tantalum. These stents require an important anticoagulant therapy. These technique have widened the limits of angioplasty by tackling stenoses that have long been regarded as inaccessible. They have also made it possible to treat a number of acute occlusions. On the other hand, none of them has yet proved effective in the prevention of restenosis.

Arterial Occlusive Diseases↗

PubMed1990

Percutaneous coronary rotary ablation.

The rotablator is a high-speed rotating ablative system developed to grind obstructing atheromatous material into fine particles. It consists of a rotating burr attached to a long, flexible driving shaft with a central flexible guidewire. The device rotates with a speed of 190,000 r.p.m. In this study, after appropriate pretreatment, the atherectomy system was positioned over the guidewire, the steerable guidewire advanced to beyond the stenosis, the abrasive burr positioned at the stenosis and the rotation commenced. The abrasive burr was advanced until a resistance was experienced and then, with back and forth motion, further advanced until passage of the stenosis was achieved. The procedure was repeated six to eight times until no further mechanical resistance was encountered. Patients were maintained on aspirin and nifedipine. With a burr size between 1.5 and 2 mm, in 32 patients in the right coronary artery, twelve patients in the left anterior descending artery and eight patients in the circumflex artery, an average increase in diameter from 0.52 +/- 0.28 mm to 1.27 +/- 0.37 mm was achieved with respective reduction in the stenosis from 80 +/- 11% to 47 +/- 17%. Balloon dilatation was subsequently carried out in 19 patients in 15 of whom residual significant stenosis was due to the use of an inadequately large burr. There were no deaths. During ablation, in six patients evanescent (of few seconds in duration), spontaneously-reversible AV-block developed probably due to embolization of particles into the sinus node artery. Two patients developed coronary spasm, three had acute occlusion with subsequent myocardial infarction.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1989

Phenylephrine, vasopressin and angiotensin II as determinants of proto-oncogene and heat-shock protein gene expression in adult rat heart and aorta.

The expression of two oncogenes (conc) c-myc and c-fos, coding for nuclear proteins which play a regulatory role in growth and differentiation, and of two genes coding for two heat shock proteins (HSP) 68 (molecular weight 68,000) and 70 (molecular weight 70,000), which have a protective function during stress, have been investigated by Northern blot analysis of the total RNA, extracted from adult rat ventricle and aorta. (1) The two onc transcripts are absent from these tissues but their expression can be enhanced by a pretreatment with cycloheximide. (2) The HSP70 is, in part, constitutive, while HSP68 is not; both are thermo-inducible in an isolated coronary perfused rat heart. (3) The four messenger RNA (mRNA) are expressed in both ventricles and aorta, 1 or 2 hours after i.p. injection of 6 mg/kg phenylephrine or 12 IU/kg of vasopressin. (4) They are also induced by a continuous or discontinuous injection of angiotensin II (7.5 micrograms/kg per min) for 1-2 h, but only in the aorta. The lack of ventricular response to angiotensin II in rat ventricles has been attributed to the lack of angiotensin II receptors in this tissue. This indicates that, in addition to mechanical factors, circulating hormones which have in common the use of the phosphoinositol pathway, may activate the expression of genes coding for regulatory proteins. This may play a role in the genesis of both ventricular and aortic hypertrophy.

Angiotensin II↗

PubMed1988

Coronary flow as a determinant of c-myc and c-fos proto-oncogene expression in an isolated adult rat heart.

Chronic cardiac overload induces quantitative and qualitative changes of the phenotype which finally adapt the myocardium to its new functional requirements (Swynghedauw, 1986). It has been proposed that both stretch and enhanced isometric tension could trigger these modifications (Peterson and Lesch, 1972), but until now no real messenger has been found. In a search for signals which may account for these changes, we decided to investigate the expression of two proto-oncogenes, c-fos and c-myc, coding for nuclear proteins (review in Adamson, 1987) because several of their properties are consistent with their possessing a role in the transduction of extracellular growth signals to the cell interior. We report here that, in adult rat heart, expression of the c-fos and c-myc proto-oncogene was both sequentially and transitorily increased when, in a beating heart but not in an arrested heart, the coronary flow (and/or pressure) was augmented. This was studied in an isolated, coronary perfused heart preparation, a model in which the initial conditions of a cardiac overload may be mimicked in such a way that protein synthesis is stimulated by increasing the coronary perfusion pressure (Kira et al., 1984).

Animals↗

PubMed1988

[Augmentation of the expression of c-myc and c-fos oncogenes as a function of the mechanical activity of the isolated adult rat heart].

c-myc and c-fos oncogenes encode nuclear DNA binding proteins, and are involved in both growth regulation and differentiation. Using the molecular hybridization technique and DNA probes complementary to c-myc and c-fos mRNA, we report an increase in c-myc and c-fos expression level in the isolated beating adult rat heart with reference to the arrested isolated heart. This suggests a causal relationship between mechanical activity of the heart and c-myc and c-fos expression. It evidences for the first time a messenger between mechanical factor and adaptational changes in the phenotype which occurs at the beginning of cardiac hypertrophy.

Animals↗

PubMedDate not supplied

Immunohistochemical detection of glycoprotein hormone alpha subunit in somatoprolactinic and pure somatotroph adenomas.

Glycoprotein hormone alpha subunit (alpha SU) is expressed in nearly all thyreotroph adenomas and most gonadotrophinomas, but is less well documented in plurisecreting adenomas. We therefore examined the immunohistochemical (IHC) expression of alpha SU in a generally accepted model of plurisecreting adenomas (somatoprolactinic type) by comparison to a series of pure monosecreting somatotroph tumors. Fifty patients (32 females, 18 males) aged 15 to 68 years with clinical and/or biological acromegaly requiring adenomectomy were studied. Forty-five had clinical acromegaly and 5 had isolated amenorrhea and/or galactorrhea syndromes. Forty-eight of the 49 patients who had baseline assessments of plasma GH had a mean concentration of 5 ng/ml or more (normal value < 5). Fifteen of the 46 patients who had baseline measurements of plasma PRL had a prolactinemia value greater than 20 ng/ml (normal value < 20) but below 100 ng/ml, except for one patient. All the adenomas studied were positive by GH immunohistochemistry; 21 were immunostained by an antiPRL antibody and formed the "somatoprolactinic" (GH-PRL) group. Five of these 21 patients were male. The 12 female patients younger than 50 years had amenorrhea or galactorrhea, and one male patient complained of impotence. Eleven patients (9 females, 2 males) in this GH-PRL group had hyperprolactinemia. Sixteen of these GH-PRL adenomas were immunolabeled by alpha SU antiserum. The remaining 29 adenomas, which were immunonegative with the PRL antibody and formed the "somatotroph adenoma" (GH) group, were more frequent in male patients (13/29; 45%) compared to GH-PRL group. Eight amenorrhea or galactorrhea syndromes occurred among the 14 women younger than 50 years, 3 of whom had hyperprolactinemia. Thirteen of these 29 adenomas (45%) were immunopositive with alpha SU antibody. Compared to the GH group, the GH-PRL group had a significant higher frequency of amenorrhea and/or galactorrhea syndromes among women under 50 years (100% vs 57%; p < 0.01), as well as hyperprolactinemia (55% vs 15%; p < 0.01) and positive alpha SU immunoreactivity (76% vs 45%; p < 0.05). The frequency of extrasellar macroadenomas was not different according to PRL or alpha SU immunoreactivity. Thus, in this series of somatoprolactinic adenomas, alpha SU immunopositivity was slightly more frequent than in a control group of pure somatotroph adenomas. Moreover, hyperprolactinemia was more frequent in patients with GH-PRL adenomas, although the size of the pure and mixed adenomas was not different. These results suggest that hyperprolactinemia and/or alpha SU immunopositivity are more often associated with mixed GH-PRL adenomas.

Acromegaly↗