IGF1 and hypertrophy: The pathogenesis of acromegaly-related cardiomyopathy includes a direct action of GH and IGF1 excess on the heart, along with indirect mechanisms by which an excess of GH and IGF1 induces hypertension and glucose and lipid metabolism disorders, resulting in cardiac glucotoxicity and lipotoxicity with cardiac remodelling and hypertrophy [3, 6].