Objective To investigate the association of growth hormone (GH) and insulin-like growth factor (IGF-1) burden with the cardiac structural and functional changes in acromegaly patients. Methods Ninety-nine acromegaly patients were enrolled in this study. According to the normal range of echocardiographic parameters of Peking Union Medical College Hospital, the patients were divided into parameter normal group and abnormal group. Correlation analyses were conducted between duration of disease, mean GH, mean IGF-1, GH burden, IGF-1 burden and echocardiography data retrospectively. Results Forty eight cases (48.5%) was diagnosed as abnormal echocardiography, including enlargement of the cardiac cambers (29.3%), valvular diseases (15.1%), dilation of aortic root (5.1%), functional abnormal of left ventricle (19.2%) and wall motion abnormalities (1.0%). The average GH and IGF-1 burdens in echocardiography abnormal group (n=48) were higher than those in the normal group (n=51), without statistical significant except for the left ventricle end-systolic diameter (LVESD) (P=0.018) in GH burden comparison and E/A (P=0.011) and left atrium longitudinal dimension (LALD) (P=0.017) in IGF-1 burden comparison. Abnormal diastolic function group (n=18) had similar GH burden with the normal group (n=81) (P=0.419), but had higher IGF-1 burden than the normal group did (P=0.018).The GH burden correlated with left ventricle end-diastolic diameter (LVEDD) and LVESD,and the IGF-1 burden correlated with left ventricular ejection fraction (LVEF) , LALD, right ventricle longitudinal dimension( RVLD), Left ventricular posterior wall thickness (LVPWT), LVEDD, LVESD,and E/A ratio statistical significantlly (P