Echocardiographic assessment of subclinical left ventricular eccentric hypertrophy in adult-onset GHD patients by geometric remodeling: an observational case-control study

Gregorio, Cesare de; Curtò, Lorenzo; Recupero, Antonino; Grimaldi, Patrizia; Almoto, B.; Venturino, M; Cento, D; Narbone, M. C.; Trimarchi, Francesco; Coglitore, Sebastiano; Cannavò, Salvatore

doi:10.1186/1472-6823-6-1

Cited by 7 publications

(5 citation statements)

References 42 publications

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“…However, the data from the majority of studies derive from small populations of normal/slightly overweight patients, or with a childhood-onset GHD. Similarly to our findings, De Gregorio et al [ 32 ] observed that a subgroup of GHD patients had high LVMi and eccentric hypertrophy. This finding is typically observed in patients with obesity, and so we may speculate that ectopic adipose tissue accumulation is the first strong determinant of cardiovascular remodelling in these patients and that GHD may act as an additive factor for increasing cardiometabolic risk by acting on MS elements and exacerbating cardiac alterations.…”

Section: Discussionsupporting

confidence: 92%

“…The ectopic fat deposition was also evidenced by echocardiography as follows: we found a higher EFT in patients with GHD, similarly to other authors [ 32 ]. The EF is a metabolically active organ that generates a variety of bioactive molecules with inflammatory properties that could significantly affect cardiac function [ 33 , 34 ].…”

Section: Discussionsupporting

confidence: 91%

“…This finding is typically observed in patients with obesity, and so we may speculate that ectopic adipose tissue accumulation is the first strong determinant of cardiovascular remodelling in these patients and that GHD may act as an additive factor for increasing cardiometabolic risk by acting on MS elements and exacerbating cardiac alterations. In fact, LVMi has been found to be a particularly important prognostic factor for cardiovascular events [ 32 , 51 ]. Therefore, GHD patients suffering from obesity may represent a population at particularly high risk for cardiovascular events [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

“…In fact, LVMi has been found to be a particularly important prognostic factor for cardiovascular events [ 32 , 51 ]. Therefore, GHD patients suffering from obesity may represent a population at particularly high risk for cardiovascular events [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

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Growth Hormone Secretory Capacity Is Associated with Cardiac Morphology and Function in Overweight and Obese Patients: A Controlled, Cross-Sectional Study

Gangitano

Bárbaro

Susi

et al. 2022

Cells

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Obesity is associated with increased cardiovascular morbidity. Adult patients with growth hormone deficiency (GHD) show morpho-functional cardiological alterations. A total of 353 overweight/obese patients are enrolled in the period between 2009 and 2019 to assess the relationships between GH secretory capacity and the metabolic phenotype, cardiovascular risk factors, body composition and cardiac echocardiographic parameters. All patients underwent GHRH + arginine test to evaluate GH secretory capacity, DEXA for body composition assessment and transthoracic echocardiography. Blood samples are also collected for the evaluation of metabolic parameters. In total, 144 patients had GH deficiency and 209 patients had normal GH secretion. In comparing the two groups, we found significant differences in body fat distribution with predominantly visceral adipose tissue accumulation in GHD patients. Metabolic syndrome is more prevalent in the GHD group. In particular, fasting glycemia, triglycerides and systolic and diastolic blood pressure are found to be linearly correlated with GH secretory capacity. Epicardial fat thickness, E/A ratio and indexed ventricular mass are worse in the GHD group. In the population studied, metabolic phenotype, body composition, cardiovascular risk factors and cardiac morphology are found to be related to the GH secretory capacity. GH secretion in the obese patient seems to be an important determinant of metabolic health.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Growth Hormone Secretory Capacity Is Associated with Cardiac Morphology and Function in Overweight and Obese Patients: A Controlled, Cross-Sectional Study

Gangitano

Bárbaro

Susi

et al. 2022

Cells

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“…Our baseline observations that patients with AGHD had lower exercise capacity without left ventricular systolic dysfunction are in accordance with previous studies. 13 , 34 – 37 Conversely, other researchers have reported a decreased LVM 14 , 16 , 17 , 20 , 38 and reduced ejection fraction on echocardiography 38 , 39 or radionuclide angiography 20 in patients with GHD. However, when CMR is used, 1 year of GH treatment did not influence cardiac mass or contractility.…”

Section: Discussionmentioning

confidence: 98%

Effects of human recombinant growth hormone on exercise capacity, cardiac structure, and cardiac function in patients with adult-onset growth hormone deficiency

et al. 2017

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ObjectiveEpidemiological studies suggest that adult-onset growth hormone deficiency (AGHD) might increase the risk of death from cardiovascular causes.MethodsThis was a 6-month double-blind, placebo-controlled, randomised, cross-over trial followed by a 6-month open-label phase. Seventeen patients with AGHD received either recombinant human growth hormone (rGH) (0.4 mg injection daily) or placebo for 12 weeks, underwent washout for 2 weeks, and were then crossed over to the alternative treatment for a further 12 weeks. Cardiac magnetic resonance imaging, echocardiography, and cardiopulmonary exercise testing were performed at baseline, 12 weeks, 26 weeks, and the end of the open phase (12 months). The results were compared with those of 16 age- and sex-matched control subjects.ResultsAt baseline, patients with AGHD had a significantly higher systolic blood pressure, ejection fraction, and left ventricular mass than the control group, even when corrected for body surface area. Treatment with rGH normalised the insulin-like growth factor 1 concentration without an effect on exercise capacity, cardiac structure, or cardiac function.ConclusionAdministration of rGH therapy for 6 to 9 months failed to normalise the functional and structural cardiac differences observed in patients with AGHD when compared with a control group.

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Cardiac function in growth hormone deficient patients before and after 1 year with replacement therapy: a magnetic resonance imaging study

et al. 2010

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Assessed by conventional echocardiography the influence of growth hormone deficiency (GHD) and effects of replacement therapy on left ventricle (LV) function and mass (LVM) have shown inconsistent results. We aimed to evaluate cardiac function before and during replacement therapy employing the gold standard method cardiac magnetic resonance imaging (CMRI) and measurements of circulating levels of B-type natriuretic peptides. Sixteen patients (8 males and 8 females, mean age 49 years (range 18-75)) with severe GHD and 16 matched control subjects were included. CMRI was performed at baseline and after 1 year of GH replacement therapy. IGF-I, B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-proBNP) were measured after 0, 1, 2, 3, 6 and 12 months of treatment. IGF-I Z-score increased from (median (IQR)) -2.3 (-3.8 to -1.4) to 0.5 (-0.3 to 1.7). LVM index (LVMI), ejection fraction (range 63-80%), cardiac output index and levels of BNP and NT-proBNP were similar at baseline in patients compared to controls (P-values from 0.09 to 0.37). The patients had significantly smaller LV end-diastolic volume index (P = 0.032) and end-systolic volume index (P = 0.038). No significant change in LV systolic function or LVM occurred during 1 year of GH treatment. BNP levels were unchanged (P = 0.88), whereas NT-proBNP tended to decrease (P = 0.052). Assessed by the highly sensitive and precise CMRI method, untreated GHD was not associated with impaired systolic function or reduced LVMI and 1 year of GH replacement using physiological doses did not influence cardiac mass or function.

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Echocardiographic assessment of subclinical left ventricular eccentric hypertrophy in adult-onset GHD patients by geometric remodeling: an observational case-control study

Cited by 7 publications

References 42 publications

Growth Hormone Secretory Capacity Is Associated with Cardiac Morphology and Function in Overweight and Obese Patients: A Controlled, Cross-Sectional Study

Growth Hormone Secretory Capacity Is Associated with Cardiac Morphology and Function in Overweight and Obese Patients: A Controlled, Cross-Sectional Study

Effects of human recombinant growth hormone on exercise capacity, cardiac structure, and cardiac function in patients with adult-onset growth hormone deficiency

Cardiac function in growth hormone deficient patients before and after 1 year with replacement therapy: a magnetic resonance imaging study

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