Growth Hormone Deficiency in Adults Impacts Left Ventricular Mechanics: A Two-Dimensional Speckle-Tracking Study

Mihaila, S.; Mincu, Raluca I; Rimbaş, Roxana Cristina; Dobrescu, Ruxandra; Magda, Stefania; Badiu, Corin; Vinereanu, Dragoş

doi:10.1016/j.cjca.2015.01.008

Cited by 14 publications

(13 citation statements)

References 31 publications

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“…14 Similar to the results of our study, Mihaila et al reported that the E/Vp ratio, which is a marker of diastolic function, was inversely correlated with serum IGF-1 levels in patients with growth hormone deficiency. 17 This evidence may support our hypothesis that lower circulating levels of serum IGF-1 in SGA infants result in cardiac diastolic dysfunction due to increased cardiac fibrosis.…”

Section: Discussionsupporting

confidence: 79%

“…14,15 Likewise, in a human study, low circulatory IGF-1 levels increased the risk of heart failure in adults, 16 and patients with growth hormone deficiency exhibited cardiac dysfunction. 17 IUGR fetuses have decreased serum IGF-1 levels, as fetal IGF-1 is regulated by oxygen and nutritional conditions in utero. Interestingly, Alsaied et al reported that intraplacental gene transfer of IGF-1 to IUGR model mice prevented cardiac dysfunction.…”

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confidence: 99%

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Decreased Circulating Insulin-Like Growth Factor 1 Levels Are Associated with Cardiac Diastolic Dysfunction in Small for Gestational Age Infants

et al. 2018

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Section: Discussionsupporting

confidence: 79%

mentioning

confidence: 99%

Decreased Circulating Insulin-Like Growth Factor 1 Levels Are Associated with Cardiac Diastolic Dysfunction in Small for Gestational Age Infants

et al. 2018

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“…Although patients were effectively treated with hormone replacement therapy and were in sex-and age-specific reference ranges, their earlier absence or reduced presence could have effects on the presented abnormalities. It can be hypothesized that these changes might partly be the result of GH deficiency as this is directly linked to the amount of cardiac muscle mass (29). Similar abnormalities in acromegaly with higher presence of LV-RBR could be demonstrated in a recent study (16).…”

Section: Discussionsupporting

confidence: 59%

“…Studies assessing LV deformation and rotational abnormalities are severely lacking in hypopituitarism. Mihaila et al presented decreased 2DSTE-derived longitudinal (LS) and circumferential strains in the presence of GH deficiency, which was accompanied with impaired LV basal rotation and twist (29). In contrast, increased 3DSTE-derived LS and area strain could be detected in our group of patients with treated hypopituitarism in a recent study, in which most cases had GH deficiency (19).…”

Section: Discussioncontrasting

confidence: 47%

Left Ventricular Rotational Abnormalities in Treated Hypopituitarism: Insights From the Three-Dimensional Speckle-Tracking Echocardiographic MAGYAR-Path Study

Kormányos

Gyenes

Horváth

et al. 2021

Front. Cardiovasc. Med.

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Introduction: Hypopituitarism is a rare, often underdiagnosed, complex hormonal disease caused by the decreased secretion of one or more hormones in the pituitary gland. The present study was designed to assess left ventricular (LV) rotational mechanics in patients with treated hypopituitarism. It was also aimed to find possible differences in these parameters according to the origin of hypopituitarism (congenital vs. acquired).Methods: The present prospective study involved 35 treated patients with hypopituitarism; however, 4 patients had to be excluded due to inferior image quality. The mean age of the remaining 31 cases was 56.3 ± 13.2 years (18 males). The control group consisted of 29 age- and sex-matched healthy volunteers (mean age: 55.3 ± 4.8 years, 14 males). In all cases a complete two-dimensional echocardiography examination was performed followed by three-dimensional speckle-tracking echocardiography.Results: No significant differences could be found in LV volumes between the controls and patients with hypopituitarism and hypopituitary subgroups. LV apical rotation (8.1 ± 5.1° vs. 10.6 ± 3.5°, p < 0.05) and LV twist (11.9 ± 5.3° vs. 15.1 ± 3.8°, p < 0.05) were impaired in the hypopituitary group with normally directed LV rotational mechanics as compared to the healthy controls. However, 13% of patients showed a near absence of LV twist called LV “rigid body rotation” (LV-RBR). There were no significant differences regarding LV apical and basal rotations and twist between acquired and congenital hypopituitary subgroups.Conclusions: Impaired LV apical rotation and twist could be demonstrated in hypopituitarism regardless of its origin. In the present study with small number of patients with hypopituitarism, LV-RBR was present in 13% of cases.

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“…These cardiovascular comorbidities in hypopituitarism (and GH deficiency) could affect myocardial mechanics via cellular dysfunction, hypertrophy, fibrosis or increased wall stress (16,17). Adults with GH deficiency had reduced LV-LS and LV-CS with preserved LV-RS compared with controls (18). GH-HRT in adultonset GH deficiency demonstrated to have beneficial effects on strain and strain rate parameters, but these parameters returned to baseline levels after the withdrawal of GH (19).…”

Section: Discussionmentioning

confidence: 89%

Is treated hypopituitarism associated with increased left ventricular strains?—detailed analysis from the three-dimensional speckle-tracking echocardiographic MAGYAR-Path Study

Nemes¹,

Kormányos²,

Gyenes³

et al. 2022

Quant Imaging Med Surg

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Reduced secretion of one or more of the hormones normally produced by the pituitary gland is called hypopituitarism, which is a rare and frequently underdiagnosed condition. Hypopituitarism can be present at birth called congenital or may develop due to acquired causes like tumor, infection, infiltration, vascular or other causes. Symptoms of hypopituitarism are highly dependent on which hormones are insufficient. The present prospective study was designed to test whether treated hypopituitarism is associated with changes in 3DSTE-derived LV strains in patients without known cardiovascular disorder. We investigated 38 patients with treated hypopituitarism who were in sinus rhythm (57.0±13.6 years, 19 males), 6 patients were excluded from the study due to inferior image quality. The remaining patient group consisted of 16 patients with congenital hypopituitarism and 16 patients with acquired form of hypopituitarism. Their results were compared to age-and gender-matched controls (mean age: 55.3±4.7 years, 14 males). Out of the 32 patients with hypopituitarism, 30 patients had growth hormone deficiency, 27 patients had central adrenal insufficiency, 12 patients had central hypothyroidism, 12 patients had hypogonadotropic hypogonadism and 5 patients had diabetes insipidus. Only LV longitudinal and area strains proved to be significantly increased in patients with hypopituitarism, other LV strains did not differ between patients and controls. No significant differences could be confirmed in LV strains between patients with congenital and acquired hypopituitarism.It could be concluded that longitudinal LV strains are increased in both congenital and acquired treated hypopituitarism.

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Growth Hormone Deficiency in Adults Impacts Left Ventricular Mechanics: A Two-Dimensional Speckle-Tracking Study

Cited by 14 publications

References 31 publications

Decreased Circulating Insulin-Like Growth Factor 1 Levels Are Associated with Cardiac Diastolic Dysfunction in Small for Gestational Age Infants

Decreased Circulating Insulin-Like Growth Factor 1 Levels Are Associated with Cardiac Diastolic Dysfunction in Small for Gestational Age Infants

Left Ventricular Rotational Abnormalities in Treated Hypopituitarism: Insights From the Three-Dimensional Speckle-Tracking Echocardiographic MAGYAR-Path Study

Is treated hypopituitarism associated with increased left ventricular strains?—detailed analysis from the three-dimensional speckle-tracking echocardiographic MAGYAR-Path Study

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