Characterisation of myocardial structure and function in adult-onset growth hormone deficiency using cardiac magnetic resonance.
Thomas, Julia DJ
Akker, Scott A
Grossman, Ashley B
Davies, L Ceri
Springer Science and Business Media LLC
MetadataShow full item record
Thomas, J. D., Dattani, A., Zemrak, F., Burchell, T., Akker, S. A., Gurnell, M., Grossman, A. B., et al. (2016). Characterisation of myocardial structure and function in adult-onset growth hormone deficiency using cardiac magnetic resonance.. Endocrine, 54 (3), 778-787. https://doi.org/10.1007/s12020-016-1067-6
Growth hormone (GH) can profoundly influence cardiac function. While GH excess causes well-defined cardiac pathology, fewer data are available regarding the more subtle cardiac changes seen in GH deficiency (GHD). This preliminary study uses cardiac magnetic resonance imaging (CMR) to assess myocardial structure and function in GHD. Ten adult-onset GHD patients underwent CMR, before and after 6 and 12 months of GH replacement. They were compared to 10 age-matched healthy controls and sex-matched healthy controls. Left ventricular (LV) mass index (LVMi) increased with 1 year of GH replacement (53.8 vs. 57.0 vs. 57.3 g/m2, analysis of variance p = 0.0229). Compared to controls, patients showed a trend towards reduced LVMi at baseline (51.4 vs. 60.0 g/m2, p = 0.0615); this difference was lost by 1 year of GH treatment (57.3 vs. 59.9 g/m2, p = 0.666). Significantly reduced aortic area was observed in GHD (13.2 vs. 19.0 cm2/m2, p = 0.001). This did not change with GH treatment. There were no differences in other LV parameters including end-diastolic volume index (EDVi), end-systolic volume index, stroke volume index (SVi), cardiac index and ejection fraction. There was a trend towards reduced baseline right ventricular (RV)SVi (44.1 vs. 49.1 ml/m2, p = 0.0793) and increased RVEDVi over 1 year (70.3 vs. 74.3 vs. 73.8 ml/m2, p = 0.062). Two patients demonstrated interstitial expansion, for example with fibrosis, and three myocardial ischaemia as assessed by late gadolinium enhancement and stress perfusion. The increased sensitivity of CMR to subtle cardiac changes demonstrates that adult-onset GHD patients have reduced aortic area and LVMi increases after 1 year of GH treatment. These early data should be studied in larger studies in the future.
Adult, Aged, Aorta, Case-Control Studies, Female, Fibrosis, Gadolinium, Growth Hormone, Heart, Heart Ventricles, Humans, Insulin-Like Growth Factor I, Magnetic Resonance Imaging, Male, Middle Aged, Myocardial Perfusion Imaging, Myocardium, Pituitary Diseases
External DOI: https://doi.org/10.1007/s12020-016-1067-6
This record's URL: https://www.repository.cam.ac.uk/handle/1810/285036
Attribution 4.0 International
Licence URL: https://creativecommons.org/licenses/by/4.0/
Recommended or similar items
The current recommendation prototype on the Apollo Repository will be turned off on 03 February 2023. Although the pilot has been fruitful for both parties, the service provider IKVA is focusing on horizon scanning products and so the recommender service can no longer be supported. We recognise the importance of recommender services in supporting research discovery and are evaluating offerings from other service providers. If you would like to offer feedback on this decision please contact us on: firstname.lastname@example.org