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dc.contributor.authorThomas, Julia DJ
dc.contributor.authorDattani, Abhishek
dc.contributor.authorZemrak, Filip
dc.contributor.authorBurchell, Thomas
dc.contributor.authorAkker, Scott A
dc.contributor.authorGurnell, Mark
dc.contributor.authorGrossman, Ashley B
dc.contributor.authorDavies, L Ceri
dc.contributor.authorKorbonits, Márta
dc.date.accessioned2018-11-14T00:30:57Z
dc.date.available2018-11-14T00:30:57Z
dc.date.issued2016-12
dc.identifier.issn1355-008X
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/285036
dc.description.abstractGrowth 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.
dc.format.mediumPrint-Electronic
dc.languageeng
dc.publisherSpringer Science and Business Media LLC
dc.rightsAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectMyocardium
dc.subjectAorta
dc.subjectHeart
dc.subjectHeart Ventricles
dc.subjectHumans
dc.subjectPituitary Diseases
dc.subjectFibrosis
dc.subjectGadolinium
dc.subjectGrowth Hormone
dc.subjectInsulin-Like Growth Factor I
dc.subjectMagnetic Resonance Imaging
dc.subjectCase-Control Studies
dc.subjectAdult
dc.subjectAged
dc.subjectMiddle Aged
dc.subjectFemale
dc.subjectMale
dc.subjectMyocardial Perfusion Imaging
dc.titleCharacterisation of myocardial structure and function in adult-onset growth hormone deficiency using cardiac magnetic resonance.
dc.typeArticle
prism.endingPage787
prism.issueIdentifier3
prism.publicationDate2016
prism.publicationNameEndocrine
prism.startingPage778
prism.volume54
dc.identifier.doi10.17863/CAM.32406
dcterms.dateAccepted2016-06-16
rioxxterms.versionofrecord10.1007/s12020-016-1067-6
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2016-12
dc.contributor.orcidGurnell, Mark [0000-0001-5745-6832]
dc.identifier.eissn1559-0100
rioxxterms.typeJournal Article/Review
cam.issuedOnline2016-08-17


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Attribution 4.0 International
Except where otherwise noted, this item's licence is described as Attribution 4.0 International