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    Characterisation of myocardial structure and function in adult-onset growth hormone deficiency using cardiac magnetic resonance. 
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    • Characterisation of myocardial structure and function in adult-onset growth hormone deficiency using cardiac magnetic resonance.
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    Characterisation of myocardial structure and function in adult-onset growth hormone deficiency using cardiac magnetic resonance.

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    Accepted version (384.4Kb)
    Volume
    54
    Pagination
    778 - 787
    DOI
    10.1007/s12020-016-1067-6
    Journal
    Endocrine
    Issue
    3
    Metadata
    Show full item record
    Abstract
    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.
    Authors
    Thomas, JDJ; Dattani, A; Zemrak, F; Burchell, T; Akker, SA; Gurnell, M; Grossman, AB; Davies, LC; Korbonits, M
    URI
    http://qmro.qmul.ac.uk/xmlui/handle/123456789/15985
    Collections
    • Centre for Endocrinology [517]
    Language
    eng
    Licence information
    The final publication is available at Springer via http://dx.doi.org/10.1007/s12020-016-1067-6
    Copyright statements
    © The Author(s) 2016. This article is published with open access at Springerlink.com
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