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Cardiovascular effects of short-term growth hormone hypersecretion
S Fazio1, A Cittadini, B Biondi
1Department of Internal Medicine, Federico II University Medical School, Naples, Italy.
Insights
Short-term acromegaly significantly impacts the heart, increasing left ventricular mass and cardiac output while maintaining normal diastolic function. This early cardiac remodeling in acromegaly offers insights into growth hormone
Area of Science:
- Cardiology
- Endocrinology
- Human Physiology
Background:
- Acromegaly significantly affects the cardiovascular system.
- Limited data exist on the cardiac effects of short-term acromegaly.
- Understanding early changes is crucial for clarifying disease progression and growth hormone (GH) mechanisms.
Purpose of the Study:
- To investigate the cardiac morphology and function in patients with short-term acromegaly.
- To elucidate the early impact of GH excess on the heart.
- To differentiate short-term from long-term acromegaly cardiac effects.
Main Methods:
- Doppler echocardiography was used to assess cardiac parameters.
- A cohort of 10 young patients with uncomplicated short-term acromegaly (<5 years) was studied.
- Key cardiovascular indices including left ventricular mass, diastolic function, stroke index, cardiac index, and systemic vascular resistance were measured.
Main Results:
- Significantly increased left ventricular mass (P<0.005) with normal relative wall thickness was observed.
- Doppler indices indicated normal diastolic function.
- Stroke index (P<0.01) and cardiac index (P<0.001) were significantly enhanced.
- Systemic vascular resistance was significantly reduced (P<0.001).
Conclusions:
- Short-term acromegaly leads to increased left ventricular mass with eccentric remodeling and preserved diastolic function.
- A high cardiac output state with reduced systemic vascular resistance characterizes early acromegaly.
- These findings provide novel insights into the early cardiovascular adaptations in acromegaly.
Abstract:
Many studies have shown that acromegaly has relevant effects on cardiovascular system, but few data are available regarding the effects of short-term acromegaly on heart morphology and function. These data would help to clarify the natural history of acromegalic disease and could provide new insight into the mechanisms of GH action on the human heart. Therefore, we studied by Doppler echocardiography a group of 10 young subjects strictly selected as having short-term (<5 yr) uncomplicated acromegaly. The results of this study have shown that shortterm acromegaly is characterized by significantly increased left ventricular mass (P<0.005), with normal relative wall thickness, associated with Doppler indices of diastolic function in the normal range. Furthermore, stroke index and cardiac index were significantly enhanced in the patient group (P<0.01 and P<0.001, respectively), whereas systemic vascular resistance was significantly reduced (P<0.001). In conclusion, our study shows that short-term acromegaly significantly affects the heart, but, at variance with long-term disease, it is characterized by increased left ventricular mass, with eccentric remodeling and normal diastolic function. Moreover, short-term acromegaly induces a high cardiac output state with reduction of systemic vascular resistance.