Structural, functional and autonomic changes in the cardiovascular system in growth hormone deficient patients

Area of Science:

• Cardiology
• Endocrinology
• Autonomic Neuroscience

Background:

• Growth hormone deficiency (GHD) is associated with elevated cardiovascular mortality rates.
• Understanding cardiac structural and functional changes in GHD is crucial for risk assessment.
• Autonomic nervous system function, assessed via heart rate variability (HRV), may be impacted by GHD.

Purpose of the Study:

• To analyze structural and functional cardiac alterations in adult patients with GHD.
• To investigate the relationship between cardiac changes and autonomic function (HRV) in GHD.
• To identify potential mechanisms underlying increased cardiovascular risk in GHD.

Main Methods:

• Comparison of 11 untreated GHD patients with 15 age- and sex-matched healthy controls.
• Echocardiography to assess cardiac structure and function.
• Heart rate variability (HRV) analysis for autonomic function assessment.
• Exercise testing to evaluate functional capacity.

Main Results:

• GHD patients exhibited significantly lower exercise duration and metabolic equivalent (MET) values.
• Echocardiography revealed reduced interventricular septum diameter, posterior wall thickness, and left ventricle mass index in GHD patients.
• Left ventricular ejection fraction was significantly lower in GHD patients.
• HRV analysis showed decreased time and frequency domain parameters (SDNN, SDANN, VLF, LF, LF/HF) in GHD patients.
• A significant correlation was found between left ventricle diastolic diameter and LF (a measure of sympathetic activity).

Conclusions:

• GHD is associated with decreased left ventricle mass and impaired cardiac function.
• GHD patients demonstrate reduced sympathetic components of HRV.
• These cardiac and autonomic alterations in GHD may contribute to the heightened cardiovascular risk observed in this population.