Heart Rate Variability in Postoperative Patients with Nonfunctioning Pituitary Adenoma

Area of Science:

• Endocrinology
• Cardiology
• Autonomic Neuroscience

Background:

• Nonfunctioning pituitary adenoma (NFPA) can lead to hypopituitarism, increasing cardiovascular mortality risk.
• Decreased heart rate variability (HRV) is linked to cardiac autonomic dysfunction.
• Postoperative NFPA patients with hormone deficiencies may experience HRV alterations.

Purpose of the Study:

• To investigate HRV changes in postoperative NFPA patients with hormone deficiencies.
• To assess cardiac autonomic function in relation to specific pituitary hormone deficiencies.

Main Methods:

• 22 NFPA patients underwent combined pituitary function tests (CPFT) and HRV measurement 3-6 months post-surgery.
• HRV was analyzed during stable (sleep) and unstable (hypoglycemic) periods of the CPFT.
• HRV parameters were compared based on the presence of hormone deficiencies.

Main Results:

• Patients with adrenocorticotropic hormone (ACTH) deficiency and other deficiencies showed an increased low frequency to high frequency ratio (P=0.005).
• The standard deviation of the normal-to-normal interval decreased during hypoglycemia in these patients (P=0.030).
• Panhypopituitarism was associated with an increased low frequency to high frequency ratio during hypoglycemia (P=0.007).

Conclusions:

• HRV analysis during CPFT can detect cardiac autonomic dysfunction in NFPA patients with ACTH deficiency or panhypopituitarism.
• These patients may benefit from preemptive cardiovascular risk evaluation.
• Findings highlight the link between pituitary hormone deficiencies and autonomic dysfunction.