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Updated: Oct 13, 2025
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Left Ventricular Rotational Abnormalities in Treated Hypopituitarism: Insights From the Three-Dimensional
Árpád Kormányos1, Nándor Gyenes1, Ágnes Horváth1
1Department of Medicine, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.
Insights
Patients with hypopituitarism show impaired left ventricular (LV) rotation and twist, regardless of disease origin. Some patients exhibit LV rigid body rotation, indicating potential cardiac dysfunction in this hormonal disorder.
Area of Science:
- Cardiology
- Endocrinology
- Medical Imaging
Background:
- Hypopituitarism is a rare hormonal disorder affecting pituitary gland function.
- Cardiac involvement in hypopituitarism is not fully understood.
- Assessing left ventricular mechanics may reveal subclinical cardiac dysfunction.
Purpose of the Study:
- To evaluate left ventricular (LV) rotational mechanics in treated hypopituitarism patients.
- To compare LV rotational parameters between hypopituitarism patients and healthy controls.
- To investigate differences in LV mechanics based on the origin (congenital vs. acquired) of hypopituitarism.
Main Methods:
- Prospective study involving 31 treated hypopituitarism patients and 29 healthy controls.
- Utilized complete two-dimensional and three-dimensional speckle-tracking echocardiography.
- Analyzed left ventricular apical rotation, basal rotation, and twist.
Main Results:
- No significant differences in LV volumes between groups.
- Impaired LV apical rotation and LV twist observed in hypopituitarism patients compared to controls.
- 13% of patients displayed LV rigid body rotation (LV-RBR), characterized by near absence of LV twist.
Conclusions:
- Hypopituitarism is associated with impaired LV apical rotation and twist, irrespective of its cause.
- LV-RBR is a notable finding in a subset of hypopituitarism patients.
- Further research is warranted to understand the clinical implications of these cardiac findings.
Abstract:
Introduction: Hypopituitarism is a rare, often underdiagnosed, complex hormonal disease caused by the decreased secretion of one or more hormones in the pituitary gland. The present study was designed to assess left ventricular (LV) rotational mechanics in patients with treated hypopituitarism. It was also aimed to find possible differences in these parameters according to the origin of hypopituitarism (congenital vs. acquired). Methods: The present prospective study involved 35 treated patients with hypopituitarism; however, 4 patients had to be excluded due to inferior image quality. The mean age of the remaining 31 cases was 56.3 ± 13.2 years (18 males). The control group consisted of 29 age- and sex-matched healthy volunteers (mean age: 55.3 ± 4.8 years, 14 males). In all cases a complete two-dimensional echocardiography examination was performed followed by three-dimensional speckle-tracking echocardiography. Results: No significant differences could be found in LV volumes between the controls and patients with hypopituitarism and hypopituitary subgroups. LV apical rotation (8.1 ± 5.1° vs. 10.6 ± 3.5°, p < 0.05) and LV twist (11.9 ± 5.3° vs. 15.1 ± 3.8°, p < 0.05) were impaired in the hypopituitary group with normally directed LV rotational mechanics as compared to the healthy controls. However, 13% of patients showed a near absence of LV twist called LV "rigid body rotation" (LV-RBR). There were no significant differences regarding LV apical and basal rotations and twist between acquired and congenital hypopituitary subgroups. Conclusions: Impaired LV apical rotation and twist could be demonstrated in hypopituitarism regardless of its origin. In the present study with small number of patients with hypopituitarism, LV-RBR was present in 13% of cases.
