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Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Is treated hypopituitarism associated with increased left ventricular strains?-detailed analysis from the
Attila Nemes1, Árpád Kormányos1, Nándor Gyenes1
1Department of Medicine, Faculty of Medicine, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.
Insights
Hypopituitarism, a rare pituitary hormone deficiency, is linked to increased left ventricular (LV) longitudinal strains. This finding holds true for both congenital and acquired forms of the condition, suggesting potential cardiovascular implications.
Area of Science:
- Endocrinology
- Cardiology
- Medical Imaging
Background:
- Hypopituitarism is a rare condition involving reduced pituitary hormone secretion, often underdiagnosed.
- It can be congenital or acquired, with symptoms varying based on hormone deficiencies.
- Cardiovascular effects in hypopituitarism patients without prior heart conditions are not well-understood.
Purpose of the Study:
- To investigate changes in 3DSTE-derived LV strains in patients with treated hypopituitarism.
- To compare LV strains between patients with congenital and acquired hypopituitarism and healthy controls.
Main Methods:
- Prospective study of 32 patients with treated hypopituitarism (16 congenital, 16 acquired) and age/gender-matched controls.
- 3D Speckle Tracking Echocardiography (3DSTE) used to assess LV strains.
- Patients had various hormone deficiencies, including growth hormone deficiency and central adrenal insufficiency.
Main Results:
- Significantly increased LV longitudinal and area strains were observed in hypopituitarism patients compared to controls.
- No significant differences in LV strains were found between congenital and acquired hypopituitarism groups.
- Other LV strains did not differ between patients and controls.
Conclusions:
- Treated hypopituitarism, both congenital and acquired, is associated with increased longitudinal LV strains.
- These findings suggest potential subclinical cardiac alterations in hypopituitarism patients.
Abstract:
Reduced secretion of one or more of the hormones normally produced by the pituitary gland is called hypopituitarism, which is a rare and frequently underdiagnosed condition. Hypopituitarism can be present at birth called congenital or may develop due to acquired causes like tumor, infection, infiltration, vascular or other causes. Symptoms of hypopituitarism are highly dependent on which hormones are insufficient. The present prospective study was designed to test whether treated hypopituitarism is associated with changes in 3DSTE-derived LV strains in patients without known cardiovascular disorder. We investigated 38 patients with treated hypopituitarism who were in sinus rhythm (57.0±13.6 years, 19 males), 6 patients were excluded from the study due to inferior image quality. The remaining patient group consisted of 16 patients with congenital hypopituitarism and 16 patients with acquired form of hypopituitarism. Their results were compared to age- and gender-matched controls (mean age: 55.3±4.7 years, 14 males). Out of the 32 patients with hypopituitarism, 30 patients had growth hormone deficiency, 27 patients had central adrenal insufficiency, 12 patients had central hypothyroidism, 12 patients had hypogonadotropic hypogonadism and 5 patients had diabetes insipidus. Only LV longitudinal and area strains proved to be significantly increased in patients with hypopituitarism, other LV strains did not differ between patients and controls. No significant differences could be confirmed in LV strains between patients with congenital and acquired hypopituitarism. It could be concluded that longitudinal LV strains are increased in both congenital and acquired treated hypopituitarism.
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