Effects of Hormones on Left Heart Structure and Function with Echocardiography in Acromegaly

The relationship between growth hormone (GH) and changes in cardiac morphology and function in the current study has not been fully elucidated, and this study aimed to assess the effect of hormonal factors on left ventricular structure and function in acromegaly patients using echocardiography.

We retrospectively analyzed the relationships between various echocardiographic parameters in 117 pre-treatment patients with acromegaly and four hormonal variables: GH, GH nadir during the oral glucose tolerance test (OGTT-GH), insulin-like growth factor-1 (IGF-1), and IGF-1/upper limit of normal (IGF-1/ULN) adjusted for age and sex. Patients were categorized into normal and abnormal subgroups based on interventricular septal (IVS) thickening, left atrial (LA) enlargement, and left ventricular (LV) abnormal LV peak flow velocities E and A (E/A ratios). Furthermore, the hormonal levels within these subgroups were compared.

Correlation analysis revealed that IGF-1/ULN was positively associated with IVS thickening and LA enlargement (p = 0.003 and p = 0.001), and negatively associated with an abnormal LV E/A ratio (p < 0.001). Regression analysis identified IGF-1/ULN as a significant risk factor for left heart alterations. Among the four hormonal variables, IGF-1/ULN demonstrated the largest area under the receiver operating characteristic (ROC) curve (AUC), with values of 0.628 for IVS thickening, 0.701 for LA enlargement, and 0.653 for LV abnormal E/A ratio.

IGF-1/ULN is strongly associated with changes in left heart structure and function in acromegaly and serves as a risk factor for these alterations. Thus, monitoring IGF-1/ULN may help predict cardiac changes via echocardiography, suggesting that early clinical management of GH-related levels could prevent early cardiac abnormalities in patients with acromegaly.