Cardiac morphology and function in adult patients with growth hormone deficiency – a cross-sectional case-control study

I. Uzunova*^a (Dr), N. Zlatareva^b (Prof), K. Kalinov^c (Prof), G. Kirilov^a (Prof), S. Zacharieva^a (Prof)

^a Department of Endocrinology, Medical University – Sofia; Expert Center for Rare Endocrine Diseases - Sofia, USHATE “Acad. Ivan Penchev”, ENDO-ERN, Sofia, BULGARIA ; ^b Acibadem City Clinic – Cardiovascular Centre, Medical University – Sofia, Sofia, BULGARIA ; ^c New Bulgarian University, Sofia, BULGARIA

* dr_uzunova@yahoo.com

Introduction: Growth hormone (GH) has a major influence on cardiac development, morphology and function. GH deficiency (GHD) may, therefore, result in impaired cardiac performance. The aim of our research was to assess cardiac morphology and function in patients with hyposomatotropism and in healthy subjects.

Material and methods: This cross-sectional case-control study included 23 adults with childhood-onset and 20 patients with adult-onset GHD as well as 2 control groups (one for each of the patient groups) consisting of 23 and 20, respectively, age- and gender-matched healthy subjects. All participants underwent a transthoracic echocardiographic examination, assessing the following parameters: left atrium (LA) anterior-posterior dimension, interventricular septum thickness (IVST), left ventricular end-systolic and end-diastolic volumes, left ventricular ejection fraction; early (E) and late (A) transmitral filling velocities, and E/A ratio (by pulsed Doppler); systolic (s’), early (e’) and late diastolic (a’) mitral annular velocities, and e’/a’ ratio (by tissue Doppler imaging, TDI).

Results: In the childhood-onset GHD group structural changes were found only in LA (33.13±4.13 mm vs. 37.52±2.31 mm in controls, p<0.0001). Functional measurements revealed impairment of both the systolic (s’: 9.30±1.66 cm/s vs. 11.22±1.35 cm/s, p<0.0001) and the diastolic (e’: 8.09±0.79 cm/s vs. 11.70±2.32 cm/s, p<0.0001; e’/a’: 1.34±0.34 vs. 1.76±0.50, p=0.002) TDI parameters. In the adult-onset GHD group statistically significant differences were observed in LA (34.55±4.56 mm vs. 37.35±2.39 mm, p=0.020), IVST (11.48±1.16 mm vs. 10.45±1.50 mm, p=0.021), in TDI measurements (s’: 9.60±1.73 cm/s vs. 11.20±1.28 cm/s, p=0.002; e’: 9.06±2.74 cm/s vs. 11.85±2.41 cm/s, p=0.002) as well as in pulsed Doppler parameters (Е: 73.25±10.83 cm/s vs. 84.05±8.56 cm/s, p=0.001; Е/А: 1.33±0.33 vs. 1.65±0.32, p=0.004).

Discussion: Both adult-onset and childhood-onset GHD is associated with impairment in the cardiac morphology and function - more pronounced in the later, especially in the left ventricular diastolic performance and in the adult-onset patients.

The author has declared no conflict of interest.