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Yılmaz M, Gürses D, Ata A. Electrocardiographic Findings in Children With Growth Hormone Deficiency. Cureus 2023; 15:e36385. [PMID: 36960228 PMCID: PMC10030162 DOI: 10.7759/cureus.36385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2023] [Indexed: 03/25/2023] Open
Abstract
Introduction It has been shown that cardiac functions begin to deteriorate in growth hormone (GH) deficiency even in childhood. However, little is known about how GH deficiency affects arrhythmogenesis. The aim of this study was to evaluate the parameters of P wave dispersion (Pd), QT dispersion (QTd), corrected QT (QTc) dispersion (QTcd), T wave peak-to-end (Tp-e) interval, Tp-e/QT ratio, and Tp-e/QTc ratio in children with GH deficiency. This study also aimed to evaluate the relationship of these parameters with insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP-3). Method In the study, records of children diagnosed with GH deficiency in Adana City Training and Research Hospital Pediatric Endocrine Outpatient Clinic between September 2021 and December 2022 were retrospectively reviewed. The control group consisted of children in the same age group who applied to the Emergency Outpatient Clinic with a complaint of chest pain and no pathological finding was detected. The electrocardiograms (ECGs) of all patients were retrospectively evaluated. Results There were a total of 82 children in the study, 41 of whom were diagnosed with GH deficiency and 41 in the healthy control group. The age and male/female ratio of children with GH deficiency were similar to those in the control group (p>0.05). There were 27 (66%) children with complete GH deficiency and 14 (34%) children with partial GH deficiency. P wave dispersion was similar in both GH-deficient children and control group children. It was also similar in children with complete and partial GH deficiency (p>0.05). QT and QTc dispersions were found to be increased in children with GH deficiency, although not statistically significant, compared to the control group (p>0.05). Tp-e interval, Tp-e/QTmax (longest QT interval), and Tp-e/QTcmax (longest QTc interval) ratios were increased in children with GH deficiency compared to the control group (p=0.001, p=0.003, and p=0.001, respectively). QT and QTc dispersion, Tp-e interval, Tp-e/QTmax, and Tp-e/QTcmax ratios were found to be increased in children with complete GH deficiency compared to children with partial GH deficiency, but the difference was not significant (p>0.05). No correlation was found between these ECG parameters and IGF-1, IGFBP-3, and peak GH levels after stimulation tests (p>0.05). Conclusion We found in our study that the Tp-e interval was longer and Tp-e/QT and Tp-e/QTc ratios were increased in children with GH deficiency. These results suggest that the risk of ventricular arrhythmias in children with GH deficiency may start to increase from childhood. However, further prospective studies are needed to confirm our results.
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Affiliation(s)
- Münevver Yılmaz
- Pediatric Cardiology, Faculty of Medicine, Pamukkale University, Denizli, TUR
| | - Dolunay Gürses
- Pediatric Cardiology, Faculty of Medicine, Pamukkale University, Denizli, TUR
| | - Aysun Ata
- Pediatric Endocrinology, Adana City Training and Research Hospital, Adana, TUR
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Alkan F, Ersoy B, Kızılay DO, Ozyurt BC, Coskun S. Evaluation of cardiac structure, exercise capacity and electrocardiography parameters in children with partial and complete growth hormone deficiency and their changes with short term growth hormone replacement therapy. Pituitary 2023; 26:115-123. [PMID: 36463549 DOI: 10.1007/s11102-022-01295-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/27/2022] [Indexed: 12/05/2022]
Abstract
PURPOSE To evaluate cardiac structure, exercise capacity and electrocardiography (ECG) parameters of children with complete and partial growth hormone (GH) deficiency (GHD) and the effect of 12 months GH treatment on these. METHODS M-mode echocardiography, ECG and exercise test expressed as metabolic equivalent (MET) were performed in children with GHD, aged 9-14 years, divided into those with a peak GH response < 7 µg/L (complete GHD; n = 30) and 7-10 µg/L (partial GHD; n = 17) after two GH stimulation tests, at baseline and 12 months after GH initiation. Forty-eight healthy peers underwent the same tests once. RESULTS Left ventricular mass (LVM) was significantly lower before treatment in both groups with GHD compared to healthy peers (p = 0.015 and p = 0.032) but LVM in the GHD groups was similar to controls after 12 months of treatment. The increase in LVM in the complete GHD group was significant (p = 0.044). LVM index was significantly reduced with treatment in children with partial GHD (p = 0.035). Max METs, VO2max and exercise duration were significantly increased in children with complete GHD after treatment (p = 0.022, p = 0.015 and p = 0.002, respectively). Significant changes in P wave and QTc dispersion on ECG between groups were within physiological limits. CONCLUSION This study showed that children with both partial and complete GHD had smaller cardiac structures and less exercise capacity compared to their healthy peers prior to GH treatment but this improved with 12 months of treatment. The cardiac trophic effect of GH, as well as the effect of increasing exercise capacity, is greater in those with complete GHD than in those with partial GHD.
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Affiliation(s)
- Fatos Alkan
- School of Medicine, Division of Pediatric Cardiology, Manisa Celal Bayar University, Manisa, Turkey.
| | - Betul Ersoy
- School of Medicine, Division of Pediatric Endocrinology and Metabolism, Manisa Celal Bayar University, Manisa, Turkey
| | - Deniz Ozalp Kızılay
- School of Medicine, Division of Pediatric Endocrinology and Metabolism, Manisa Celal Bayar University, Manisa, Turkey
| | - Beyhan Cengız Ozyurt
- School of Medicine, Department of Public Health, Manisa Celal Bayar University, Manisa, Turkey
| | - Senol Coskun
- School of Medicine, Division of Pediatric Cardiology, Manisa Celal Bayar University, Manisa, Turkey
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Ratku B, Sebestyén V, Erdei A, Nagy EV, Szabó Z, Somodi S. Effects of adult growth hormone deficiency and replacement therapy on the cardiometabolic risk profile. Pituitary 2022; 25:211-228. [PMID: 35106704 PMCID: PMC8894188 DOI: 10.1007/s11102-022-01207-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/10/2022] [Indexed: 12/12/2022]
Abstract
Adult growth hormone deficiency (AGHD) is considered a rare endocrine disorder involving patients with childhood-onset and adult-onset growth hormone deficiency (AoGHD) and characterized by adverse cardiometabolic risk profile. Besides traditional cardiovascular risk factors, endothelial dysfunction, low-grade inflammation, impaired adipokine profile, oxidative stress and hypovitaminosis D may also contribute to the development of premature atherosclerosis and higher cardiovascular risk in patients with AGHD. Growth hormone replacement has been proved to exert beneficial effects on several cardiovascular risk factors, but it is also apparent that hormone substitution in itself does not eliminate all cardiometabolic abnormalities associated with the disease. Novel biomarkers and diagnostic techniques discussed in this review may help to evaluate individual cardiovascular risk and identify patients with adverse cardiometabolic risk profile. In the absence of disease-specific guidelines detailing how to assess the cardiovascular status of these patients, we generally recommend close follow-up of the cardiovascular status as well as low threshold for a more detailed evaluation.
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Affiliation(s)
- Balázs Ratku
- Department of Emergency Medicine, Faculty of Medicine, University of Debrecen, Egyetem tér 1, Debrecen, 4032, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
- Department of Emergency and Oxyology, Faculty of Health, University of Debrecen, Debrecen, Hungary
| | - Veronika Sebestyén
- Department of Emergency Medicine, Faculty of Medicine, University of Debrecen, Egyetem tér 1, Debrecen, 4032, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Annamária Erdei
- Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Endre V Nagy
- Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Zoltán Szabó
- Department of Emergency Medicine, Faculty of Medicine, University of Debrecen, Egyetem tér 1, Debrecen, 4032, Hungary
| | - Sándor Somodi
- Department of Emergency Medicine, Faculty of Medicine, University of Debrecen, Egyetem tér 1, Debrecen, 4032, Hungary.
- Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
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Lemos MDP, Miranda MT, Marocolo M, Resende EAMRD, Chriguer RS, Sordi CCD, Barbosa Neto O. Low levels of dehydroepiandrosterone sulfate are associated with the risk of developing cardiac autonomic dysfunction in elderly subjects. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2019; 63:62-69. [PMID: 30864633 PMCID: PMC10118840 DOI: 10.20945/2359-3997000000104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Accepted: 07/08/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To assess the relationships between serum dehydroepiandrosterone sulfate (DHEA-S) levels and heart rate variability (HRV) among different age groups. SUBJECTS AND METHODS Forty-five healthy men were divided into 3 groups: young age (YA; 20-39 yrs; n = 15), middle age (MA; 40-59 yrs; n = 15) and old age (OA; ≥ 60 yrs; n = 15). Hemodynamic parameters, linear analyses of HRV and concentrations of cortisol and DHEA-S were measured at rest. RESULTS The OA group presented a higher resting heart rate (84.3 ± 4.6 bpm) than the YA group (72.0 ± 4.4 bpm; p < 0.05). The YA group showed an attenuated variance of HRV (2235.1 ± 417.9 ms2) compared to the MA (1014.3 ± 265.2 ms2; p < 0.05) and OA (896.3 ± 274.1 ms2; p < 0.05) groups, respectively. The parasympathetic modulation of HRV was lower in both the MA (244.2 ± 58.0 ms2) and OA (172.8 ± 37.9 ms2) groups in comparison with the YA group (996.0 ± 255.4 ms2; p < 0.05), while serum DHEA-S levels were significantly lower in both the MA (91.2 ± 19.6 mg/dL) and OA (54.2 ± 17.7 mg/dL) groups compared to the YA group (240.0 ± 50.8 mg/dL; p < 0.05). A positive correlation between lower serum concentrations of DHEA-S and attenuated variance of HRV (r = 0.47, p = 0.031), as well as lower serum concentrations of DHEA-S and decreased parasympathetic modulation of HRV (r = 0.54, p = 0.010), were found. CONCLUSION The present study demonstrated that the decline of plasma DHEA-S is associated with reduced cardiac autonomic modulation during the aging process.
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Affiliation(s)
- Marina de Paiva Lemos
- Departamento de Ciências do Esporte, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, MG, Brasil
| | - Munique Tostes Miranda
- Departamento de Ciências do Esporte, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, MG, Brasil
| | - Moacir Marocolo
- Departamento de Fisiologia, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, MG, Brasil
| | | | | | - Carla Cristina de Sordi
- Departamento de Endocrinologia e Metabolismo, Curso de Pós-Graduação em Ciências da Saúde, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, MG, Brasil
| | - Octávio Barbosa Neto
- Departamento de Ciências do Esporte, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, MG, Brasil
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Willaschek C, Meint S, Rager K, Buchhorn R. Modified Clonidine Testing for Growth Hormone Stimulation Reveals α2-Adrenoreceptor Sub Sensitivity in Children with Idiopathic Growth Hormone Deficiency. PLoS One 2015; 10:e0137643. [PMID: 26361394 PMCID: PMC4567306 DOI: 10.1371/journal.pone.0137643] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Accepted: 08/20/2015] [Indexed: 11/19/2022] Open
Abstract
Introduction The association between short stature and increased risk of ischemic heart disease has been subject to studies for decades. The recent discussion of cardiovascular risk during growth hormone therapy has given new importance to this question. We have hypothesized that the autonomic system is a crucial element relating to this subject. Methods Heart rate variability calculated from 24-hour electrocardiogram data is providing insight into the regulatory state of the autonomous nervous system and is an approved surrogate parameter for estimating cardiovascular risk. We have calculated heart rate variability during clonidine testing for growth hormone stimulation of 56 children. As clonidine is a well-known effector of the autonomous system, stimulating vagal tone and decreasing sympathetic activity, we compared the autonomous reactions of children with constitutional growth delay (CGD), growth hormone deficiency (GHD) and former small for gestational age (SGA). Results During clonidine testing children with CGD showed the expected α2-adrenoreceptor mediated autonomous response of vagal stimulation for several hours. This vagal reaction was significantly reduced in the SGA group and nearly non- existent in the GHD group. Discussion Children with GHD show a reduced autonomous response to clonidine indicating α2-adrenoreceptor sub sensitivity. This can be found prior to the start of growth hormone treatment. Since reduction of HRV is an approved surrogate parameter, increased cardiovascular risk has to be assumed for patients with GHD. In the SGA group a similar but less severe reduction of the autonomous response to clonidine was found. These findings may enrich the interpretation of the data on growth hormone therapy, which are being collected by the SAGhE study group.
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Affiliation(s)
- Christian Willaschek
- Caritas Krankenhaus, Department of Pediatrics, Bad Mergentheim, Germany
- * E-mail:
| | - Sebastian Meint
- Caritas Krankenhaus, Department of Pediatrics, Bad Mergentheim, Germany
| | - Klaus Rager
- Caritas Krankenhaus, Department of Pediatrics, Bad Mergentheim, Germany
| | - Reiner Buchhorn
- Caritas Krankenhaus, Department of Pediatrics, Bad Mergentheim, Germany
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Tanriverdi F, Unluhizarci K, Kelestimur F. Growth hormone replacement therapy in adults with growth hormone deficiency: benefits and cost-effectiveness. Expert Rev Pharmacoecon Outcomes Res 2014; 6:131-8. [DOI: 10.1586/14737167.6.2.131] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Moisey R, Orme S, Barker D, Lewis N, Sharp L, Clements RE, Goldspink DF, Tan LB. Cardiac Functional Reserve is Diminished in Growth Hormone-Deficient Adults. Cardiovasc Ther 2009; 27:34-41. [DOI: 10.1111/j.1755-5922.2009.00073.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Nyström HC, Klintland N, Caidahl K, Bergström G, Wickman A. Short-term administration of growth hormone (GH) lowers blood pressure by activating eNOS/nitric oxide (NO)-pathway in male hypophysectomized (Hx) rats. BMC PHYSIOLOGY 2005; 5:17. [PMID: 16271154 PMCID: PMC1291375 DOI: 10.1186/1472-6793-5-17] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2005] [Accepted: 11/07/2005] [Indexed: 11/12/2022]
Abstract
Background The aim of the study was to evaluate the acute and continuous (up to 14 days of treatment) effect of growth hormone (GH) on blood pressure (BP) regulation and to investigate the interplay between GH, nitric oxide (NO) and BP. In un-supplemented and GH supplemented hypophysectomized (Hx) male rats as well as intact rats, continuous resting mean arterial blood pressure (MAP) was measured using telemetry. Baroreceptor activity and the influences of NO on BP control were assessed during telemetric measurement. Furthermore, basal plasma and urine nitrate levels and aortic endothelial nitric oxide synthase (eNOS) expression were analysed. Endothelial function as well as vascular structure in the hindquarter vascular bed was estimated using an in vivo constant-flow preparation. Results Hypophysectomy was associated with decreased MAP (Hx: 83 ± 3 vs Intact: 98 ± 6 mmHg, p < 0.05) and heart rate (HR) (Hx: 291 ± 4 vs Intact: 351 ± 7 beat/min, p < 0.05). Endothelial dysfunction and reduced vasculature mass in the hindquarter vascular bed was found in Hx rats. GH substitution caused a further transient decrease in MAP and a transient increase in HR (14% and 16% respectively, p < 0.05). The reduction in MAP appeared to be NO dependent. Aortic eNOS expression was unchanged. GH substitution resulted in an impaired baroreceptor function. Two weeks of GH treatment did not normalise the BP, vascular structure and the endothelial function in the resistance vessels. Conclusion GH substitution seems to have a short lasting effect on lowering blood pressure via activation of the NO-system. An interaction between GH, NO-system and BP regulation can be demonstrated.
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Affiliation(s)
- Henrik C Nyström
- Department of Physiology, Institute of Physiology & Pharmacology, The Sahlgrenska Academy, Göteborg University, P.O. Box 432, SE-405 30 Göteborg, Sweden
| | - Natalia Klintland
- Department of Clinical Physiology, Sahlgrenska University Hospital/SU, SE-413 45 Göteborg, Sweden
| | - Kenneth Caidahl
- Department of Clinical Physiology, Sahlgrenska University Hospital/SU, SE-413 45 Göteborg, Sweden
| | - Göran Bergström
- Department of Physiology, Institute of Physiology & Pharmacology, The Sahlgrenska Academy, Göteborg University, P.O. Box 432, SE-405 30 Göteborg, Sweden
- Department of Clinical Physiology, Sahlgrenska University Hospital/SU, SE-413 45 Göteborg, Sweden
| | - Anna Wickman
- Department of Physiology, Institute of Physiology & Pharmacology, The Sahlgrenska Academy, Göteborg University, P.O. Box 432, SE-405 30 Göteborg, Sweden
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Tanriverdi F, Eryol NK, Atmaca H, Unluhizarci K, Ozdogru I, Sarikaya I, Bayram F, Kelestimur F. The effects of 12 months of growth hormone replacement therapy on cardiac autonomic tone in adults with growth hormone deficiency. Clin Endocrinol (Oxf) 2005; 62:706-12. [PMID: 15943833 DOI: 10.1111/j.1365-2265.2005.02283.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Growth hormone deficiency (GHD) in adults is associated with a cluster of cardiovascular risk factors. Some abnormalities of cardiac structure and function have been reported in adult patients with GHD, but there are few data related to cardiac autonomic tone. Non-invasive assessment of cardiac autonomic status can be achieved by heart rate variability (HRV), which can be measured by using time-domain or frequency-domain variables. To our knowledge, short-term (6 months) effects of GH replacement therapy (GHRT) on HRV in a limited number of patients have been evaluated prospectively in only two previous studies. The present study was therefore designed to investigate the effects of GHD and 12 months of GHRT on cardiac autonomic tone in a larger number of adult patients with severe GHD. PATIENTS AND METHODS HRV measurement, by using time-domain variables, was performed in 22 patients with GHD (eight men, 14 women; mean age 45.4 +/- 2.4 years) and 22 healthy controls (nine men, 13 women; mean age 40.8 +/- 1.8 years) at baseline. The time-domain variables (sympathetically influenced parameters SDNN and SDANN and parasympathetically influenced parameters RMSSD and PNN50) were derived from 24-h electrocardiogram (ECG) recordings. In the patient group, cardiac autonomic tone was re-evaluated after 6 and 12 months of GHRT. RESULTS Mean baseline values of SDNN and SDANN were significantly higher (higher values mean lower sympathetic activity) in GHD patients than in healthy controls (P < 0.05), but mean baseline values of RMSSD and PNN50 did not differ significantly in healthy controls and patients. After 6 and 12 months of GHRT, mean SDNN and SDANN were decreased significantly when compared with the baseline values before GHRT (P < 0.05). However, mean RMSSD and PNN50 did not differ significantly from baseline. When SDNN and SDANN measurements were evaluated individually for each patient, after 12 months of GHRT both of the sympathetically influenced parameters decreased in 90% of the patients. CONCLUSIONS These data indicate that sympathetic tone is decreased in adult patients with severe GHD. Additionally, an increment in sympathetic activity and normalization of sympathovagal balance have been demonstrated after 6 and 12 months of GHRT. This result suggests that, at least at the doses used in this study, GHRT improves sympathetic tone, without an obvious arrhythmogenic effect.
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Affiliation(s)
- F Tanriverdi
- Department of Endocrinology, Erciyes University Medical School, Kayseri, Turkey
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Erdoğan D, Tükek T, Aral F, Oflaz H, Özaydin M, Kocaman O, Akkaya V, Gören T, Molvalilar S. Structural, functional and autonomic changes in the cardiovascular system in growth hormone deficient patients. Ann Noninvasive Electrocardiol 2004; 9:19-23. [PMID: 14731212 PMCID: PMC6931926 DOI: 10.1111/j.1542-474x.2004.91521.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Growth hormone deficiency (GHD) is known to cause higher rates of cardiovascular mortality. The purpose of the study was to analyze the structural and functional changes in the heart and investigate their relation to autonomic function as assessed with heart rate variability (HRV). METHODS Eleven untreated GHD patients (mean age 50.4 +/- 10.7 years, M/F: 3/8) and 15 age- and sex-matched healthy persons (mean age 45.3 +/- 10.4 years, M/F: 5/10) were compared. Both groups were examined with echocardiography, HRV, and exercise testing and findings were analyzed. RESULTS The groups were similar in height, weight, body mass index, body surface area, systolic and diastolic blood pressure, heart rate. The GHD patients had lower exercise duration and metabolic equivalent (MET) compared to controls (7.94 +/- 1.26 vs. 9.8 +/- 1.9 min, P < 0.001, for MET 8.85 +/- 0.86 vs. 10.7 +/- 2.23, P = 0.03). On echocardiography, GHD patients had lower interventricular septum diastolic diameter (9 +/- 0.89 vs. 10.7 +/- 0.88 mm, P < 0.001) and posterior wall thickness (8.4 +/- 0.93 vs. 9.8 +/- 0.91 mm, P = 0.002), and lower left ventricle mass index (90.9 +/- 20 vs. 112 +/- 8 g/m2, P = 0.01). Left ventricular ejection fraction was lower in the GHD patients (57.4 +/- 5.12% vs. 65.5 +/- 4.1%, P < 0.001). Time and frequency domain heart rate variability parameters, SDNN, SDANN, VLF, LF ve LF/HF were lower in GHD patients compared to controls. There was a significant correlation between left ventricle diastolic diameter and LF (r = 0.62, P = 0.02). CONCLUSION GHD seemed to cause decreased left ventricle mass and decreases in the sympathetic components of HRV that may have a bearing on the increased cardiovascular risk seen in these patients.
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Affiliation(s)
- Doğan Erdoğan
- Department of Cardiology, Istanbul University, Medical Faculty of Istanbul, Turkey
| | - Tufan Tükek
- Department of Cardiology, Istanbul University, Medical Faculty of Istanbul, Turkey
| | - Ferihan Aral
- Department of Internal Medicine, Istanbul University, Medical Faculty of Istanbul, Turkey
| | - Hüseyin Oflaz
- Department of Cardiology, Istanbul University, Medical Faculty of Istanbul, Turkey
| | - Mehmet Özaydin
- Department of Cardiology, Süleyman Demirel University, Medical Faculty of Isparta, Turkey
| | - Orhan Kocaman
- Department of Cardiology, Süleyman Demirel University, Medical Faculty of Isparta, Turkey
| | - Vakur Akkaya
- Department of Cardiology, Istanbul University, Medical Faculty of Istanbul, Turkey
| | - Taner Gören
- Department of Cardiology, Istanbul University, Medical Faculty of Istanbul, Turkey
| | - Senay Molvalilar
- Department of Internal Medicine, Istanbul University, Medical Faculty of Istanbul, Turkey
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The effect of growth hormone (GH) replacement therapy on sympathetic nerve hyperactivity in hypopituitary adults. J Hypertens 2003. [DOI: 10.1097/00004872-200310000-00018] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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The effects of growth hormone therapy on heart rate variability in adults with growth hormone deficiency. Curr Ther Res Clin Exp 2002. [DOI: 10.1016/s0011-393x(02)80048-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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