title: Structural, functional and autonomic changes in the cardiovascular system in growth hormone deficient patients.
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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Cardiology, Istanbul University, Medical Faculty of Istanbul, Turkey.
authors.forename: Doğan
authors.initials: D
authors.lastname: Erdoğan
authors.forename: Tufan
authors.initials: T
authors.lastname: Tükek
authors.forename: Ferihan
authors.initials: F
authors.lastname: Aral
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Oflaz
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ozaydin
authors.forename: Orhan
authors.initials: O
authors.lastname: Kocaman
authors.forename: Vakur
authors.initials: V
authors.lastname: Akkaya
authors.forename: Taner
authors.initials: T
authors.lastname: Gören
authors.forename: Senay
authors.initials: S
authors.lastname: Molvalilar
mesh_terms: D001341:Autonomic Nervous System / Q000503:physiopathology; D002319:Cardiovascular System / Q000503:physiopathology*; D016022:Case-Control Studies; D004452:Echocardiography; D015716:Electrocardiography, Ambulatory; D005080:Exercise Test; D005260:Female; D006339:Heart Rate / Q000502:physiology; D019382:Human Growth Hormone / Q000172:deficiency*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018709:Statistics, Nonparametric
chemical_list: D019382:Human Growth Hormone