title: Growth hormone deficiency in adults impacts left ventricular mechanics: a two-dimensional speckle-tracking study.
abstract: BACKGROUND
  Growth hormone deficiency (GHD) in adults is associated with increased cardiovascular events, but detailed assessment of cardiac and vascular function is lacking. Thus we assessed cardiac, arterial, and endothelial functions, using conventional and speckle-tracking echocardiography, in adults with GHD compared with controls with similar cardiovascular risk.
  
  
  METHODS
  Fifty-two patients with GHD (47 ± 16 years; 34 men) and no cardiovascular disease or diabetes were enrolled prospectively and compared with 50 age- and sex-matched controls. Comprehensive echocardiography was performed in all participants. Regional left ventricular (LV) function was assessed from global longitudinal strain (GLS), global radial strain (GRS), and global circumferential strain (GCS), whereas LV torsion (LVtor) was calculated from basal (RotB) and apical (RotA) rotations. Arterial function was assessed from intima-media thickening, local wave speed, and beta index of stiffness, whereas endothelial function was assessed from flow-mediated dilation. Levels of pro-brain natriuretic peptide (proBNP) were measured.
  
  
  RESULTS
  GLS and GCS were decreased more in patients with GHD than in controls (-17.2% ± 2.7% vs. -19.3% ± 3.3% and -15.9% ± 5.4% vs. -18.8% ± 3.5%; both P < 0.01), whereas GRS was similar. RotB and LVtor were also decreased in patients with GHD (-4.8° ± 2.6° vs. -6.2° ± 2.1°/cm and 1.8° ± 0.6° vs. 2.3° ± 1.1°/cm; both P < 0.05). ProBNP was increased in patients with GHD (61.0 ± 74 pg/dL vs. 24.7 ± 21 pg/dL; P = 0.002). Arterial and endothelial functions were similar between groups.
  
  
  CONCLUSIONS
  In conclusion, adults with GHD had LV longitudinal dysfunction and increased proBNP levels compared with controls, suggesting intrinsic myocardial disease. Further studies are needed to assess if this cardiac impairment in adults with GHD is reversible after GH replacement.
authors.affiliation: University of Medicine and Pharmacy Carol Davila, Bucharest, Romania. Electronic address: sorinamihaila@yahoo.com.
authors.forename: Sorina
authors.initials: S
authors.lastname: Mihaila
authors.affiliation: University of Medicine and Pharmacy Carol Davila, Bucharest, Romania.
authors.forename: Raluca I
authors.initials: RI
authors.lastname: Mincu
authors.affiliation: University & Emergency Hospital Bucharest, Bucharest, Romania.
authors.forename: Roxana C
authors.initials: RC
authors.lastname: Rimbas
authors.affiliation: University of Medicine and Pharmacy Carol Davila, Bucharest, Romania.
authors.forename: Raluca E
authors.initials: RE
authors.lastname: Dulgheru
authors.affiliation: Institute of Endocrinology "C.I. Parhon," Bucharest, Romania.
authors.forename: Ruxandra
authors.initials: R
authors.lastname: Dobrescu
authors.affiliation: University of Medicine and Pharmacy Carol Davila, Bucharest, Romania.
authors.forename: Stefania L
authors.initials: SL
authors.lastname: Magda
authors.affiliation: University of Medicine and Pharmacy Carol Davila, Bucharest, Romania.
authors.forename: Corin
authors.initials: C
authors.lastname: Badiu
authors.affiliation: University of Medicine and Pharmacy Carol Davila, Bucharest, Romania.
authors.forename: Dragos
authors.initials: D
authors.lastname: Vinereanu
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003677:Deficiency Diseases / Q000150:complications / Q000175:diagnosis; D004393:Dwarfism, Pituitary / Q000150:complications / Q000175:diagnosis; D004452:Echocardiography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D019382:Human Growth Hormone / Q000172:deficiency*; D006801:Humans; D007018:Hypopituitarism / Q000150:complications* / Q000175:diagnosis; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011446:Prospective Studies; D012016:Reference Values; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology*
chemical_list: D019382:Human Growth Hormone