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Cardiac manifestations of GH deficiency after treatment for acromegaly: a comparison to patients with biochemical remission and controls

Departments of¹ Endocrinology and Metabolic Diseases, C4-R² Cardiology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands

(Correspondence should be addressed to A A van der Klaauw; Email: a.a.van_der_klaauw{at}lumc.nl)

Objective: Both GH excess and GH deficiency (GHD) lead to specific cardiac pathology. The aim of this study was to evaluate cardiac morphology and function in patients with GHD after treatment for acromegaly.

Design: Cross-sectional study.

Patients and methods: Cardiac parameters were studied by conventional two-dimensional echocardiography and tissue Doppler imaging in 53 patients with acromegaly (16 patients with GHD, 20 patients with biochemical remission, and 17 patients with active disease). Patients with GHD were also compared with age- and gender-matched controls.

Results: Left ventricular (LV) dimensions, wall thickness, and mass did not differ between the three groups, or between the patients with GHD and healthy controls. Systolic function, assessed by LV ejection fraction, tended to be lower in patients with GHD compared with patients with biochemical remission (65.9±7.3% vs 72.4±8.5%, P=0.070), but was higher when compared with active acromegaly (58.8±9.3%, P=0.047). No differences were found with healthy controls. Diastolic function, measured with early diastolic velocity (E'), was lower in patients with GHD when compared with both patients with biochemical remission (6.0±2.1 cm/s vs 8.3±1.5 cm/s, P=0.005) and healthy controls (8.1±1.9 cm/s, P=0.006).

Conclusion: GHD after acromegaly results in a specific decrease in diastolic function compared with patients with biochemical remission of acromegaly and healthy controls. In addition, systolic function tends to be decreased in patients with GHD compared with patients with biochemical remission, but was higher than that in patients with active acromegaly.