Cardiovascular Effects of Short-Term Growth Hormone Hypersecretion

Fazio, Serafino; Cittadini, Antonio; Biondi, Bernadette; Palmieri, Emiliano Antonio; Riccio, Giuseppe; Bonè, F; Oliviero, Ugo; Saccà, Luigi

doi:10.1210/jcem.85.1.6313

Cited by 72 publications

(46 citation statements)

References 27 publications

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“…Cardiac valve abnormalities were associated with left ventricular hypertrophy [28,29]. Increased stroke volume and cardiac output and decreased end-systolic stress and systemic vascular resistance were observed in some studies [30,31]. In our study, IVST, PWT, LVM, LVMI, DT, ET, IVRT, VPR, and LVESV values were significantly greater in acromegalic patients showing biventricular hypertrophy and impairment of diastolic and systolic function.…”

Section: Discussionsupporting

confidence: 63%

Adiponectin and Cardiac Hypertrophy in Acromegaly

Gurbulak¹,

Akın²,

Yerlikaya³

et al. 2016

Adv Clin Exp Med

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Section: Discussionsupporting

confidence: 63%

Adiponectin and Cardiac Hypertrophy in Acromegaly

Gurbulak¹,

Akın²,

Yerlikaya³

et al. 2016

Adv Clin Exp Med

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“…GH treatment did not increase the need for insulin and did not result in an increase in cardiac hypertrophy compared with the placebo group. This in contrast to adults, in whom a low dose of GH increases left ventricular mass and an excess of GH is associated with cardiac hypertrophy (39,40). In our GH-treated patients, we did not find an increase in severe ROP, although recent studies suggest an association between the persistence of high GH levels in preterm infants and the development of severe retinopathy (41).…”

contrasting

confidence: 94%

A Randomized, Placebo-Controlled GH Trial in Very Preterm Infants Who Were at Risk for Bronchopulmonary Dysplasia and Were Treated with Dexamethasone

et al. 2005

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Very preterm infants who develop bronchopulmonary dysplasia are often treated with dexamethasone (DEXA) to wean them from the ventilator. As DEXA has growth-suppressive and catabolic effects, which might have long-term consequences on growth and organ development, we investigated whether high-dose GH treatment could overcome these effects. In a randomized, double-blind, placebo-controlled trial, 30 ventilated very low birth weight infants were assigned to receive either GH or placebo treatment after start of DEXA. DEXA was given for 24 d (starting dose 0.5 mg · kg, tapering off every third day). Simultaneously, high-dose GH (0.3 mg · kg Ϫ1 · d Ϫ1) or placebo was administered during 6 wk. During high-dose DEXA treatment (dose 0.5-0.3 mg · kg Ϫ1 · d Ϫ1), no gain in head circumference, weight, crown-heel length, and knee-heel length occurred in the GH and placebo groups. Growth during the 6-wk study period was not different between the GH and the placebo groups. Two patients in the placebo group died, but the number and the severity of adverse effects was not statistically different between the GH and placebo groups. In conclusion, highdose GH treatment did not improve growth in DEXA-treated very preterm infants and thus cannot be recommended to prevent growth failure in these infants. During high-dose DEXA, a complete growth arrest occurred, including stunting of head growth. Growth in head circumference and weight with lower dose DEXA was comparable to growth after discontinuation of DEXA. In very preterm infants, the development of bronchopulmonary dysplasia (BPD) is a major problem. According to the latest classification, BPD is evaluated at 36 wk postmenstrual age or at discharge from the neonatal intensive care unit (NICU), whichever comes first, and is defined as a persistent need for supplemental oxygen for at least 28 d with a persistence of respiratory features, such as retractions, tachypnea, and rales as a result of respiratory disease (1). The incidence of BPD increases from 12% in infants with a gestational age of 30 wk to 30 -40% in those who are born after a gestational age of 25-26 wk (2,3).In NICUs, systemic corticosteroids are often given to wean very preterm infants with severe and prolonged respiratory problems from the ventilator (4 -6). Many infants who are at risk for development of BPD are treated with dexamethasone (DEXA). DEXA treatment in preterm infants is known to have an inhibiting effect on weight gain as well as linear growth and head circumference (7-11). Follow-up studies suggest impairment in brain growth and persisting growth retardation into childhood (12-16).

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“…371 Hypothyroidism promotes myocardial fibrosis by stimulating fibroblasts, whereas the reverse is seen in hyperthyroidism. 372 Chronic hypothyroidism in adult rats leads to loss of coronary arterioles, impaired blood flow, and a maladaptive change in myocyte shape. Hyperthyroidism and hypothyroidism can both lead to cardiovascular injury, including HF.…”

Section: Epidemiology and Pathophysiologymentioning

confidence: 99%

Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association

Bozkurt¹,

Colvin²,

Cook³

et al. 2016

Circulation

624

663

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CLINICAL STATEMENTS AND GUIDELINEST he intent of this American Heart Association (AHA) scientific statement is to summarize our current understanding of dilated cardiomyopathies. There is special emphasis on recent developments in diagnostic approaches and therapies for specific cardiomyopathies. Recommendations in this document are based on published studies, published practice guidelines from the American College of Cardiology (ACC)/AHA 1 and other organizations, 2,3 and the multidisciplinary expertise of the writing group. Existing evidence in epidemiology, classification, diagnosis, and management of specific cardiomyopathies is usually derived from nonrandomized observational studies, registries, case reports, or expert opinion based on clinical experience, not large-scale randomized clinical trials or systematic reviews. Therefore, in this document, rather than using the standard ACC/AHA classification schema of recommendations and level of evidence, 4 we have included key management strategies at the end of each section and categorized our recommendations according to the level of consensus. Although the format of our recommendations might resemble the ACC/AHA classification of recommendations used in the ACC/AHA practice guidelines, because of the preponderance of expert opinion or level of evidence C evidence in our document, we elected to use different terminology to provide a distinction from the practice guidelines, in which stronger levels and quality of evidence with randomized clinical trials or meta-analyses are usually present. 4 The levels of evidence follow the AHA and ACC methods of classifying the level of certainty of the treatment effect. 4 DEfINITIoN of DILATED CArDIoMyopAThyThe term dilated cardiomyopathy (DCM) refers to a spectrum of heterogeneous myocardial disorders that are characterized by ventricular dilation and depressed myocardial performance in the absence of hypertension, valvular, congenital, or ischemic heart disease. 5 In clinical practice, the pathogenesis of heart failure (HF) has often been placed into 2 categories: ischemic and nonischemic cardiomyopathy. The term nonischemic cardiomyopathy has been interchangeably used with DCM. Although this approach might be practical, it fails to recognize that nonischemic cardiomyopathy can include cardiomyopathies caused by volume or pressure overload (such as hypertension or valvular heart disease) that are not conventionally accepted under the definition of DCM. 1,5 Again, in general practice and clinical research trials, the term ischemic cardiomyopathy is defined as cardiomyopathy caused by ischemic heart disease. Current use of ischemic cardiomyopathy terminology implies ventricular dilation and depressed myocardial contractility caused by ischemia or infarction. CLASSIfICATIoN of CArDIoMyopAThIESThe first classification on this topic categorized cardiomyopathies as heart muscle diseases with dilated (DCM), hypertrophic, restrictive, arrhythmogenic right ventricular (ARVC), or nonclassifiable cardiomyopathy in 1980. 5 Subse...

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Cardiovascular Effects of Short-Term Growth Hormone Hypersecretion

Cited by 72 publications

References 27 publications

Adiponectin and Cardiac Hypertrophy in Acromegaly

Adiponectin and Cardiac Hypertrophy in Acromegaly

A Randomized, Placebo-Controlled GH Trial in Very Preterm Infants Who Were at Risk for Bronchopulmonary Dysplasia and Were Treated with Dexamethasone

Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association

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