MRI Assessment of Cardiac Function and Morphology in Adult Patients With Growth Hormone Deficiency: A Systematic Review and Meta-Analysis
BackgroundAdult GH deficiency (GHD) has been described as a heterogeneous condition characterized by many clinical modifications, such as metabolic alterations, impaired quality of life, and increased mortality. The clinical relevance of cardiac involvement remains, however, only partially elucidate...
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Frontiers Media S.A.
2022-06-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2022.910575/full |
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| author | Fabio Bioletto Nunzia Prencipe Alessandro Maria Berton Chiara Bona Mirko Parasiliti-Caprino Riccardo Faletti Ezio Ghigo Silvia Grottoli Valentina Gasco |
| author_facet | Fabio Bioletto Nunzia Prencipe Alessandro Maria Berton Chiara Bona Mirko Parasiliti-Caprino Riccardo Faletti Ezio Ghigo Silvia Grottoli Valentina Gasco |
| author_sort | Fabio Bioletto |
| collection | DOAJ |
| description | BackgroundAdult GH deficiency (GHD) has been described as a heterogeneous condition characterized by many clinical modifications, such as metabolic alterations, impaired quality of life, and increased mortality. The clinical relevance of cardiac involvement remains, however, only partially elucidated.MethodsPubMed/Medline, EMBASE, Cochrane library, OVID and CINAHL databases were systematically searched until February 2022 for studies evaluating cardiac function and morphology by magnetic resonance imaging in adult patients with GHD. Effect sizes were pooled through a random-effect model.ResultsFour studies were considered in the meta-analysis. With respect to the left ventricle, GHD patients were characterized by a lower stroke-volume-index (-3.6 ml/m2, standardized mean difference (SMD) -0.60, 95%CI [-1.15,-0.05], p=0.03), lower end-diastolic-volume-index (-6.2 ml/m2, SMD -0.54, 95%CI [-0.97,-0.10], p=0.02) and, after accounting for possible biases, lower mass-index (-15.0 g/m2, SMD -1.03, 95%CI [-1.89,-0.16], p=0.02). With respect to the right ventricle, a lower end-diastolic-volume-index (-16.6 ml/m2, SMD -1.04, 95%CI [-2.04,-0.03], p=0.04) and a borderline-significant lower stroke-volume-index (-5.0 ml/m2, SMD -0.84, 95%CI [-1.77,0.08], p=0.07) could be observed. Data about the effect of GH replacement therapy highlighted a significant increase in left ventricular mass-index after treatment initiation (+3.7 g/m2, 95%CI [1.6,5.7], p<0.01).ConclusionWith respect to the left ventricle, our results confirmed those retrieved by echocardiographic studies. In addition, significant alterations were demonstrated also for the right ventricle, for which echocardiographic data are nearly absent. This supports the thesis of a biventricular cardiac involvement in patients with GHD, with a similar pattern of morphological and functional alterations in both ventricles. |
| first_indexed | 2024-04-12T18:06:30Z |
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| id | doaj.art-a8e011dc27d64010b4ebdc335b3b6c22 |
| institution | Directory Open Access Journal |
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| language | English |
| last_indexed | 2024-04-12T18:06:30Z |
| publishDate | 2022-06-01 |
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| series | Frontiers in Endocrinology |
| spelling | doaj.art-a8e011dc27d64010b4ebdc335b3b6c222022-12-22T03:21:59ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922022-06-011310.3389/fendo.2022.910575910575MRI Assessment of Cardiac Function and Morphology in Adult Patients With Growth Hormone Deficiency: A Systematic Review and Meta-AnalysisFabio Bioletto0Nunzia Prencipe1Alessandro Maria Berton2Chiara Bona3Mirko Parasiliti-Caprino4Riccardo Faletti5Ezio Ghigo6Silvia Grottoli7Valentina Gasco8Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Turin, ItalyEndocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Turin, ItalyEndocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Turin, ItalyEndocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Turin, ItalyEndocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Turin, ItalyRadiology Unit, Department of Surgical Sciences, University of Turin, Turin, ItalyEndocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Turin, ItalyEndocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Turin, ItalyEndocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Turin, ItalyBackgroundAdult GH deficiency (GHD) has been described as a heterogeneous condition characterized by many clinical modifications, such as metabolic alterations, impaired quality of life, and increased mortality. The clinical relevance of cardiac involvement remains, however, only partially elucidated.MethodsPubMed/Medline, EMBASE, Cochrane library, OVID and CINAHL databases were systematically searched until February 2022 for studies evaluating cardiac function and morphology by magnetic resonance imaging in adult patients with GHD. Effect sizes were pooled through a random-effect model.ResultsFour studies were considered in the meta-analysis. With respect to the left ventricle, GHD patients were characterized by a lower stroke-volume-index (-3.6 ml/m2, standardized mean difference (SMD) -0.60, 95%CI [-1.15,-0.05], p=0.03), lower end-diastolic-volume-index (-6.2 ml/m2, SMD -0.54, 95%CI [-0.97,-0.10], p=0.02) and, after accounting for possible biases, lower mass-index (-15.0 g/m2, SMD -1.03, 95%CI [-1.89,-0.16], p=0.02). With respect to the right ventricle, a lower end-diastolic-volume-index (-16.6 ml/m2, SMD -1.04, 95%CI [-2.04,-0.03], p=0.04) and a borderline-significant lower stroke-volume-index (-5.0 ml/m2, SMD -0.84, 95%CI [-1.77,0.08], p=0.07) could be observed. Data about the effect of GH replacement therapy highlighted a significant increase in left ventricular mass-index after treatment initiation (+3.7 g/m2, 95%CI [1.6,5.7], p<0.01).ConclusionWith respect to the left ventricle, our results confirmed those retrieved by echocardiographic studies. In addition, significant alterations were demonstrated also for the right ventricle, for which echocardiographic data are nearly absent. This supports the thesis of a biventricular cardiac involvement in patients with GHD, with a similar pattern of morphological and functional alterations in both ventricles.https://www.frontiersin.org/articles/10.3389/fendo.2022.910575/fullcardiovascular systemcardiac magnetic resonance imaginggrowth hormone deficiencygrowth hormone replacement therapymeta-analysis |
| spellingShingle | Fabio Bioletto Nunzia Prencipe Alessandro Maria Berton Chiara Bona Mirko Parasiliti-Caprino Riccardo Faletti Ezio Ghigo Silvia Grottoli Valentina Gasco MRI Assessment of Cardiac Function and Morphology in Adult Patients With Growth Hormone Deficiency: A Systematic Review and Meta-Analysis Frontiers in Endocrinology cardiovascular system cardiac magnetic resonance imaging growth hormone deficiency growth hormone replacement therapy meta-analysis |
| title | MRI Assessment of Cardiac Function and Morphology in Adult Patients With Growth Hormone Deficiency: A Systematic Review and Meta-Analysis |
| title_full | MRI Assessment of Cardiac Function and Morphology in Adult Patients With Growth Hormone Deficiency: A Systematic Review and Meta-Analysis |
| title_fullStr | MRI Assessment of Cardiac Function and Morphology in Adult Patients With Growth Hormone Deficiency: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | MRI Assessment of Cardiac Function and Morphology in Adult Patients With Growth Hormone Deficiency: A Systematic Review and Meta-Analysis |
| title_short | MRI Assessment of Cardiac Function and Morphology in Adult Patients With Growth Hormone Deficiency: A Systematic Review and Meta-Analysis |
| title_sort | mri assessment of cardiac function and morphology in adult patients with growth hormone deficiency a systematic review and meta analysis |
| topic | cardiovascular system cardiac magnetic resonance imaging growth hormone deficiency growth hormone replacement therapy meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2022.910575/full |
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