Autonomic nervous system and cardiovascular risk assessment during one year of growth hormone replacement therapy in adults with growth hormone deficiency

Mara Boschetti, Massimo Casu, Sara Moretti, Claudia Teti, Valeria Albanese, Manuela Albertelli, Giovanni Murialdo, Francesco Minuto, Diego Ferone

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

OBJECTIVE: This prospective study aimed to evaluate the impact of growth hormone deficiency (GHD) on cardiac autonomic tone and on cardiovascular risk and the changes after 12 months of GH replacement therapy (GHRT). GHD is associated with increased cardiovascular morbidity and mortality. This has been attributed to increased markers of cardiovascular risk and to abnormalities of both the cardiac and peripheral autonomic nervous systems. The autonomic cardiac nervous system (ACNS) can be indirectly evaluated by analysis of heart rate variability (HRV) in clinostatism and orthostatism. DESIGN: We compared 14 GHD patients at baseline and after 12 months of GHRT and 17 healthy controls. We analyzed a number of cardiovascular risk factors and we used analysis of HRV during the Tilt Test that identified high frequency (HF) and low frequency (LF), representing parasympathetic and sympathetic activity, respectively. RESULTS: Compared with the control group, in either clinostatism or in orthostatism our patients showed a significantly lower value of LF (P=0.047; P=0.004, re-spectively), whereas HF was significantly reduced in orthostatism (P=0.037), and indicatively in clinostatism (P=0.065). These values remained unchanged after 12 months of GHRT. No statistically significant differences were found between the LF/HF ratio in untreated and treated patients. In GHD patients, there was a significant reduction of cardiovascular risk in 12 months of replacement therapy (P=0.002). CONCLUSIONS: Our study highlights the absence of sympathovagal imbalance in GHD patients; GHRT does not change ACNS during the first year of GH treatment but it reduces the absolute cardiovascular risk in these patients.

Original languageEnglish
Pages (from-to)134-141
Number of pages8
JournalHormones
Volume14
Issue number1
Publication statusPublished - 2015

Fingerprint

Autonomic Nervous System
Hormone Replacement Therapy
Growth Hormone
Therapeutics
Heart Rate
Peripheral Nervous System
Risk Reduction Behavior
Statistical Factor Analysis
Prospective Studies
Morbidity
Control Groups
Mortality

Keywords

  • Autonomic nervous system
  • GHD
  • IGF-I

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Medicine(all)

Cite this

Autonomic nervous system and cardiovascular risk assessment during one year of growth hormone replacement therapy in adults with growth hormone deficiency. / Boschetti, Mara; Casu, Massimo; Moretti, Sara; Teti, Claudia; Albanese, Valeria; Albertelli, Manuela; Murialdo, Giovanni; Minuto, Francesco; Ferone, Diego.

In: Hormones, Vol. 14, No. 1, 2015, p. 134-141.

Research output: Contribution to journalArticle

Boschetti, M, Casu, M, Moretti, S, Teti, C, Albanese, V, Albertelli, M, Murialdo, G, Minuto, F & Ferone, D 2015, 'Autonomic nervous system and cardiovascular risk assessment during one year of growth hormone replacement therapy in adults with growth hormone deficiency', Hormones, vol. 14, no. 1, pp. 134-141.
Boschetti, Mara ; Casu, Massimo ; Moretti, Sara ; Teti, Claudia ; Albanese, Valeria ; Albertelli, Manuela ; Murialdo, Giovanni ; Minuto, Francesco ; Ferone, Diego. / Autonomic nervous system and cardiovascular risk assessment during one year of growth hormone replacement therapy in adults with growth hormone deficiency. In: Hormones. 2015 ; Vol. 14, No. 1. pp. 134-141.
@article{e2133c837eb94ae9a1a35c8275fb7d9b,
title = "Autonomic nervous system and cardiovascular risk assessment during one year of growth hormone replacement therapy in adults with growth hormone deficiency",
abstract = "OBJECTIVE: This prospective study aimed to evaluate the impact of growth hormone deficiency (GHD) on cardiac autonomic tone and on cardiovascular risk and the changes after 12 months of GH replacement therapy (GHRT). GHD is associated with increased cardiovascular morbidity and mortality. This has been attributed to increased markers of cardiovascular risk and to abnormalities of both the cardiac and peripheral autonomic nervous systems. The autonomic cardiac nervous system (ACNS) can be indirectly evaluated by analysis of heart rate variability (HRV) in clinostatism and orthostatism. DESIGN: We compared 14 GHD patients at baseline and after 12 months of GHRT and 17 healthy controls. We analyzed a number of cardiovascular risk factors and we used analysis of HRV during the Tilt Test that identified high frequency (HF) and low frequency (LF), representing parasympathetic and sympathetic activity, respectively. RESULTS: Compared with the control group, in either clinostatism or in orthostatism our patients showed a significantly lower value of LF (P=0.047; P=0.004, re-spectively), whereas HF was significantly reduced in orthostatism (P=0.037), and indicatively in clinostatism (P=0.065). These values remained unchanged after 12 months of GHRT. No statistically significant differences were found between the LF/HF ratio in untreated and treated patients. In GHD patients, there was a significant reduction of cardiovascular risk in 12 months of replacement therapy (P=0.002). CONCLUSIONS: Our study highlights the absence of sympathovagal imbalance in GHD patients; GHRT does not change ACNS during the first year of GH treatment but it reduces the absolute cardiovascular risk in these patients.",
keywords = "Autonomic nervous system, GHD, IGF-I",
author = "Mara Boschetti and Massimo Casu and Sara Moretti and Claudia Teti and Valeria Albanese and Manuela Albertelli and Giovanni Murialdo and Francesco Minuto and Diego Ferone",
year = "2015",
language = "English",
volume = "14",
pages = "134--141",
journal = "Hormones",
issn = "1109-3099",
publisher = "Hellenic Endocrine Society",
number = "1",

}

TY - JOUR

T1 - Autonomic nervous system and cardiovascular risk assessment during one year of growth hormone replacement therapy in adults with growth hormone deficiency

AU - Boschetti, Mara

AU - Casu, Massimo

AU - Moretti, Sara

AU - Teti, Claudia

AU - Albanese, Valeria

AU - Albertelli, Manuela

AU - Murialdo, Giovanni

AU - Minuto, Francesco

AU - Ferone, Diego

PY - 2015

Y1 - 2015

N2 - OBJECTIVE: This prospective study aimed to evaluate the impact of growth hormone deficiency (GHD) on cardiac autonomic tone and on cardiovascular risk and the changes after 12 months of GH replacement therapy (GHRT). GHD is associated with increased cardiovascular morbidity and mortality. This has been attributed to increased markers of cardiovascular risk and to abnormalities of both the cardiac and peripheral autonomic nervous systems. The autonomic cardiac nervous system (ACNS) can be indirectly evaluated by analysis of heart rate variability (HRV) in clinostatism and orthostatism. DESIGN: We compared 14 GHD patients at baseline and after 12 months of GHRT and 17 healthy controls. We analyzed a number of cardiovascular risk factors and we used analysis of HRV during the Tilt Test that identified high frequency (HF) and low frequency (LF), representing parasympathetic and sympathetic activity, respectively. RESULTS: Compared with the control group, in either clinostatism or in orthostatism our patients showed a significantly lower value of LF (P=0.047; P=0.004, re-spectively), whereas HF was significantly reduced in orthostatism (P=0.037), and indicatively in clinostatism (P=0.065). These values remained unchanged after 12 months of GHRT. No statistically significant differences were found between the LF/HF ratio in untreated and treated patients. In GHD patients, there was a significant reduction of cardiovascular risk in 12 months of replacement therapy (P=0.002). CONCLUSIONS: Our study highlights the absence of sympathovagal imbalance in GHD patients; GHRT does not change ACNS during the first year of GH treatment but it reduces the absolute cardiovascular risk in these patients.

AB - OBJECTIVE: This prospective study aimed to evaluate the impact of growth hormone deficiency (GHD) on cardiac autonomic tone and on cardiovascular risk and the changes after 12 months of GH replacement therapy (GHRT). GHD is associated with increased cardiovascular morbidity and mortality. This has been attributed to increased markers of cardiovascular risk and to abnormalities of both the cardiac and peripheral autonomic nervous systems. The autonomic cardiac nervous system (ACNS) can be indirectly evaluated by analysis of heart rate variability (HRV) in clinostatism and orthostatism. DESIGN: We compared 14 GHD patients at baseline and after 12 months of GHRT and 17 healthy controls. We analyzed a number of cardiovascular risk factors and we used analysis of HRV during the Tilt Test that identified high frequency (HF) and low frequency (LF), representing parasympathetic and sympathetic activity, respectively. RESULTS: Compared with the control group, in either clinostatism or in orthostatism our patients showed a significantly lower value of LF (P=0.047; P=0.004, re-spectively), whereas HF was significantly reduced in orthostatism (P=0.037), and indicatively in clinostatism (P=0.065). These values remained unchanged after 12 months of GHRT. No statistically significant differences were found between the LF/HF ratio in untreated and treated patients. In GHD patients, there was a significant reduction of cardiovascular risk in 12 months of replacement therapy (P=0.002). CONCLUSIONS: Our study highlights the absence of sympathovagal imbalance in GHD patients; GHRT does not change ACNS during the first year of GH treatment but it reduces the absolute cardiovascular risk in these patients.

KW - Autonomic nervous system

KW - GHD

KW - IGF-I

UR - http://www.scopus.com/inward/record.url?scp=84927587557&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84927587557&partnerID=8YFLogxK

M3 - Article

C2 - 25402370

AN - SCOPUS:84927587557

VL - 14

SP - 134

EP - 141

JO - Hormones

JF - Hormones

SN - 1109-3099

IS - 1

ER -