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Evaluation of the relation between subclinical systolic dysfunction defined by four-dimensional speckle-tracking echocardiography and growth differentiation factor-15 levels in patients with acromegaly

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Abstract

Purpose

In patients with acromegaly, the long-term presence of elevated GH and IGF-1 levels is associated with an unfavorable cardiovascular risk profile. We aimed to assess the relationship of four-dimensional speckle tracking echocardiographic (4DSTE) measurements with growth differentiation factor-15 (GDF-15) levels and the Framingham Cardiovascular Risk Score (FRS) in patients with acromegaly.

Methods

A single-center, cross-sectional study was conducted. The study included 40 acromegaly and 32 age- and gender-matched controls. Anthropometric, biochemical, and echocardiographic assessments were performed. GDF-15 levels were measured using ELISA.

Results

In the controlled acromegaly group, global longitudinal (GLS), circumferential (GCS), area (GAS), and radial (GRS) strain measurements identified by 4DSTE were lower than those of the controls (p < 0.05). Moreover, strain parameters were lower in active acromegaly patients than in controls, but the difference was not statistically significant. The GLS was negatively correlated with age, the estimated disease duration, and FRS. Serum GDF-15 levels showed no significant difference between the acromegaly and control groups. In patients with acromegaly, serum GDF-15 levels were positively correlated with age, waist-to-hip ratio, systolic and diastolic blood pressure, FRS, fasting plasma glucose, and HbA1c, but not with strain parameters. The multiple regression analysis revealed that FRS was an independent factor associated with serum GDF-15 levels in patients with acromegaly and the overall cohort (p < 0.001).

Conclusion

Our study demonstrates that while LVEF was within normal limits, global strain parameters (GLS, GCS, GAS, and GRS) measured by using a novel imaging technique, 4DSTE, were lower in patients with acromegaly, suggesting the presence of subclinical systolic dysfunction in patients with acromegaly. GDF-15 can be a potential predictor of cardiovascular risk in patients with acromegaly.

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Acknowledgements

This study was supported by the Hacettepe University Scientific Research Projects Coordination Unit (Funding Number # THD-2019-18223).

Funding

This study was supported by the Hacettepe University Scientific Research Projects Coordination Unit (Funding Number # THD-2019-18223).

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Authors and Affiliations

  1. Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey

    Busra Firlatan

  2. Department of Cardiology, Hacettepe University School of Medicine, Ankara, Turkey

    Ugur Nadir Karakulak, Vedat Hekimsoy & Giray Kabakci

  3. Department of Endocrinology and Metabolism, Hacettepe University School of Medicine, Ankara, Turkey

    Burcin Gonul Iremli, Selcuk Dagdelen & Tomris Erbas

  4. Department of Medical Biochemistry, Hacettepe University School of Medicine, Ankara, Turkey

    Incilay Lay

  5. Department of Preventive Oncology, Hacettepe University School of Medicine, Ankara, Turkey

    Deniz Yuce

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  1. Busra Firlatan
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Contributions

BF, TE, UNK, and GK contributed to the study conception and design. The provision of study materials or patients, data collection, and assembly were performed by BF, UNK, VH, BGI, SD, and IL. Data analysis was performed by BF and DY. The first draft of the manuscript was written by BF. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Busra Firlatan.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Non-interventional Clinical Research Ethics Board of the Hacettepe University (Project Number # GO 19/302).

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Informed consent was obtained from all individual participants included in the study.

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The authors have no relevant financial or non-financial interests to disclose.

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Firlatan, B., Karakulak, U.N., Hekimsoy, V. et al. Evaluation of the relation between subclinical systolic dysfunction defined by four-dimensional speckle-tracking echocardiography and growth differentiation factor-15 levels in patients with acromegaly. Hormones (2024). https://doi.org/10.1007/s42000-024-00558-7

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