Subject(s)
COVID-19 , Thyroiditis, Subacute , Vaccines , COVID-19/prevention & control , Humans , RNA, Viral , Recurrence , SARS-CoV-2 , Thyroiditis, Subacute/etiologyABSTRACT
It is known that hypopituitarism reduces life expectancy and increases the risk of death for cardio- and cerebrovascular disease. Many studies report this phenomenon due to vascular diseases, and GH deficiency (GHD) seems to significantly contribute to the higher mortality. Aim of this article is to review the relationship between GH and cardiovascular risk factors to evaluate the beneficial effects of therapy in the adult GHD. GH replacement therapy (GHRT) improves insulin sensitivity, and reduces LDL cholesterol and triglyceride levels. Several studies also documented a decrease in the intima-media thickness at major arteries and improvement in microvascular and endothelial function. Other studies showed a decrease of inflammatory markers and the normalization of coagulation parameters. Finally, some authors have reported improvements in cardiac performance as well. These data evidence the positive effects of GHRT in the prevention of premature atherosclerosis in adults with GHD, and encourage the early administration of replacement therapy.
Subject(s)
Cardiovascular Diseases/prevention & control , Hormone Replacement Therapy , Human Growth Hormone/therapeutic use , Hypopituitarism/drug therapy , Atherosclerosis/epidemiology , Biomarkers/blood , Blood Coagulation Factors/analysis , Cardiovascular Diseases/blood , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/pathology , Human Growth Hormone/deficiency , Humans , Hypopituitarism/blood , Hypopituitarism/complications , Hypopituitarism/epidemiology , Inflammation/blood , Lipids/blood , Models, Biological , Prevalence , Tunica Intima/pathologyABSTRACT
The effects of the dialysis fistula were evaluated by echocardiography in 10 patients with terminal renal failure. Echocardiography was performed the day before creation of the fistula (E0) and was then repeated 24 hours after surgery (E1), the day before the first dialysis (E2), the day following the fourth dialysis (E3) and, finally, after 6 months of RDT (E4). Left ventricular internal diameter was measured both in diastole (LVIDd) and in systole (LVIDs), allowing calculation of ventricular diameter percent shortening (LVID%), of ventricular diastolic (EDV) and systolic volume (ESV). In E1 the fistula caused a significant increase in LVIDd, accounting for a rise also in EDV. This ventricular dilation persisted in E2, but was abolished in E3 and in E4. LVIDs, ESV, and LVID% were unmodified throughout the study. these results show that the dialysis fistula causes an immediate rise in cardiac pre-load, which is rapidly reversed by RDT.
