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Cited by 20Pituitary Gland Disorders and TreatmentsCardiovascular Function and Risk FactorsGrowth Hormone and Insulin-like Growth Factors

Cardiac remodeling in patients with childhood-onset craniopharyngioma-results of HIT-Endo and KRANIOPHARYNGEOM 2000/2007

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Sowithayasakul, Panjarat, Buschmann, Leona Katharin, Boekhoff, Svenja, Müller, Hermann L.·2021·European Journal of Pediatrics
DOI 10.1007/s00431-020-03915-xPMC PMC8032608
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Abstract

Hypothalamic obesity caused by childhood-onset craniopharyngioma results in long-term cardiovascular morbidity. Knowledge about clinical markers and risk factors for cardiovascular morbidity is scarce. A cross-sectional study on transthoracic echocardiographic parameters was performed to determine the associations with clinical and anthropometric parameters in 36 craniopharyngioma patients. BMI correlated with the thickness of interventricular septum in diastole (IVSd) (r = 0.604, p < 0.001) and left ventricular posterior wall thickness in diastole (LVPWd) (r = 0.460, p = 0.011). In multivariate analyses on risk factors for cardiac remodeling, sex hormone replacement therapy, BMI, and male gender were positively correlated with increased left ventricular internal diameter in diastole (LVIDd), R2 = 0.596, F = 10.323, p < 0.001. BMI and insulin resistance were selected as significant independent determinants of IVSd, produced R2 = 0.655, F = 29.441, p < 0.001. Due to a wide range of disease duration, 17 pediatric and 19 adult patients were analyzed separately. In the adult subgroup (age at study ≥ 18 years), BMI correlated with IVSd (r = 0.707, p = 0.003), LVPWd (r = 0.592, p = 0.020), and LVIDd (r = 0.571, p = 0.026). In the pediatric subgroup (age at study < 18 years), no correlation between transthoracic echocardiography (TTE) parameters and BMI was observed. Only LVIDd correlated with disease duration (r = 0.645, p < 0.001). All cardiac functions were within the normal range, indicating no association with functional impairments. Conclusion: Cardiac remodeling in patients with craniopharyngioma correlated with the degree of hypothalamic obesity, disease duration, sex hormone replacement therapy, male gender, and insulin resistance. As echocardiography has limited sensitivity in patients with obesity, further research on more sensitive techniques for cardiac diagnostics in craniopharyngioma patients is warranted. What is Known:•Long-term prognosis in survivors of craniopharyngioma is impaired by obesity and cardiovascular disease.•Associations between echocardiographic findings and clinical and anthropometric parameters after craniopharyngioma are not yet analyzed. What is New:•In patients with childhood-onset craniopharyngioma, cardiac remodeling was associated with hypothalamic obesity, duration of disease, male gender sex hormone replacement, and insulin resistance.•Due to reduced echocardiographic sensitivity caused by obesity-related technical limitations, more sensitive cardiac diagnostics should be considered.

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  • Adverse cardiac remodeling is evident even in the youngest survivors of craniopharyngioma, and worsens with increasing age and by adulthood, also with obesity.

    “Adverse cardiac remodeling is evident even in the youngest survivors, and worsens with increasing age and by adulthood, also with obesity (66).”

    From Approach to the patient with acquired hypothalamic syndrome (2026) · cites this paper as [66]

    The Results (page unavailable) report that all echocardiographic parameters were normal in the pediatric subgroup except for increased wall thickness in one extremely obese patient. The Abstract and Discussion associate remodeling with BMI and disease duration, but this cross-sectional study does not show that remodeling is evident in the youngest survivors or worsens as individuals age into adulthood. (LLM, conf=0.88)

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Sorted by citations

Authors
Sowithayasakul, P., Buschmann, L. K., Boekhoff, S., & Müller, H. L.
Affiliations
Carl von Ossietzky Universität Oldenburg (DE)
Corresponding author
  • Sowithayasakul, Panjarat
  • Buschmann, Leona Katharin
  • Boekhoff, Svenja
ORCID
Venue
European Journal of Pediatrics
Publisher
Springer Science and Business Media LLC
Published
2021-01-18
Volume
180
Issue
5
Pages
1593-1602
ISSN
  • 0340-6199 (ISSN-L)
  • 1432-1076
DOI
10.1007/s00431-020-03915-x
PMC
PMC8032608
OpenAlex
W3122432154
Cited by
20
References
5
Citations by year
2026: 5 · 2025: 6 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 3
FWCI
1.68
Type
journal article
Language
en
Open access
Licence
Locations
  • European Journal of Pediatrics (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Informationszentrum Lebenswissenschaften (ZB MED) (submittedVersion, cc-by)
Funders
Projekt DEAL
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
Keywords
craniopharyngioma, childhood-onset craniopharyngioma, cardiac remodeling, hypothalamic obesity, cardiovascular morbidity, body mass index, insulin resistance, sex hormone replacement therapy, left ventricular wall thickness, disease duration, pediatric and adult patients, transthoracic echocardiography, risk factors, left ventricular ejection fraction
MeSH terms
Adolescent, Adult, Child, Craniopharyngioma, Cross-Sectional Studies, Humans, Male, Obesity, Pituitary Neoplasms, Ventricular Remodeling

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