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Subclinical left ventricular dysfunction in normotensive women with Turner’s syndrome
  1. N H Andersen1,
  2. B E Hjerrild1,
  3. K Sørensen1,
  4. E M Pedersen3,
  5. K Stochholm1,
  6. L C Gormsen1,
  7. A Hørlyck4,
  8. J S Christiansen1,
  9. C H Gravholt1
  1. 1Medical Department M (Endocrinology and Diabetes) and Medical Research Laboratories, Aarhus Sygehus NBG, Aarhus University Hospital, Aarhus, Denmark
  2. 2Department of Cardiology, Skejby Sygehus, Aarhus University Hospital, Aarhus, Denmark
  3. 3The MR Centre, Skejby Sygehus, Aarhus University Hospital, Aarhus, Denmark
  4. 4Department of Radiology, Skejby Sygehus, Aarhus University Hospital, Aarhus, Denmark
  1. Correspondence to:
    Dr Claus Højbjerg Gravholt
    Medical Department M (Endocrinology and Diabetes), Aarhus Sygehus NBG, DK-8000 Aarhus C, Denmark; ch.gravholt{at}

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Women with Turner’s syndrome (TS) are at risk of not only congenital cardiovascular malformations but also hypertension and ischaemic heart disease,1 risk factors that may all interact and reduce left ventricular (LV) performance. Conventional echocardiography, however, has not been able to identify LV dysfunction in TS,2 but the techniques used may well have been insufficient to detect subtle alterations in cardiac function.

To confirm our hypothesis of impaired LV function in women with TS, we therefore used tissue and conventional Doppler echocardiography to evaluate systolic long-axis function and diastolic filling in a group of asymptomatic, normotensive women with TS.


We studied 33 women with TS. Exclusion criteria were cardiac malformations (bicuspid aortic valve not included), LV ejection fraction < 55%, hypertension, impaired insulin sensitivity, and diabetes. All participants were not taking any drugs other than hormone replacement therapy (HRT). Three had previously received growth hormone. Thirty-three age-matched healthy female volunteers served as controls.

To address the metabolic state of the women with TS, fasting blood samples were drawn between 09 00 and 10 00. Insulin sensitivity (homeostasis model assessment (HOMA) -S) and β cell function (HOMA-B) were assessed by the HOMA model.

All echocardiographic examinations were performed by NHA on a GE Vivid Five (GE Medical Systems, Horten, Norway) equipped with a 2.5 MHz transducer.

Assessment of LV …

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