ECE2024 Eposter Presentations Adrenal and Cardiovascular Endocrinology (155 abstracts)
Gender-affirming hormone therapy and its impact on myocardial mass and cardiac function: a prospective magnetic resonance study on transgender men and women
Carola Deischinger 1 , Dorota Slukova 1 , Jürgen Harreiter 1 , Stephan Nopp 2 , Ivica Just 3 , Martin Krssak 3 , Siegfried Trattnig 3 , Lana Kosi-Trebotic 1 , Ulrike Kaufmann 4 & Alexandra Kautzky-Willer 1
1Medical University of Vienna, Endocrinology and Metabolism, Vienna, Austria; 2Medical University of Vienna, Hematology and Hemostaseology, Vienna, Austria; 3Medical University of Vienna, High field MR Centre of Excellence, Department of Biomedical Imaging and Image guided Therapy, Vienna, Austria; 4Medical University of Vienna, Department of Obstetrics and Gynaecology, Vienna, Austria
Background: The differences in cardiac parameters such as myocardial mass, left ventricular ejection fraction (LVEF), cardiac output, and brain natriuretic peptide (NT-proBNP) levels between cisgender men and women are well-established. However, no evidence exists regarding changes in myocardial mass or cardiac function parameters in transgender individuals undergoing gender-affirming hormone therapy (GAHT).
Patients and method: A prospective study enrolling 20 transgender men (TM) and 15 transgender women (TW) was conducted at the Medical University of Vienna from 2019 to 2022. A 3-Tesla electrocardiogram-gated magnetic resonance imaging was used to measure myocardial mass, LVEF and other cardiac function parameters before GAHT and at six-month follow-up. Myocardial lipid content was quantified using magnetic resonance spectroscopy.
Results: In TM, myocardial mass increased significantly after six months of GAHT from in mean (±SD) 48 (±8) g/m2; at baseline to 54 (±7) g/m2; at follow-up (P=0.011). TW showed a non-significant decrease of 4 (±14) g/m2; in myocardial mass. In both groups, no significant changes were noted in LVEF, stroke volume, cardiac output, or peak filling rate. Neither testosterone (TM: r=-0.127, P=0.679; TW: r=-0.127, P=0.679) nor estrogen levels (TM: r=-0.154, P=0.616; TW: r=-0.154, P=0.616) were related to myocardial mass at follow-up in either group. However, testosterone levels in TM correlated with cardiac output index (r=0.396, P=0.019), and in TW, with myocardial lipid content (r=0.579, P=0.007). Notably, NT-proBNP levels in TM were significantly reduced at follow-up (from in median (IQR) 41 (26-57) pg/ml to 19 (12-34) pg/ml). Myocardial lipid content decreased in transgender men but remained similar in transgender women at follow-up.
Conclusions: Myocardial mass increased while NT-proBNP levels decreased significantly in TM after six months of GAHT. However, no significant changes in cardiac function were noted in both TW and TM. Long-term studies are needed to better understand the cardiac effects of GAHT.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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