{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T09:59:28Z","timestamp":1784368768773,"version":"3.55.0"},"reference-count":42,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2008,7,7]],"date-time":"2008-07-07T00:00:00Z","timestamp":1215388800000},"content-version":"vor","delay-in-days":2744,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2001,1]]},"abstract":"<jats:p>Besides its effects on water balance, arginine vasopressin (AVP) increases peripheral vascular resistance and decreases cardiac output, mainly by decreasing heart rate.<\/jats:p><jats:p>The current study was designed to evaluate cardiac performance in patients with central diabetes insipidus (CDI), focusing on the acute effects of desmopressin replacement withdrawal and its subsequent reinstatement in patients with CDI.<\/jats:p><jats:p>Twelve patients with CDI and 12 sex\u2010 and age\u2010matched healthy subjects entered the study. All patients were receiving treatment with intranasal desmopressin at standard doses.<\/jats:p><jats:p>All patients and controls were assessed for water balance, by measuring plasma osmolality and total body water, anterior pituitary function, heart rate, systolic and diastolic blood pressure. Left ventricular (LV), end\u2010diastolic and end\u2010systolic diameters (LVEDD, LVESD) and volumes (LVEDV, LVESD), end\u2010diastolic and end\u2010systolic interven\u2010tricular septum thickness (EDIVST, ESIVST) and posterior wall thickness (LVEDPWT, LVESPWT), and mass (LVM) were measured by echocardiography. Moreover, LV systolic function was assessed by measuring the ejection fraction (EF), the fractional shortening (FS), the Suga index, the stroke volume and the cardiac output, while LV diastolic function was assessed by measuring early (M1) and late (M2) maximal transmitral blood flow velocities, the ratio between M1 and M2, the mitral deceleration time (MDT) and the isovolumetric relaxation time. All parameters were assessed in the patient group 24\u2003h after discontinuing treatment with nasal desmo\u2010pressin (baseline study) and 1\u2003week after re\u2010starting replacement treatment, while in the control group before (baseline study) and after 1\u2010week of a nasally administered placebo.<\/jats:p><jats:p>At baseline, compared to controls, patients\u00a0with CDI had increased plasma osmolality (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030\u00b701), plasma ACTH (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030\u00b701), serum (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030\u00b701) and urinary cortisol (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030\u00b701) levels, and heart rate\u00a0(<jats:italic>P<\/jats:italic>\u2003&lt;\u20030\u00b705), and decreased total body water (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030\u00b705). Systolic and diastolic blood pressure and the other anterior pituitary hormones were similar in patients and controls. At echo\u2010cardiography, EDIVST (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030\u00b705), ESIVST (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030\u00b701), LVEDPWT (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030\u00b705) and LVESPWT (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030\u00b701), EF (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030\u00b701), Suga index (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030\u00b705), FS (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030\u00b705), M2 (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030\u00b701) and IRT (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030\u00b705) were significantly higher while LVESD (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030\u00b701), LVESV (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030\u00b701), LVEDD (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030\u00b705), LVEDV (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030\u00b705), M1 (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030\u00b705), and M1\/M2 (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030\u00b701) were significantly lower in patients than in controls. LVM, stroke volume and cardiac output, were similar in patients and controls. In the patient group, after 1\u2003week of replacement treatment with desmopressin, all echocardiographic parameters were normalized, except IVT, LVPWT and the diastolic parameters that were still abnormal compared to controls. No difference was found in any of the parameters in the control group one week after placebo administration.<\/jats:p><jats:p>Patients with central diabetes insipidus have increased heart rate and left ven\u2010tricular contractility, and impaired diastolic function. The altered heart rate and left ventricular contractility, reversible after desmopressin replacement, is likely to be due to stimulation of sympathetic nervous activity, induced by the hypovolemia associated with arginine vasopressin deficiency. Conversely, the impairment of diastolic function, persistent after desmopressin replacement, probably relates to a stable impairment of the left ventricular compliance.<\/jats:p>","DOI":"10.1046\/j.1365-2265.2001.01207.x","type":"journal-article","created":{"date-parts":[[2003,3,11]],"date-time":"2003-03-11T10:47:45Z","timestamp":1047379665000},"page":"97-106","source":"Crossref","is-referenced-by-count":8,"title":["Central diabetes insipidus and heart: effect of acute arginine vasopressin deficiency and replacement treatment with desmopressin on cardiac performance"],"prefix":"10.1111","volume":"54","author":[{"given":"Rosario","family":"Pivonello","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antongiulio","family":"Faggiano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Arrichiello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Di Sarno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Di Somma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Ferone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaetano","family":"Lombardi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annamaria","family":"Colao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2008,7,7]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.1994.tb02490.x"},{"key":"e_1_2_6_3_1","first-page":"255","article-title":"The site of origin of the hormones of the posterior pituitary","volume":"39","author":"Bargmann W.","year":"1951","journal-title":"American Scientist"},{"key":"e_1_2_6_4_1","unstructured":"Baylis P.H.(1989)Vasopressin and its neurophysins. 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