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Cardiovascular effects of growth hormone treatment: potential risks and benefits
1Department of Molecular and Clinical Endocrinology and Oncology, Federico II University of Naples, Naples, Italy. colao@unina.it
Insights
Growth hormone (GH) deficiency impacts heart function, increasing cardiovascular risk. GH replacement therapy can partially reverse these cardiac abnormalities, though its use in cardiomyopathy shows mixed results.
Area of Science:
- Cardiology
- Endocrinology
- Internal Medicine
Background:
- Growth hormone (GH) and insulin-like growth factor-I are crucial for cardiac development and function.
- Cardiovascular disease is linked to reduced life expectancy in both GH deficiency (GHD) and GH excess.
- GHD is associated with impaired left ventricular performance and increased cardiovascular risk due to arterial changes.
Purpose of the Study:
- To investigate the cardiovascular implications of GH deficiency.
- To evaluate the efficacy of GH replacement therapy in reversing GHD-related cardiac abnormalities.
- To assess the current use and outcomes of GH therapy in cardiomyopathy.
Main Methods:
- Review of existing literature on GH, IGF-I, and cardiovascular health.
- Analysis of studies detailing cardiac performance in GHD patients.
- Examination of data on GH replacement therapy outcomes in GHD and cardiomyopathy.
Main Results:
- GHD patients exhibit reduced diastolic filling and exercise response, alongside increased carotid intima-media thickness and atherosclerotic plaques.
- GH replacement therapy demonstrates potential for partial reversal of these cardiovascular abnormalities.
- Contradictory data exists regarding the effectiveness of GH therapy in increasing cardiac mass in ischaemic or dilated cardiomyopathy.
Conclusions:
- GHD significantly impacts cardiac function and increases cardiovascular risk.
- GH replacement therapy offers partial benefits for GHD-related cardiovascular issues.
- Further research is needed to clarify the role of GH therapy in managing cardiomyopathy.
Abstract:
Growth hormone (GH) and insulin-like growth factor-I are involved in heart development and in maintaining cardiac structure and performance. Cardiovascular disease has been reported to reduce life expectancy both in GH deficiency (GHD) and in GH excess. Patients with GHD suffer from abnormalities of left ventricular performance, i.e. reduced diastolic filling and impaired response to peak exercise. Patients with GHD also have increased intima-media thickness at the common carotid arteries, associated with a higher occurrence of atherosclerotic plaques, which may further aggravate the haemodynamic conditions. This may contribute to increased cardiovascular and cerebrovascular risk. These cardiovascular abnormalities can be reversed, at least partially, with GH replacement therapy. In recent years, GH therapy has been used to increase cardiac mass in ischaemic or dilated cardiomyopathy, but the results have produced contradictory data.
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