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Cardiovascular effects of growth hormone (GH) treatment on GH-deficient adults: a meta-analysis update
Siwen Zhang1, Zhuo Li1, You Lv1
1Department of Endocrinology and Metabolism, The First Hospital of Jilin University, NO.71 Xinmin Street, 130021, Changchun, Jilin, People's Republic of China.
Insights
Growth hormone (GH) replacement therapy in adults with GH deficiency (AGHD) shows potential cardiovascular benefits. Echocardiography reveals improvements in heart function and vital signs, suggesting enhanced quality of life for AGHD patients.
Area of Science:
- Cardiology
- Endocrinology
- Clinical Trials
Background:
- The cardiovascular effects of growth hormone (GH) replacement therapy in adults with GH deficiency (AGHD) remain incompletely understood.
- Existing clinical trials provide varied evidence on GH's impact on cardiovascular parameters in AGHD.
Purpose of the Study:
- To systematically review and analyze updated clinical trial data on the effects of GH treatment on cardiovascular parameters in adults with GH deficiency (AGHD).
- To evaluate the impact of GH therapy on general indicators, cardiac structure, cardiovascular function, and quality of life in AGHD patients using echocardiography.
Main Methods:
- A systematic review of 11 clinical trials involving GH treatment in AGHD patients over the past decade.
- Combined analysis of echocardiographic data assessing general indicators (heart rate, blood pressure), cardiac structure (ventricular volumes, wall thickness, mass), cardiovascular function (ejection fraction, NT-BNP), and quality of life metrics (peak VO2, VE/VCO2 slope).
Main Results:
- GH treatment significantly increased baseline heart rate (BHR), left ventricular interventricular septum (LVIS), left ventricular posterior wall (LVPW), and ejection fraction (EF).
- Significant negative effects were observed for diastolic blood pressure (DBP), left ventricular end diastolic volume (LVEDV), NT-BNP levels, and VE/VCO2 slope.
- GH therapy demonstrated a positive impact on BHR and a negative impact on DBP and VE/VCO2 slope.
Conclusions:
- Echocardiographic assessment suggests GH administration may improve vital signs and quality of life in AGHD patients.
- GH treatment positively influences cardiac structure (LVIS, LVPW) and reduces LVEDV, leading to improved systolic function (increased EF, decreased NT-BNP).
Background:
It is still unclear whether growth hormone (GH) replacement is able to improve cardiovascular parameters in adults with GH deficiency (AGHD) from the updated clinical trials reported to date.
Methods And Results:
We systematically reviewed clinical trials of GH treatment on AGHD patients in recent decade, and evaluated the effects of GH on cardiovascular parameters assessed by echocardiography. 11 clinical trials were identified in 3 bibliographic databases. We conducted a combined analysis of effects on four aspects: General indicators: baseline heart rate (BHR), peak heart rate (PHR), systolic blood pressure (SBP), diastolic blood pressure (DBP); Cardiac structure: left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), left ventricular interventricular septum (LVIS), left ventricular mass (LVM), left ventricular posterior wall (LVPW); Cardiovascular function: deceleration time of E wave (DT), E/A ratio (E/A), ejection fraction (EF), NT-BNP; Life quality: peak VO2, VE/VCO2 slope. Overall effect size was used to evaluate significance, and weighted mean difference after GH treatment was given to appreciate size of the effect. GH treatment was associated with a significant increase in BHR (3.03[2.00, 4.06]), LVIS (0.50[0.43, 0.57]), LVPW (0.50[0.43, 0.57]), and EF (2.12[1.34, 2.90]). Overall effect sizes were negative significant for DBP (- 1.19[- 2.33, - 0.05]), LVEDV (- 9.84[- 16.53, - 3.15]), NT-BNP (- 206.34[- 308.95, - 103.72]), and VE/VCO2 slope (- 2.31[- 2.92, - 1.71]).
Conclusions:
As assessed by echocardiography, GH administration may improve the general vital signs and life quality of AGHD patients, based on the positive effect on BHR and negative effects on DBP and VE/VCO2 slope. Also, GH treatment would influence the structure of heart with positive effects on LVIS, LVPW and negative effect on LVEDV, which together with the increase of EF and decrease of NT-BNP, then resulting in improving the systolic function of AGHD patients.
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