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Impaired cardiac performance in GH-deficient adults and its improvement after GH replacement
A Cittadini1, A Cuocolo, B Merola
1Department of Internal Medicine, Federico II University Medical School, Naples, Italy.
Insights
Childhood growth hormone (GH) deficiency impairs cardiac function and exercise tolerance. Treatment with recombinant human GH (rhGH) significantly improves cardiac performance and restores exercise capacity in these patients.
Area of Science:
- Endocrinology
- Cardiology
- Pediatrics
Background:
- Growth hormone (GH) deficiency can impact overall health.
- Cardiac function in children with GH deficiency is not well understood.
Purpose of the Study:
- To investigate cardiac performance in children with GH deficiency.
- To assess the effect of recombinant human GH (rhGH) treatment on cardiac function and exercise tolerance.
Main Methods:
- Radionuclide angiography was used to assess cardiac function at rest and during exercise.
- 11 patients with childhood-onset GH deficiency and 12 controls were studied.
- 5 GH-deficient patients received 6 months of rhGH treatment.
Main Results:
- GH-deficient patients exhibited depressed systolic function and lower cardiac index compared to controls.
- Ejection fraction remained unchanged or decreased during exercise in GH-deficient patients.
- rhGH treatment improved cardiac index and exercise response, restoring exercise tolerance.
Conclusions:
- GH plays a crucial role in maintaining normal cardiac performance in humans.
- rhGH therapy can effectively improve cardiac function and exercise capacity in children with GH deficiency.
Abstract:
Cardiac performance was investigated by radionuclide angiography in 11 patients with childhood-onset growth hormone (GH) deficiency and in 12 control subjects. Both at rest and during maximal physical exercise, systolic function was markedly depressed in GH-deficient patients. Ejection fraction rose from 66 +/- 6 to 76 +/- 7% during exercise in control subjects, whereas in GH-deficient patients it remained unchanged or even decreased (55 +/- 6 and 54 +/- 9% at rest and after exercise, respectively; P < 0.01 vs. controls). Cardiac index was significantly lower in GH-deficient patients than in controls, both at rest (2.7 +/- 0.6 vs. 3.7 +/- 0.5 l.min-1.m-2; P < 0.001) and during exercise (8 +/- 1.2 vs. 10 +/- 1.5 l.min-1.m-2; P < 0.01). Five GH-deficient patients were treated with recombinant human (rh) GH for 6 mo at a dose of 0.05 IU.kg-1.day-1. Cardiac index at rest improved from 2.8 +/- 0.6 to 3.3 +/- 0.8 l.min-1.m-2 (P < 0.01) after rhGH. Also, cardiac index response to exercise improved markedly and became similar to that of controls (7.5 +/- 1.2 and 10.1 +/- 1.1 l.min-1.m-2 before and after rhGH, respectively; P < 0.005). Exercise tolerance was impaired in GH-deficient patients and was restored by rhGH treatment. The data support the hypothesis that GH plays an important role in the maintenance of a normal cardiac performance in humans.