Related Experiment Videos
Improved left ventricular function after growth hormone replacement in patients with hypopituitarism: assessment with
A Cuocolo1, E Nicolai, A Colao
1Cattedra di Medicina Nucleare, Centro per la Medicina Nucleare del CNR, Universitá Federico II, Napoli, Italy.
Insights
Growth hormone deficiency (GHD) impairs cardiac function. Six months of recombinant human growth hormone (rhGH) therapy significantly improved cardiac function in patients with childhood-onset GHD.
Area of Science:
- Cardiology
- Endocrinology
Background:
- Prolonged growth hormone deficiency (GHD) is associated with cardiac dysfunction.
- The reversibility of cardiac abnormalities following growth hormone replacement therapy requires further investigation.
Purpose of the Study:
- To evaluate the effect of recombinant human growth hormone (rhGH) therapy on cardiac function in patients with childhood-onset GHD.
Main Methods:
- Equilibrium radionuclide angiography was performed on 14 patients with childhood-onset GHD and 12 normal controls.
- Patients with GHD were reassessed after 6 months of rhGH treatment (0.05 IU/kg/day).
Main Results:
- Patients with GHD exhibited significantly lower left ventricular ejection fraction, stroke volume index, and cardiac index compared to controls.
- rhGH therapy did not cause adverse effects or require dose reduction.
- After 6 months of rhGH therapy, significant improvements were observed in left ventricular ejection fraction, stroke volume index, and cardiac index in GHD patients.
Conclusions:
- Prolonged GHD leads to impaired resting left ventricular function.
- Six months of rhGH replacement therapy can reverse cardiac abnormalities in patients with childhood-onset GHD.
Abstract:
Prolonged growth hormone deficiency (GHD) leads to marked cardiac dysfunction; however, whether reversal of this abnormality may be achieved after specific replacement therapy has not yet been completely clarified. Fourteen patients with childhood-onset GHD (nine men and five women, mean age 27+/-4 years) and 12 normal control subjects underwent equilibrium radionuclide angiography under control conditions at rest. Patients with GHD were also studied 6 months after recombinant human (rh) GH treatment (0.05 IU/kg per day). Normal control subjects and patients with GHD did not differ with respect to age, gender and heart rate. In contrast, left ventricular ejection fraction (53%+/-9% vs 66%+/-6%, P <0.001), stroke volume index (41+/-11 vs 51+/-8 ml/m2, P <0.01) and cardiac index (2.8+/-0.6 vs 3.+/-0.5 l/min/m2, P <0.001) were significantly lower in GHD patients than in normal control subjects. None of the GHD patients showed adverse or side-effects during rhGH therapy; thus none required a reduction in GH dose during the treatment period. Heart rate and arterial blood pressure were not significantly modified by rhGH treatment. After 6 months of rhGH therapy a significant improvement in left ventricular ejection fraction (from 53%+/-9% to 59%+/-9%, P <0.01), stroke volume index (from 41+/-11 to 47+/-13 ml/m2, P <0.05) and cardiac index (from 2.8+/-0.6 to 3.3+/-0.8 l/min/m2, P <0.01) was observed in GHD patients. In conclusion, prolonged lack of GH leads to impaired left ventricular function at rest. Reversal of this abnormality may be observed after 6 months of specific replacement therapy in patients with childhood-onset GHD.