The effect of one year of recombinant human growth hormone (rhGH) therapy on left ventricle structure and function in adults with severe growth hormone deficiency

UNLABELLED: The aim of the study was to analyze the functional and structural changes in the echocardiographic parameters of the left ventricle (LV) in adult patients (pts) with growth hormone deficiency (GHD) without any treatment in childhood before and after one year long somatropin treatment. MATERIAL AND METHODS: Twelve GHD pts (mean age 42 +/- 10 years; M/F: 6/6) before (group GHD-1) and after one year rhGH therapy (group GHD-2) were compared. The s.c. rhGH treatment with somatropin (Genotropin, Pharmacia) at a dose 0.125 U/kg/week up to 0.25 U/kg/week has been continued for 1 year. Both groups were examined with echocardiography Twelve GHD pts (mean age 42 +/- 10 years; M/F: 6/6): with indiopatic GHD (n = 10, age from 29 to 46 years; M/F: 6/4) and with Sheehan syndrome (n = 2, age from 46 to 61 years; M/F: 0/2) before (group GHD-1) and after one year rhGH therapy (group GHD-2) were compared. The s.c. rhGH treatment with somatropin (Genotropin, Pharmacia) at a dose 0.125 U/kg/week up to 0.25 U/kg/week (till 50 percentyl of blood IGF-1 concentration for age and sex norm ) has been continued for 1 year. Both groups were examined with echocardiography. RESULTS: On echocardiography, in the group GHD-1 pts compared to GHD-2 pts, had lower LVM and LVMI were lower (adequately (138.4 +/- 39.8 vs. 153.1 +/- 49.5, p < 0.036), lower and LVMI (87.3 +/- 19.7 vs. 96 +/- 23.7, p < 0.05). There was no Therapy had no significant therapy effect on systolic LV function. The diastolic function of LV did not differ between both GHD-1 and GHD-2 groups (E/A: 1.4 +/- 0.2 vs. 1.3 +/- 0.3 ; E: 79 +/- 17; A: 59 +/- 16 vs. 58 +/- 10, ns), but DT increased significantly from 132 +/- 21 vs. 147 +/- 30, p < 0.05). There was only significant correlation between LV systolic dimension after one year and IGF plasma basal concentration (r = 0.7, p < 0.01). CONCLUSIONS: One year medical therapy with rhGH (somatropin) is associated with a significant positive effect on LVM and LVMI but no significant effect on systolic LV function, as assessed by echocardiography in adults with GHD. Significant decrease of DT after therapy may suggest an influence of GH therapy on diastolic LV function. The level of IGF did correlate with LV systolic diameter after therapy.