The influence of growth hormone (GH) therapy on cardiac performance in patients with childhood onset GH deficiency

Abstract Objective: There is accumulating evidence that growth hormone (GH) plays an important role in the maintenance of normal cardiac growth and function. Abnormalities in left ventricular diastolic function and impairment of systolic function have also been reported in patients with GHD. In this study, we investigated the effects of 12 months GH replacement therapy on cardiac functional indices measured by echocardiography, the ECG stress test and SPECT imaging. Design: Sixteen patients with childhood onset GHD (age 42.3 ± 13.1 years, 10 males) were investigated before, and after, 12 months of GH treatment at a dosage of 0.02 IU/kg/day (7 μg/kg/day). The GH administration resulted in serum IGF-I levels within the normal range in all the patients. The following investigations were performed initially and after 12 months: electrocardiography, systolic and diastolic blood pressure, heart rate measurement, a complete Doppler-echocardiographic examination, treadmill exercise test and Technetium-99m sestamibi single-photon emission computer tomography (SPECT) imaging at rest and after exercise. Results: Echocardiography showed improvement in left ventricular systolic function after GH treatment. End-systolic volume fell from 29.9 ± 12.4 to 24.4 ± 6.9 ml ( p p p p p p E ), diastolic flow secondary to atrial contraction ( A ), or the E/A ratio. The LV-mass index did not change significantly after GH treatment (78.4 ± 22.1 vs. 81.9 ± 21.1 g/m 2 ). After 12 months of GH treatment the myocardial performance index (MPI) decreased significantly from 0.483 ± 0.146 at baseline to 0.410 ± 0.086 at the end of the study ( p In conclusion, GH replacement therapy in adults with GHD demonstrated the beneficial effects on cardiac functions.