[Blood levels of somatotropic hormone in patients with various degrees of heart failure].
BACKGROUND
The hypothesis that in normal pituitary patients (pts) with heart failure the heart is a target-organ of the hypophysis has not be held in due consideration. Aim of the study was: 1) to determine Growth Hormone (GH) plasma levels in pts with various degree of heart failure; 2) to evaluate the relationship between GH, left ventricular mass and some haemodynamic and endocrine parameters of ventricular dysfunction.


METHODS
Blood samples for determination of GH and Atrial Natriuretic Factor (ANF) were collected 24 hours before haemodynamic study. Plasma concentrations of GH and ANF were determined by radio-immuno-assay in 20 normotensive pts (age ranging 31 to 54) without mellitus diabetes in IV (10 pts) and III (10 pts) NYHA FC: Echocardiographic determination of left atrial diameter, end-diastolic and end-systolic left ventricular diameters, index of left ventricular mass (ILVM), were performed. All pts underwent right and left cardiac catheterization and coronary angiography.


RESULTS
The pts in IV NYHA FC, Group A, had lower cardiac index (IC) (1.8 +/- 0.4 vs 2.9 +/- 0.1, p < 0.0001) and higher GH and ANF plasma levels than those in III NYHA FC, Group B (4.9 +/- 4.5 vs 0.12 +/- 0.04, p < 0.01; 157.9 +/- 43.9 vs 65.6 +/- 14.6, p < 0.0001). No significant difference was found by comparing in both groups ILVM (212.6 +/- 64.7 vs 192.9 +/- 71.9, NS). GH and ANF plasma levels were 4.1 +/- 5.0 and 113.8 +/- 59.6 in pts with ILVM > or = 200 g/mq and 0.9 +/- 2.7 and 109.7 +/- 57.3 in pts with ILVM < 200 g/mq (no significant statistical difference). We found an high correlation by comparing GH and ANF in group with ILVM > or = 200 g/mq (r = 0.82, p < 0.005) and in group with ILVM < 200 g/mq (r = 0.68, p < 0.05).


CONCLUSIONS
Our study demonstrated: 1) increased GH plasma levels in pts with severe heart failure; 2) an high correlation between GH and ANF plasma levels in pts with ILVM > or = 200 g/mq.
Mangieri
E
E
Istituto di Chirurgia del Cuore e Grossi Vasi, Policlinico Umberto I, Università degli Studi di Roma La Sapienza.
Croce
C T
CT
Tanzilli
G
G
Lomurno
A
A
Mangiaracina
F
F
Bonifacio
V
V
Attanasio
D
D
Nardi
M
M
Ferri
F M
FM
Ferri
F
F
D000328:Adult; D001022:Aortic Valve Insufficiency / Q000097:blood / Q000503:physiopathology; D009320:Atrial Natriuretic Factor / Q000097:blood; D006328:Cardiac Catheterization; D002311:Cardiomyopathy, Dilated / Q000097:blood* / Q000503:physiopathology; D005260:Female; D013006:Growth Hormone / Q000097:blood*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011863:Radioimmunoassay
D009320:Atrial Natriuretic Factor; D013006:Growth Hormone
Livelli ematici dell'ormone somatotropo in pazienti con diverso grado di scompenso cardiaco.