Adults with childhood-onset growth hormone deficiency: effects of growth hormone treatment on cardiac structure.
OBJECTIVE
To evaluate the effects of growth hormone deficiency (GHD) and of growth hormone (GH) therapy on cardiac structure in adults with childhood-onset GHD.


METHODS
Out-patient clinic in the Italian Institute for Auxology, Milan.


METHODS
Eight adults with childhood-onset GHD and eight healthy controls, matched for sex, age, exercise and body mass index.


METHODS
Recombinant GH (Saizen Serono, Italy), administered in a conventional dose of 0.5 IU kg-1 week-1 for 6 months.


METHODS
Cardiac structure parameters, evaluated by two-dimensional, M-mode and Doppler echocardiograms, and stress test, by means of a modified Bruce protocol with a bicycle ergometer, were determined before and after 6 months GH therapy.


RESULTS
Before treatment, mean (+/- SE) intraventricular septal thickness (IVST: 7.1 +/- 0.2 mm), LV posterior wall thickness (LVPT: 5.2 +/- 0.1 mm), LV mass (LVM: 94.6 +/- 5.0 g), LV mass index (LVM/body surface area, LVMI: 65.1 +/- 3.0 g m-2) and left ventricular end-diastolic diameter (LVED: 41.4 +/- 0.6 mm) of patients were significantly lower (P < 0.01) than in controls, whilst LV end-systolic diameter (LVES) of patients (25.5 +/- 0.7 mm) was similar to controls (27.5 +/- 0.7). GH treatment significantly (P < 0.01) increased LVPT (6.8 +/- 0.2 mm), LVM (111.6 +/- 4.6 g) and LVMI (80.5 +/- 3.5 g m-2); no significant changes were observed in LVED, LVES and IVST values. The stress test showed a significant improvement of cardiac performance, as demonstrated by the reduction of blood pressure x heart rate product at the same workload (basal: 32,722.5 +/- 897.4 vs. after: 25,574.6 +/- 439.7).


CONCLUSIONS
GH plays a role in the maintenance of a normal cardiac structure in adulthood. The present study suggests that GH treatment might be able to improve the cardiac structure of patients with childhood-onset GHD.
Sartorio
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A
Laboratorio Sperimentale di Ricerche Endocrinologiche, Istituto Auxologico Italiano, IRCCS, Milano, Italy.
Ferrero
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S
Conti
A
A
Bragato
R
R
Malfatto
G
G
Leonetti
G
G
Faglia
G
G
D000328:Adult; D017668:Age of Onset; D002648:Child; D015150:Echocardiography, Doppler; D005080:Exercise Test; D006321:Heart / Q000187:drug effects*; D019382:Human Growth Hormone / Q000172:deficiency* / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D011994:Recombinant Proteins / Q000494:pharmacology / Q000627:therapeutic use
D011994:Recombinant Proteins; D019382:Human Growth Hormone