The severity of growth hormone deficiency correlates with the severity of cardiac impairment in 100 adult patients with hypopituitarism: an observational, case-control study.
In 100 patients with hypopituitarism and 80 sex- and age-matched healthy subjects, we correlated the severity of cardiac impairment to the severity of GH deficiency (GHD). By the GH peak after arginine plus GHRH test (normal > 16.5 microg/liter), the patients were classified as severe GHD (n = 56), partial GHD (n = 27), and non-GHD (n = 17). Compared with controls, decreased left ventricular ejection fraction at rest was found only in severe GHD patients (55.0 +/- 8.8 vs. 63.4 +/- 4.5%, P < 0.001); decreased left ventricular ejection fraction response on effort in severe (-4.6 +/- 17.4 vs. 15.2 +/- 9.1%, P < 0.001) and partial GHD patients (3.6 +/- 6.6 vs. 14.6 +/- 8.3%, P < 0.001); decreased diastolic filling at rest in severe (2.53 +/- 0.68 vs. 3.01 +/- 0.48 end-diastolic volume per second, P < 0.001) and partial GHD (2.61 +/- 0.45 vs. 2.89 +/- 0.54 end-diastolic volume per second, P = 0.004) patients; and decreased exercise duration and capacity in all the patient groups. A normal systolic performance on effort was found in 21.4% of severe GHD, 55.6% of partial GHD, all non-GHD, and 93.7% of controls. A normal diastolic filling at rest was found in 57.1% of severe GHD, 74.1% of partial GHD, 76.5% of non-GHD, and 90% of controls. In conclusion, cardiac performance is correlated with the GH status because significant impairment was found in patients with severe and partial GHD but not in non-GHD hypopituitary patients.
Colao
Annamaria
A
Department of Molecular and Clinical Endocrinology and Oncology, Federico II University of Naples, 80131 Napoli, Italy. colao@unina.it
Di Somma
Carolina
C
Cuocolo
Alberto
A
Filippella
Mariagiovanna
M
Rota
Francesca
F
Acampa
Wanda
W
Savastano
Silvia
S
Salvatore
Marco
M
Lombardi
Gaetano
G
D000328:Adult; D000368:Aged; D001120:Arginine; D016022:Case-Control Studies; D003326:Coronary Circulation; D003971:Diastole; D005080:Exercise Test; D005260:Female; D013007:Growth Hormone-Releasing Hormone; D006331:Heart Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology*; D006439:Hemodynamics; D019382:Human Growth Hormone / Q000172:deficiency*; D006801:Humans; D007018:Hypopituitarism / Q000150:complications*; D016014:Linear Models; D008297:Male; D008659:Metabolic Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology*; D008875:Middle Aged; D012720:Severity of Illness Index; D013318:Stroke Volume; D013599:Systole; D016277:Ventricular Function, Left
D019382:Human Growth Hormone; D013007:Growth Hormone-Releasing Hormone; D001120:Arginine