The growth hormone system and cardiac function in patients with growth hormone disturbances and in the normal population.
Pathological high and low levels of Insulin-like Growth factor I (IGF-I) might exert harmful influences on cardiovascular structures. In the normal population low IGF-I levels might be harmful. In a retrospective investigation in patients with growth hormone deficiency (GHD), normal levels of NT-proBNP at baseline and no changes during two years of GH treatment could be detected. A subsequent prospective study confirmed normal levels of NT-proBNP and also of BNP. Furthermore cardiac systolic function and left ventricle (LV) mass assessed by cardiac magnetic resonance imaging (CMRI) were unchanged compared to control subjects. One year of GH replacement therapy did not change levels of NT-proBNP, BNP or any of the variables obtained by CMRI. In a retrospective study of acromegalic patients we found reduced serum NT-proBNP in the untreated stage and a 4-fold increase after 3 months of treatment. A subsequent prospective CMRI investigation confirmed an initial increase in natriuretic peptides after 3 months treatment, and showed that the increase in natriuretic peptides was accompanied by an increase in end diastolic volume. In a normal population followed prospectively for 5 years, high plasma IGF-I was accompanied by increased incidence of chronic heart failure, whereas IGF-I levels did not seem to influence the overall development of cardiovascular diseases.


CONCLUSIONS
assessed by sensitive methods patients with GHD had normal systolic function, and one year of GH replacement therapy did not change LV function or size. In acromegalic patients short-term treatment was associated with a minor decrease in cardiac function. In the normal population high levels of IGF-I was a risk factor for development of heart failure. The results illustrates that the interaction between the GH/IGF-I system and cardiovascular disease is very complex.
Department of internal medicine O, Herlev Hospital, University of Copenhagen, Denmark. andreassenmikkel@hotmail.com
Mikkel
M
Andreassen
D009320:Atrial Natriuretic Factor / Q000097:blood; D005260:Female; D054439:Ghrelin / Q000502:physiology*; D013006:Growth Hormone; D013007:Growth Hormone-Releasing Hormone / Q000502:physiology*; D006321:Heart; D006352:Heart Ventricles; D006801:Humans; D007334:Insulin-Like Growth Factor I; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D020097:Natriuretic Peptide, Brain / Q000097:blood; D012189:Retrospective Studies; D013318:Stroke Volume; D016277:Ventricular Function, Left
D054439:Ghrelin; D020097:Natriuretic Peptide, Brain; D007334:Insulin-Like Growth Factor I; D009320:Atrial Natriuretic Factor; D013006:Growth Hormone; D013007:Growth Hormone-Releasing Hormone