title: Effect of growth hormone treatment on diastolic function in patients who have developed growth hormone deficiency after definitive treatment of acromegaly.
abstract: OBJECTIVE
  Although growth hormone (GH) replacement is prescribed for patients with hypopituitarism due to many etiologies, it is not routinely prescribed for patients with GH deficiency (GHD) after cure of acromegaly (acroGHD). This study was designed to investigate the effect of GH replacement on cardiac parameters in acroGHD.
  
  
  METHODS
  We prospectively evaluated for 12months 23 patients with acroGHD: 15 subjects on GH replacement and eight subjects not on GH replacement. Main outcome measures included LV mass corrected for body surface area (LVM/BSA) and measures of diastolic dysfunction (E/A ratio and deceleration time), as assessed by echocardiography.
  
  
  RESULTS
  After 12months of follow-up, there were no differences between the GH-treated group and the untreated group in LVM/BSA (GH: 74.4±22.5g/m(2) vs untreated: 72.9±21.3g/m(2), p=0.89), E/A ratio (GH: 1.21±0.39 vs untreated: 1.08±0.39, p=0.50) or deceleration time (GH: 224.5±60.1ms vs untreated: 260±79.8ms, p=0.32). The overall degree of diastolic function was similar between the groups with 42.9% of untreated subjects and 50% of GH-treated subjects (p=0.76) classified as having normal diastolic function at follow-up.
  
  
  CONCLUSIONS
  There were no significant differences in LVM/BSA or parameters of diastolic function in patients with a history of acromegaly treated for GHD as compared to those who were untreated. These data are reassuring with respect to cardiovascular safety with GH use after treatment for acromegaly, although further longer term study is necessary to evaluate the safety and efficacy of GH treatment in this population.
authors.affiliation: Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA 02114, United States; Harvard Medical School, Boston, MA 02115, United States. Electronic address: pkfazeli@partners.org.
authors.forename: Pouneh K
authors.initials: PK
authors.lastname: Fazeli
authors.affiliation: Division of Cardiology, Massachusetts General Hospital, Boston, MA 02114, United States; Harvard Medical School, Boston, MA 02115, United States.
authors.forename: Jonathan G
authors.initials: JG
authors.lastname: Teoh
authors.affiliation: Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA 02114, United States; Harvard Medical School, Boston, MA 02115, United States.
authors.forename: Eleanor L
authors.initials: EL
authors.lastname: Lam
authors.affiliation: Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA 02114, United States.
authors.forename: Anu V
authors.initials: AV
authors.lastname: Gerweck
authors.affiliation: Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA 02114, United States; Harvard Medical School, Boston, MA 02115, United States.
authors.forename: Tamara L
authors.initials: TL
authors.lastname: Wexler
authors.affiliation: Division of Cardiology, Massachusetts General Hospital, Boston, MA 02114, United States; Harvard Medical School, Boston, MA 02115, United States.
authors.forename: Eliza P
authors.initials: EP
authors.lastname: Teo
authors.affiliation: Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA 02114, United States.
authors.forename: Brian M
authors.initials: BM
authors.lastname: Russell
authors.affiliation: Division of Cardiology, Massachusetts General Hospital, Boston, MA 02114, United States; Harvard Medical School, Boston, MA 02115, United States.
authors.forename: Ronen
authors.initials: R
authors.lastname: Durst
authors.affiliation: Division of Cardiology, Massachusetts General Hospital, Boston, MA 02114, United States; Harvard Medical School, Boston, MA 02115, United States.
authors.forename: David
authors.initials: D
authors.lastname: McCarty
authors.affiliation: Division of Cardiology, Massachusetts General Hospital, Boston, MA 02114, United States; Harvard Medical School, Boston, MA 02115, United States.
authors.forename: Rory B
authors.initials: RB
authors.lastname: Weiner
authors.affiliation: Division of Cardiology, Massachusetts General Hospital, Boston, MA 02114, United States; Harvard Medical School, Boston, MA 02115, United States.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Picard
authors.affiliation: Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA 02114, United States; Harvard Medical School, Boston, MA 02115, United States.
authors.forename: Anne
authors.initials: A
authors.lastname: Klibanski
authors.affiliation: Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA 02114, United States; Harvard Medical School, Boston, MA 02115, United States.
authors.forename: Karen K
authors.initials: KK
authors.lastname: Miller
mesh_terms: D000172:Acromegaly / Q000150:complications / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D003971:Diastole / Q000187:drug effects*; D005260:Female; D005500:Follow-Up Studies; D020249:Hormone Replacement Therapy / Q000009:adverse effects; D019382:Human Growth Hormone / Q000009:adverse effects / Q000172:deficiency / Q000627:therapeutic use*; D006801:Humans; D007018:Hypopituitarism / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged
chemical_list: D019382:Human Growth Hormone
keywords: Acromegaly; Cardiovascular risk; Diastolic dysfunction; Growth hormone deficiency