Endocrine Abstracts

Background: GH plays an important role in maintaining physiological morphology and function of the left ventricle (LV). In GH deficient (GHD) patients a systolic and/or diastolic LV dysfunction has been documented. LV systolic dysfunction results from reduced LV mass (LVM), which subsequently leads to a decrease of the LV ejection fraction (EF). Results from clinical trials evaluating the effect of GH replacement therapy on the morphological and functional changes of the LV in patients with GHD are controversial.

Objective: The aim of the study was to evaluate the effect of GH replacement therapy on the morphological and functional changes of the LV in patients with GHD.

Methods: Patients with adult-onset GHD were treated with GH. Transthoracic echocardiography was performed at baseline, after 6 and 12 months of the treatment. Interventricular septal thickness (IVST), posterior wall thickness (PWT), left ventricular end-diastolic diameter (LVEDD), left ventricular end diastolic volume (LVEDV), LVM, stroke volume (SV) and LV EF were evaluated at echocardiography and the values at respective time points were compared by a paired t-test. In addition, a gender stratified analysis was performed.

Results: 45 patients (21 men, 24 women; age 19–61 years) with GHD were included. At 6 months, only increase in PWT (+0.2 mm; P=0.044) was significantly changes compared with baseline. At 12 months of the replacement therapy, statistically significant increase in LVM (+8.6 g; P=0.035) and improvement of LV EF (+1.4%; P=0.005) were seen.

In men, significantly higher values of IVST, PWT, LVEDD, LVEDV, SV and LVM were found at 12 months of follow-up while no such effect was observed in women.

Conclusion: A mild increase in LVM and improvement of LV EF accompanies long-term GH hormone replacement therapy. The effect on left ventricle morphology is more pronounced in men than in women.