Growth hormone and cardiac function

Impaired cardiovascular function, which may reduce life expectancy, has rec ently been demonstrated both in GH deficiency and excess. Moreover, experim ental and clinical studies support the evidence implicating GH and/or IGF-I in the regulation of heart development. The existence of a specific acrome galic cardiomyophathy characterized by myocardial hypertrophy with intersti tial fibrosis, lympho-mononuclear infiltration and areas of monocyte necros is which often result in biventricular concentric hypertrophy has been rece nty demonstrated. By contrast, patients with childhood or adulthood-onset G H deficiency (GHD) present with abnormalities of structure and function of the left ventricle. In these patients, a significant increase in the vascul ar intima-media thickness and an increased number of atheromatous plaques h ave also been reported. The abnormalities of cardiovascular system could be partially reverted by suppressing GH and IGF-I levels in acromegaly or aft er GH remplacement therapy in GHD patients. The evidence that GH is able to increase cardiac mass suggested its use in the treatment of chronic heart failure of diverse etiologies. GH administra tion was demonstrated to induce an improvement in hemodynamics and clinical status in some patients. Although these data should be confirmed in double -blind placebo controlled studies in larger series, the promising results o pen new perspectives for GH treatment in humans.