ADULTS WITH CHILDHOOD-ONSET GROWTH-HORMONE DEFICIENCY - EFFECTS OF GROWTH-HORMONE TREATMENT ON CARDIAC STRUCTURE

Objectives. To evaluate the effects of growth hormone deficiency (GHD) and of growth hormone (GH) therapy on cardiac structure in adults wit h childhood-onset GHD. Setting. Out-patient clinic in the Italian Inst itute for Auxology, Milan. Subjects, Eight adults with childhood-onset GHD and eight healthy controls, matched for sex, age, exercise and bo dy mass index. Interventions. Recombinant GH (Saizen Serono, Italy), a dministered in a conventional dose of 0.5 IU kg(-1) week(-1) for 6 mon ths. Main outcome measures. Cardiac structure parameters, evaluated by two-dimensional, M-mode and Doppler echocardiograms, and stress test, by means of a modified Bruce protocol with a bicycle ergometer, were determined before and after 6 months GH therapy. Results. Before treat ment, mean (+/-SE) intraventricular septal thickness (IVST: 7.1+/-0.2 mm), LV posterior wall thickness (LVPT: 5.2+/-0.1 mm), LV mass (LVM: 9 4.6+/-5.0 g), LV mass index (LVM/body surface area, LVMI: 65.1+/-3.0 g m(-2)) and left ventricular end-diastolic diameter (LVED: 41.4+/-0.6 mm) of patients were significantly lower (P < 0.01) than in controls, whilst LV end-systolic diameter (LVES) of patients (25.5+/-0.7 mm) was similar to controls (27.5+/-0.7). GH treatment significantly (P < 0.0 1) increased LVPT (6.8+/-0.2 mm), LVM (111.6+/-4.6 g) and LVMI (80.5+/ -3.5 g m(-2)); no significant changes were observed in LVED, LVES and IVST values. The stress test showed a significant improvement of cardi ac performance, as demonstrated by the reduction of blood pressure x h eart rate product at the same workload (basal: 32722.5+/-897.4 vs. aft er: 25574.6+/-439.7). Conclusions. GH plays a role in the maintenance of a normal cardiac structure in adulthood. The present study suggests that GH treatment might be able to improve the cardiac structure of p atients with childhood-onset GHD.