The effect of growth hormone replacement therapy on the morphological and functional changes in the left ventricle in patients with adult-onset growth hormone deficiency.

Abstract

The aim of the study was to evaluate the effect of growth hormone (GH) replacement therapy on the morphological and functional changes in the left ventricle (LV) in patients with GH deficiency (GHD). Patients with adult-onset GHD were treated with GH. Transthoracic echocardiography was performed at baseline and 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), left ventricular mass (LVM), stroke volume (SV) and left ventricular ejection fraction (LVEF) 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. A total of 45 patients (21 men, 24 women; age: 19-61 years) with GHD were included. At 6 months, only increased PWT (+ 0.2mm; P = 0.044) was significantly changed compared with baseline. At 12 months of the replacement therapy, statistically significant increase in LVM (+ 8.6g; P = 0.035) and improvement of LVEF (+ 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. A mild increase in LVM and improvement of LVEF accompanies long-term GH replacement therapy. The effect on LV morphology is more pronounced in men than in women.