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Long-term growth hormone (GH) replacement of adult GH deficiency (GHD) benefits the heart.
- Source :
-
European journal of endocrinology [Eur J Endocrinol] 2019 Jul; Vol. 181 (1), pp. 79-91. - Publication Year :
- 2019
-
Abstract
- Objective: Growth hormone (GH) deficiency is related to increased cardiovascular mortality. We studied clinical status, concentration of amino-terminal-pro B-type natriuretic-peptide (NT-proBNP) and echocardiographic parameters during long-term GH replacement (GH-R).<br />Methods: Fifty-one patients (29 females), 45.9 ± 11.3 years (mean ± s.d.), median follow-up 36.2 months, echocardiography and laboratory determinations initially and at 12-months intervals.<br />Results: At the last follow-up (last observation carried forward) (LFU (LOCF)) insulin-like growth-factor-1 standard deviation score (IGF-1 SDS) was ±1 in 92% of the patients. The median NT-proBNP declined significantly and stabilized (-40.5%) at LFU (LOCF) due to patients with a basal NT-proBNP >125 ng/L (indicative of heart failure). The basal NT-proBNP and the final IGF-1 SDS were significant predictors of the NT-proBNP at LFU (LOCF). Initially left ventricular enddiastolic diameter (LVEDD), left ventricular posterior wall diameter (LVPWD) and ejection fraction (EF) were normal, while interventricular septum diameter (IVSD) and left ventricular mass index (LVMi) were slightly increased. LVPWD and IVSD had significantly declined by year three. The LVMi was moderately to severely abnormal in 37.3 and 52.0% of patients initially and at LFU (LOCF). At LFU (LOCF) LVMi and IGF-1 were significantly correlated in the 14 male patients of this subgroup.<br />Conclusion: Long-term GH-R of GHD positively affected ISVD and LVPWD. In a subgroup of patients with severe GHD, LVMi increased concomitantly to the decline in NT-proBNP and this was positively correlated to the final IGF-1 concentration. Whether this observation indicates a positive development in a structurally altered heart muscle (reversal of adverse remodelling) or poses a future risk for heart failure needs further follow-up.
- Subjects :
- Adult
Drug Administration Schedule
Echocardiography
Female
Follow-Up Studies
Heart drug effects
Humans
Insulin-Like Growth Factor I drug effects
Male
Middle Aged
Natriuretic Peptide, Brain blood
Peptide Fragments blood
Treatment Outcome
Growth Hormone administration & dosage
Heart Failure etiology
Hormone Replacement Therapy methods
Human Growth Hormone deficiency
Time Factors
Subjects
Details
- Language :
- English
- ISSN :
- 1479-683X
- Volume :
- 181
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- European journal of endocrinology
- Publication Type :
- Academic Journal
- Accession number :
- 31100717
- Full Text :
- https://doi.org/10.1530/EJE-19-0132