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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

Wirkung einer Wachstumshormon-Ersatz-Therapie auf morphologische und funktionelle Veränderungen des linken Ventrikels bei Patienten mit im Erwachsenenalter aufgetretenem Wachstumshormon-Mangel

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Summary

Objective

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).

Methods

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.

Results

A total of 45 patients (21 men, 24 women; age: 19–61 years) with GHD were included. At 6 months, only increased PWT (+ 0.2 mm; P = 0.044) was significantly changed compared with baseline. At 12 months of the replacement therapy, statistically significant increase in LVM (+ 8.6 g; 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.

Conclusion

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.

Zusammenfassung

Ziel der Studie

Beurteilung der Wirkung einer Ersatztherapie mit Wachstumshormon (GH) auf morphologische und funktionelle Veränderungen des linken Ventrikels (LV) bei Patienten mit Wachstumshormondefizienz (GHD).

Methodik

45 Patienten (21 Männer, 24 Frauen; Alter 19–61 Jahre) mit GHD wurden mit GH behandelt. Eine transthorakale Echocardiographie wurde vor, sowie 6 und 12 Monate nach Beginn der Therapie durchgeführt. Dabei wurden folgende Parameter erhoben: Dicke des interventrikulären Septums (IVST), Dicke der Hinterwand (PWT), enddiastolischer Durchmesser des linken Ventrikels (LVEDD), enddiastolisches Volumen des linken Ventrikels (LVEDV), linksventrikuläre Masse (LVM), Schlagvolumen (SV) und Auswurffraktion des linken Ventrikels (LV EF). Die zum jeweiligen Zeitpunkt erhobenen Daten wurden statistisch mittels gepaartem t-Test verglichen-. Zusätzlich wurde noch eine Gender-stratifizierte Analyse durchgeführt.

Ergebnisse

Nach 6 Monaten war nur eine Zunahme der PWT (+ 0,2 mm; P = 0,044) signifikant. Nach 12 Monaten Ersatz-Therapie war sowohl die LVM (+ 8,6 g; P = 0,035) statistisch signifikant angestiegen als die LVEF signifikant gebessert (+ 1,4 %; P = 0,005). Bei den Männern wurden nach 12 Monaten Therapie statistisch signifikant höhere Werte für IVST, PWT, LVEDD, LVEDV, SV und LVM gefunden – bei den Frauen konnten solche Änderungen nach diesem Zeitraum nicht beobachtet werden.

Schlussfolgerungen

Ein geringer Anstieg der LVM und Besserung der EF des LV tritt nach einer Langzeit Behandlung mit GH ein. Die Wirkung auf die Morphologie des LV ist bei Männern ausgeprägter als bei Frauen.

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Authors and Affiliations

  1. 5th Department of Internal Medicine, Medical Faculty of Commenius University and University Hospital, Ružinovská 6, 826 06, Bratislava, Slovakia

    Anton Dlesk MD, PhD,  Gabriel Kamenský MD, PhD, Martin Kužma MD, PhD &  Juraj Payer MD, PhD

  2. 1st Department of Internal Medicine, L. Pasteur University Hospital and Medical Faculty of P.J. Safarik University, Rastislavova, 040 01, Kosice, Slovakia

    Ivica Lazúrová MD, PhD

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  1. Anton Dlesk MD, PhD
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  2. Gabriel Kamenský MD, PhD
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  3. Ivica Lazúrová MD, PhD
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  5. Juraj Payer MD, PhD
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Correspondence to Anton Dlesk MD, PhD.

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Dlesk, A., Kamenský, G., Lazúrová, I. et al. 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. Wien Klin Wochenschr 126, 480–484 (2014). https://doi.org/10.1007/s00508-014-0536-2

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