Effect of growth hormone on cardiac contractility in patients with adult onset growth hormone deficiency.

This study was conducted to investigate the effect of growth hormone (GH) replacement on cardiac function assessed by standard or tissue Doppler echocardiography in GH deficiency. Ten patients (mean age 47+/-14 years) received GH at a dose of 1.0 IU/day (6 times/week). After 6 months of GH replacement, GH substitution was discontinued. Echocardiography was performed at baseline, after 6 months of therapy, and 1 year after the withdrawal of GH replacement. All parameters were compared with those from 11 healthy controls matched for age, gender, and left ventricular (LV) mass index. After GH replacement, LV ejection fractions were nonsignificantly increased. However, fractional shortening, LV dimensions, and LV volumes did not change. Compared with controls, peak strain (-18.9+/-4.8% vs -15.7+/-6.9%, p<0.01) and strain rate (-1.3+/-0.4/s vs -1.0+/-0.5/s, p<0.01) at baseline were significantly decreased in patients with GH deficiency. Strain and strain rate increased significantly after 6 months of replacement but returned to baseline levels after 12 months off therapy. In conclusion, GH replacement in adult-onset GH deficiency demonstrated beneficial effects on cardiac contractility assessed by strain and strain rate, but these parameters returned to baseline levels after the withdrawal of GH. Strain and strain rate can be used to evaluate subtle changes in myocardium after GH replacement.