Effect of growth hormone treatment on diastolic function in patients who have developed growth hormone deficiency after definitive treatment of acromegaly

Abstract

Objective Although growth hormone (GH) replacement is prescribed for patients with hypopituitarism due to many etiologies, it is not routinely prescribed for patients with GH deficiency (GHD) after cure of acromegaly (acroGHD). This study was designed to investigate the effect of GH replacement on cardiac parameters in acroGHD. Design We prospectively evaluated for 12 months 23 patients with acroGHD: 15 subjects on GH replacement and eight subjects not on GH replacement. Main outcome measures included LV mass corrected for body surface area (LVM/BSA) and measures of diastolic dysfunction (E/A ratio and deceleration time), as assessed by echocardiography. Results After 12 months of follow-up, there were no differences between the GH-treated group and the untreated group in LVM/BSA (GH: 74.4 ± 22.5g/m2 vs untreated: 72.9 ± 21.3g/m2, p=0.89), E/A ratio (GH: 1.21 ± 0.39 vs untreated: 1.08 ± 0.39, p=0.50) or deceleration time (GH: 224.5 ± 60.1ms vs untreated: 260 ± 79.8ms, p=0.32). The overall degree of diastolic function was similar between the groups with 42.9% of untreated subjects and 50% of GH-treated subjects (p=0.76) classified as having normal diastolic function at follow-up. Conclusions There were no significant differences in LVM/BSA or parameters of diastolic function in patients with a history of acromegaly treated for GHD as compared to those who were untreated. These data are reassuring with respect to cardiovascular safety with GH use after treatment for acromegaly, although further longer term study is necessary to evaluate the safety and efficacy of GH treatment in this population.

Filling the gap between the heart and the body in acromegaly: a case-control study

“…Biventricular hypertrophy is characteristic for acromegaly [ 12 ]. We did not find difference in the size of the left and right ventricles between acromegaly patients and controls, which is in agreement with other studies [ 17 – 19 ]. The results indicate that there is no difference in LV size, RV size, and RV free-wall thickness between AP and controls.…”

Heart in Acromegaly: The Echocardiographic Characteristics of Patients Diagnosed with Acromegaly in Various Stages of the Disease

“…They conducted a study on 23 patients with pituitary insufficiency regarding GH secretion. After 12 months of treatment, there were no differences in echocardiographic parameters between the groups (15 treated patients and 9 untreated patients) [ 25 ].…”