The Severity of Growth Hormone Deficiency Correlates with the Severity of Cardiac Impairment in 100 Adult Patients with Hypopituitarism: An Observational, Case-Control Study

• Published in: The journal of clinical endocrinology and metabolism 2004-12, Vol.89 (12), p.5998-6004
• Main Authors: Colao, Annamaria, Di Somma, Carolina, Cuocolo, Alberto, Filippella, Mariagiovanna, Rota, Francesca, Acampa, Wanda, Savastano, Silvia, Salvatore, Marco, Lombardi, Gaetano
• Format: Article
• Language: English
• Subjects: Adult; Aged; Arginine; Biological and medical sciences; Case-Control Studies; Coronary Circulation; Diastole; Endocrinopathies; Exercise Test; Female; Fundamental and applied biological sciences. Psychology; Growth Hormone-Releasing Hormone; Heart Diseases - diagnosis; Heart Diseases - etiology; Heart Diseases - physiopathology; Hemodynamics; Human Growth Hormone - deficiency; Humans; Hypopituitarism - complications; Hypothalamus. Hypophysis. Epiphysis (diseases); Linear Models; Male; Medical sciences; Metabolic Diseases - diagnosis; Metabolic Diseases - etiology; Metabolic Diseases - physiopathology; Middle Aged; Non tumoral diseases. Target tissue resistance. Benign neoplasms; Severity of Illness Index; Stroke Volume; Systole; Ventricular Function, Left; Vertebrates: endocrinology
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/jc.2004-1042

In 100 patients with hypopituitarism and 80 sex- and age-matched healthy subjects, we correlated the severity of cardiac impairment to the severity of GH deficiency (GHD). By the GH peak after arginine plus GHRH test (normal > 16.5 μg/liter), the patients were classified as severe GHD (n = 56), partial GHD (n = 27), and non-GHD (n = 17). Compared with controls, decreased left ventricular ejection fraction at rest was found only in severe GHD patients (55.0 ± 8.8 vs. 63.4 ± 4.5%, P < 0.001); decreased left ventricular ejection fraction response on effort in severe (−4.6 ± 17.4 vs. 15.2 ± 9.1%, P < 0.001) and partial GHD patients (3.6 ± 6.6 vs. 14.6 ± 8.3%, P < 0.001); decreased diastolic filling at rest in severe (2.53 ± 0.68 vs. 3.01 ± 0.48 end-diastolic volume per second, P < 0.001) and partial GHD (2.61 ± 0.45 vs. 2.89 ± 0.54 end-diastolic volume per second, P = 0.004) patients; and decreased exercise duration and capacity in all the patient groups. A normal systolic performance on effort was found in 21.4% of severe GHD, 55.6% of partial GHD, all non-GHD, and 93.7% of controls. A normal diastolic filling at rest was found in 57.1% of severe GHD, 74.1% of partial GHD, 76.5% of non-GHD, and 90% of controls. In conclusion, cardiac performance is correlated with the GH status because significant impairment was found in patients with severe and partial GHD but not in non-GHD hypopituitary patients.