Document Detail


THE CARDIOVASCULAR SYSTEM IN GH EXCESS AND GH DEFICIENCY.
MedLine Citation:
PMID:  23143695     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The clinical conditions associated with GH excess and GH deficiency are known to be associated with an increased risk for cardiovascular morbidity and mortality, suggesting that either an excess or a deficiency in GH and/or IGF-I is deleterious for cardiovascular system. In patients with acromegaly chronic GH and IGF-I excess commonly causes a specific cardiomyopathy characterized by a concentric cardiac hypertrophy associated with diastolic dysfunction, and, in later stages, with systolic dysfunction ending in heart failure if GH/IGF-I excess is not controlled. Abnormalities of cardiac rhythm and anomalies of cardiac valves can also occur. Moreover, the increased prevalence of cardiovascular risk factors, such as hypertension, diabetes mellitus and insulin resistance, as well as dyslipidemia, confer an increased risk for vascular atherosclerosis. Successful control of the disease is accompanied by a decrease of the cardiac mass and improvement of cardiac function and an improvement in cardiovascular risk factors. In patients with hypopituitarism, GH deficiency has been considered the underlying factor of the increased mortality when appropriate standard replacement of the pituitary hormones deficiencies is given. Either childhoodonset or adulthood-onset GH deficiency are characterized by a cluster of abnormalities associated with an increased cardiovascular risk, including altered body composition, unfavourable lipid profile, insulin resistance, endothelial dysfunction and vascular atherosclerosis, a decrease in cardiac mass together with an impairment of systolic function mainly after exercise. Treatment with recombinant GH in patients with GH deficiency is followed by an improvement of the cardiovascular risk factors and an increase in cardiac mass together with an improvement in cardiac performance. In conclusion, acromegaly and GHD are associated with an increased risk for cardiovascular morbidity and mortality, but the control of GH/IGF-I secretion reverses cardiovascular abnormalities and restores the normal life expectancy.
Authors:
Gaetano Lombardi; Carolina Di Somma; Ludovica F S Grasso; Maria Cristina Savanelli; Annamaria Colao; Rosario Pivonello
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-12
Journal Detail:
Title:  Journal of endocrinological investigation     Volume:  -     ISSN:  1720-8386     ISO Abbreviation:  J. Endocrinol. Invest.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7806594     Medline TA:  J Endocrinol Invest     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Molecular and Clinical Endocrinology and Oncology, Federico II University, Naples, Italy.
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