Document Detail


Effects of 5 years of growth hormone (GH) replacement therapy on cardiac parameters and physical performance in adults with GH deficiency.
MedLine Citation:
PMID:  19390974     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The purpose of this study was to evaluate the effects of 5 years of GH substitution on cardiac structure and function, physical work capacity and blood pressure levels in adults with GH deficiency (GHD). Fourteen patients were clinically assessed every 3 months for 5 years. Transthoracic echocardiography and exercise test were performed at baseline, 24, 48 and 60 months. Blood pressure (BP) was measured by means of ambulatory monitoring of blood pressure at baseline, 6, 12, 24 and 60 months. Left ventricular mass and its index increased progressively during the 5 years of GH substitution (P = 0.008 and 0.007, respectively). There were no significant changes in all others cardiac parameters evaluated. It was observed a significant improve in functional capacity (P < 0.001) and maximal oxygen uptake (P = 0.006) during the treatment. Diurnal systolic BP increased by 15 mmHg (P = 0.024) and diurnal diastolic BP by 4.5 mmHg (P = 0.037). There was no change in dirnal systolic pressure load but a considerable but non-statistically significant reduction in diurnal diastolic pressure load was observed during the study. During the night diastolic BP increased by 4 mmHg (P = 0.012) despite a substantial but non-statistically significant reduction in diastolic pressure load. We observed an increase in the proportion of persons with a non-physiological nocturnal fall (non-dippers) throughout the study (from 36.4% at baseline to 54.6% after 60 months of therapy). We concluded that 5 years of GH replacement promoted positive effects on exercise capacity and maximum oxygen uptake in spite of a modest increase in BP levels and left ventricular mass. Continuous monitoring is mandatory to arrive at further conclusions concerning the effects of GH substitution in adults on cardiovascular parameters with respect to possible unfavorable long term effects.
Authors:
Maria Claudia Peixoto Cenci; D??bora Vieira Soares; Luciana Diniz Carneiro Spina; Rosane Resende de Lima Oliveira Brasil; Priscila Marise Lobo; Vera Aleta Mansur; Jaime Gold; Eduardo Michmacher; Mario Vaisman; Fl??via L??cia Concei????o
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Publication Detail:
Type:  Journal Article     Date:  2009-04-24
Journal Detail:
Title:  Pituitary     Volume:  12     ISSN:  1573-7403     ISO Abbreviation:  Pituitary     Publication Date:  2009  
Date Detail:
Created Date:  2009-10-20     Completed Date:  2010-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9814578     Medline TA:  Pituitary     Country:  United States    
Other Details:
Languages:  eng     Pagination:  322-9     Citation Subset:  IM    
Affiliation:
Service of Endocrinology, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. marclaudia@uol.com.br
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Pressure / drug effects
Echocardiography
Exercise Tolerance / drug effects
Female
Heart / drug effects*,  physiology
Heart Ventricles / drug effects
Hormone Replacement Therapy / methods*
Human Growth Hormone / pharmacology,  therapeutic use*
Humans
Hypopituitarism / drug therapy*
Male
Middle Aged
Prospective Studies
Chemical
Reg. No./Substance:
12629-01-5/Human Growth Hormone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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