Endocrine Abstracts

Objective: To determine the effects of long-term growth hormone (GH) treatment on heart anatomy and function among adult GH deficient patients.

Design: A retrospective observational study at Copenhagen University Hospital, Rigshospitalet, Denmark between 1999 and 2015.

Patients: All patients with available echocardiography data at treatment baseline, 3–5 years and 8–10 years follow up. We included 25 naïve GH deficient patients, i.e. patients who had never received GH therapy before, and 16 semi-naive patients, i.e. patients previously on GH substitution therapy, but who had not received GH within 6 months before baseline evaluation.

Main outcome measures: Measurements of interventricular septum thickness (IVSD), left ventricular internal diameter end systole (LVISD), left ventricular internal diameter end diastole (LVIDD), left ventricular posterior wall diameter (LVPWD), mitral valve E/A ratio, mitral valve deceleration time and ejection fraction were assessed. Left ventricular mass (LVM), left ventricular mass index (LVMI) and fractional shortening were calculated based on data from the echocardiographic investigations. Biochemical data including cholesterol, triglycerides, IGF-1 and testosterone (in men), blood pressure, height and weight were assessed at baseline, 3–5 years and 8–10 years after commencement of GH substitution.

Results: No significant difference was observed in cardiac structure, nor in cardiac systolic or diastolic function during GH therapy. A non-significant positive correlation was observed between change in IGF-1 SDS versus change in LVMI, at 3–5 years and 8–10 years follow-up. In subgroups, a significant decrease was observed in both systolic function among semi-naïve patients and in diastolic function among adulthood-onset and naïve patients at follow-up.

Conclusion: Results from this study indicate that treatment duration of 8–10 years with GH replacement therapy in physiological doses on GH deficient patients appears not to be harmful, considering cardiac status. Verification of a positive effect of GH replacement on LVMI will require a larger cohort of GHD patients.