Short- and long-term effects of growth hormone on the heart.

Objective: To make a critical analysis of using growth hormone (GH) in patients with chronic heart failure and to asses its effects on the heart in long-term replacement.

Methods: We have studied 27 GHD patients (20 men; mean age: 36+/-15 years; 11 with childhood onset GHD) in a longitudinal, prospective study to assess the effect of GH therapy on the cardiovascular system with a long-term follow-up.

Results: After a mean period of 45.3+/-29.6 months, there were no significant differences in echocardiographic parameters of cardiac structure or function. By contrast, the duration of exercise test improved after treatment (8:19+/-3:27 versus 10:23+/-3:25 min; p=0.01) especially in the subgroup of patients with childhood onset of GH deficiency (7:02+/-4:23 versus 11:33+/-3:07 min; p=0.004) but not in the adult onset GHD subgroup. Systolic blood pressure was significantly higher after treatment in the global group (118+/-18.2 mmHg versus 128+/-17.9 mmHg; p=0.004) and in both subgroups.

Conclusions: The beneficial effects of GH replacement on the cardiovascular system is suggested but not fully proved and long-term GH substitution in GHD syndrome is not associated with significant changes in cardiac structure or function although these patients exhibit improved exercise capacity.