December 1, 2004The Journal of Clinical Endocrinology & Metabolism103 citationsOpen Access
View Full PaperThe Severity of Growth Hormone Deficiency Correlates with the Severity of Cardiac Impairment in 100 Adult Patients with Hypopituitarism: An Observational, Case-Control Study
Structured PICO
Does the severity of growth hormone deficiency correlate with the severity of cardiac impairment in adult patients with hypopituitarism?
P
Population
100 adult patients with hypopituitarism (56 severe GHD, 27 partial GHD, 17 non-GHD) and 80 sex- and age-matched healthy subjects
I
Intervention
Severe or partial growth hormone deficiency (GHD)
C
Comparator
Healthy subjects and non-GHD hypopituitary patients
O
Outcome
Cardiac impairment (left ventricular ejection fraction at rest and on effort, diastolic filling at rest, exercise duration and capacity)surrogate
The severity of growth hormone deficiency in adult patients with hypopituitarism correlates directly with the degree of systolic and diastolic cardiac impairment.
Abstract
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 microg/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.