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(Circulation. 2004;109:e332.)
© 2004 American Heart Association, Inc.

Correspondence

Cardiac Effects of Growth Hormone

Philipp Dreifuss, MD

Former Research Fellow in Cardiology and Endocrinology, Royal Free Hospital, London, United Kingdom, Former Research Fellow in Cardiology, University Hospital, Basel, Switzerland, p.dreifuss{at}bluewin.ch

To the Editor:

Maison and Chanson¹ reported on the effects of recombinant human growth hormone (r-hGH) in adults with growth hormone deficiency. Within the scope of a meta-analysis, they systematically reviewed clinical trials with r-hGH for the treatment of growth hormone deficiency. Their attention was directed to the cardiac effects of r-hGH as assessed by echocardiography. The authors found that growth hormone treatment in this population is associated with a significant increase in left ventricular mass, interventricular septum thickness (IVS), left ventricular posterior wall thickness, and stroke volume.

Adamopoulos et al² recently studied the effects of r-hGH in quite a different population. Within the scope of a randomized crossover trial, they looked at the cardiac effects of r-hGH by studying 12 patients with chronic congestive heart failure (CHF) due to idiopathic dilated cardiomyopathy (IDC).² The patients enrolled into this study were tested by echocardiography and had to perform cardiopulmonary exercise testing (to measure peak oxygen uptake, O₂ max). The authors found that growth hormone treatment in this population is associated with a significant increase in left ventricular mass and contractile reserve.

For one reason or another, r-hGH is a potent cardiovascular drug. Within the scope of clinical (ie, pharmacological) trials, the substance has been tested in patients with CHF due to IDC since 1996 (for reviews of the published studies see Dreifuss^3–5). So far, the published results cannot give a clear picture of what can be expected from r-hGH in the setting of CHF due to IDC. As more and more (encouraging) results appear in specialized journals, it has to be expected that within a couple of years, the body of knowledge in this field will be broader, and the advantages and disadvantages of the use of r-hGH in patients with CHF due to IDC will be better known.

References

1. Maison P, Chanson P. Cardiac effects of growth hormone in adults with growth hormone deficiency. Circulation. 2003; 108: 2648–2652.[Abstract/Free Full Text]
   
2. Adamopoulos S, Parissis J, Paraskevaidis J, et al. Effects of growth hormone on circulating cytokine network, and left ventricular contractile performance and geometry in patients with idiopathic dilated cardiomyopathy. Eur Heart J. 2003; 24: 2186–2196.[Abstract/Free Full Text]
   
3. Dreifuss P. Die therapie der terminalen dilatativen kardiomyopathie mit wachstumshormon (treatment of end-stage dilated cardiomyopathy with growth hormone). Z Kardiol. 1998; 87: 425–435.[CrossRef][Medline] [Order article via Infotrieve]
   
4. Dreifuss P. Dilatative kardiomyopathie und wachstumshormon (Dilated cardiomyopathy and growth hormone). Z Kardiol. 2002; 91: 973–977.[CrossRef][Medline] [Order article via Infotrieve]
   
5. Dreifuss P. Wachstumshormon und chronische herzinsuffizienz infolge dilatativer kardiomyopathie (Growth hormone and chronic congestive heart failure due to dilated cardiomyopathy). Dtsch Med Wochenschr. 2002; 127: 1261–1263.[CrossRef][Medline] [Order article via Infotrieve]
   

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