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Cardiovascular Effects of Short-Term Growth Hormone Hypersecretion

Departments of Internal Medicine (S.F., A.C., E.A.P., G.R., F.B., U.O., L.S.) and Endocrinology (B.B.), "Federico II" University Medical School, 80131 Naples, Italy

Address correspondence and requests for reprints to: Serafino Fazio, M.D., III Division of Internal Medicine, Via S. Pansini, 5, 80131 Naples, Italy.

Many studies have shown that acromegaly has relevant effects on cardiovascular system, but few data are available regarding the effects of short-term acromegaly on heart morphology and function. These data would help to clarify the natural history of acromegalic disease and could provide new insight into the mechanisms of GH action on the human heart.

Therefore, we studied by Doppler echocardiography a group of 10 young subjects strictly selected as having short-term (<5 yr) uncomplicated acromegaly. The results of this study have shown that short-term acromegaly is characterized by significantly increased left ventricular mass (P < 0.005), with normal relative wall thickness, associated with Doppler indices of diastolic function in the normal range. Furthermore, stroke index and cardiac index were significantly enhanced in the patient group (P < 0.01 and P < 0.001, respectively), whereas systemic vascular resistance was significantly reduced (P < 0.001).

In conclusion, our study shows that short-term acromegaly significantly affects the heart, but, at variance with long-term disease, it is characterized by increased left ventricular mass, with eccentric remodeling and normal diastolic function. Moreover, short-term acromegaly induces a high cardiac output state with reduction of systemic vascular resistance.

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