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The Severity of Growth Hormone Deficiency Correlates with the Severity of Cardiac Impairment in 100 Adult Patients with Hypopituitarism: An Observational, Case-Control Study

Departments of Molecular and Clinical Endocrinology and Oncology (A.Co., C.D.S., M.F., F.R., S.S., G.L.), and Biomorphological and Functional Sciences and Nuclear Medicine Centre of the National Council of Research (A.Cu., W.A., M.S.), "Federico II" University of Naples, 80131 Naples, Italy

Address all correspondence and requests for reprints to: Annamaria Colao, M.D., Department of Molecular and Clinical Endocrinology and Oncology, "Federico II" University, via S. Pansini 5, 80131 Napoli, Italy. E-mail: colao{at}unina.it.

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 µg/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.

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