The growth hormone deficiency syndrome in adults (GHD) is well established, as well as the benefits of replacement with recombinant growth hormone (GH). Cardiovascular disease is one of the most studied aspects of this syndrome. Increased mortality, higher incidence of atherosclerosis and impairment in heart performance has been reported. Cardiovascular alterations were sought for in 26 GHD patients: 4 of them had the deficiency since childhood (cGHD) and 22 had acquired GHD in adult life (aGHD). The study was done by analyzing the systolic and diastolic cardiac function by two-dimensional (2-D) Dopplerechocardiographic study and by performance noted on cardiopulmonary effort test. Diastolic dysfunction was noted in 2 patients (7.7%) - without systolic alterations - and reduced left ventricle systolic stress in 3 patients. Reduced left ventricle mass index was present in one patient with cGHD. The effort test results showed reduction of exercise capacity (maximum VO2 achieved) in 92% of patients and reduced inotropic response represented by oxygen pulse (VO2/heart rate) in 69%. We concluded that adults with GHD have reduced functional capacity and incipient systolic cardiac dysfunction. The 2-D dopplerechocardiographic evaluation at rest showed no significant alterations in this population.
GH deficiency; Cardiovascular disease; Dopplerechocardiography; Cardiopulmonary effort test
