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Exp Clin Endocrinol Diabetes 2010; 118(3): 172-176
DOI: 10.1055/s-0029-1220688
Article

© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Effect of Growth Hormone Replacement Therapy on Plasma Brain Natriuretic Peptide Concentration, Cardiac Morphology and Function in Adults with Growth Hormone Deficiency

I. Lazúrová 1 , M. Pura 3 , H. Wagnerová 1 , M. Tajtáková 1 , M. Sedláková 1 , L’. Tomáš 1 , J. Payer 2 , P. Hrúziková 2 , P. Vaňuga 3 , J. Podoba 4 , L‘. Trejbalová 5 , V. Popovic 6 , M. Koltowska-Häggström 7 , 8
  • 11st Department of Internal Medicine, Medical Faculty, P. J. Safarik University Košice, Slovakia
  • 25th Department of Internal Medicine, Medical Faculty, Commenius University, Bratislava, Slovakia
  • 3Department of Endocrinology, National Institute of Endocrinology and Diabetology, L’ubochňa, Slovakia
  • 4St. Elizabeth's Institute of Oncology, Bratislava, Slovakia
  • 51st Department of Internal Medicine, Derer Faculty Hospital, Bratislava, Slovakia
  • 6Neuroendocrine Unit, Institute of Endocrinology, University Clinical Center, Belgrade, Serbia
  • 7KIMS Medical Outcomes, Endocrine Care, Pfizer, Sollentuna, Sweden
  • 8Department of Pharmacy, Uppsala University, Uppsala, Sweden
Further Information

Publication History

received 25.11.2008

first decision 03.02.2009 accepted 17.02.2009

Publication Date:
17 July 2009 (online)

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Abstract

Objective: The impact of growth hormone (GH) replacement on plasma brain natriuretic peptide (BNP) in association with cardiac morphology and function in adults with growth hormone deficiency (GHD) was evaluated.

Subjects and Methods: Fifty nine adult patients with GHD (29 men, age 19–59 years) received a starting dose of 0.1–0.2 mg/day recombinant GH, which was subsequently adjusted to the 50th percentile of normal serum insulin-like growth factor (IGF-1) over a 6 month period. Plasma BNP and IGF-I levels before, 3 and 6 months after treatment were determined, as were the echocardiographic data, such as ejection fraction (EF), left ventricular end-diastolic volume (LVEDV), left ventricular end-diastolic diameter (LVEDD), interventricular septal thickness (IVST), posterior wall thickness (PWT), left ventricular mass (LVM), E/A wave and deceleration time (DT).

Results: Mean plasma BNP levels (53.1±8 pg/ml) and echocardiographic parameters were within the normal range at baseline, although men had higher LVM, IVST, PWT, LVEDV and LVEDD, respectively. A significant decrease in plasma BNP was observed after 6 months (27±5.6 pg/ml, P<0.05). No significant changes in echocardiographic parameters were observed except for a mild tendency to increase in LVM, and a borderline decrease in DT (181±8.1 vs. 155±9 ms, P<0.01).

Conclusions: Six months GH replacement therapy induced a significant decrease in plasma BNP levels despite the majority of patients having plasma BNP within the normal range at baseline. A borderline decrease in diastolic deceleration time was observed, the clinical significance of which is unclear.

Key words

Brain natriuretic peptide (BNP) - Echocardiography - Deceleration time - Growth hormone deficiency - Growth hormone replacement

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Correspondence

Prof. I. LazúrováMD, PhD 

1st Department of Internal Medicine

Medical Faculty

P. J. Safarik University Košice

Trieda SNP 1

040 11 Košice, Slovakia

Phone: +421/55/640 39 54

Fax: +421/55/640 35 51

Email: lazurova@central.medic.upjs.sk