Cho Goo-Yeong, Jeong In-Kyung, Kim Seong Hwan, Kim Min-Kyu, Park Woo-Jung, Oh Dong-Jin, Yoo Hyung-Joon
Department of Medicine, Hallym University Sacred Heart Hospital, Hallym University, Anyang City, South Korea.
Am J Cardiol. 2007 Sep 15;100(6):1035-9. doi: 10.1016/j.amjcard.2007.04.051.
This study was conducted to investigate the effect of growth hormone (GH) replacement on cardiac function assessed by standard or tissue Doppler echocardiography in GH deficiency. Ten patients (mean age 47+/-14 years) received GH at a dose of 1.0 IU/day (6 times/week). After 6 months of GH replacement, GH substitution was discontinued. Echocardiography was performed at baseline, after 6 months of therapy, and 1 year after the withdrawal of GH replacement. All parameters were compared with those from 11 healthy controls matched for age, gender, and left ventricular (LV) mass index. After GH replacement, LV ejection fractions were nonsignificantly increased. However, fractional shortening, LV dimensions, and LV volumes did not change. Compared with controls, peak strain (-18.9+/-4.8% vs -15.7+/-6.9%, p<0.01) and strain rate (-1.3+/-0.4/s vs -1.0+/-0.5/s, p<0.01) at baseline were significantly decreased in patients with GH deficiency. Strain and strain rate increased significantly after 6 months of replacement but returned to baseline levels after 12 months off therapy. In conclusion, GH replacement in adult-onset GH deficiency demonstrated beneficial effects on cardiac contractility assessed by strain and strain rate, but these parameters returned to baseline levels after the withdrawal of GH. Strain and strain rate can be used to evaluate subtle changes in myocardium after GH replacement.
本研究旨在探讨生长激素（GH）替代治疗对生长激素缺乏症患者心脏功能的影响，采用标准或组织多普勒超声心动图进行评估。10例患者（平均年龄47±14岁）接受剂量为1.0 IU/天（每周6次）的生长激素治疗。生长激素替代治疗6个月后，停止使用生长激素。在基线、治疗6个月后以及停止生长激素替代治疗1年后进行超声心动图检查。将所有参数与11名年龄、性别和左心室（LV）质量指数匹配的健康对照者的参数进行比较。生长激素替代治疗后，左心室射血分数无显著增加。然而，缩短分数、左心室尺寸和左心室容积没有变化。与对照组相比，生长激素缺乏症患者基线时的峰值应变（-18.9±4.8%对-15.7±6.9%，p<0.01）和应变率（-1.3±0.4/s对-1.0±0.5/s，p<0.01）显著降低。替代治疗6个月后应变和应变率显著增加，但停止治疗12个月后恢复到基线水平。总之，成人起病的生长激素缺乏症患者进行生长激素替代治疗对通过应变和应变率评估的心脏收缩力有有益影响，但停止使用生长激素后这些参数恢复到基线水平。应变和应变率可用于评估生长激素替代治疗后心肌的细微变化。
