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document
Changes in cardiac muscle mass and function in hemodialysis patients during growth hormone treatment . BACKGROUND Adult patients with chronic renal failure ( CRF ) often show symptoms as fatigue , wasting , and reduced working capacity with concomitant findings of reduced cardiac performance and muscle mass . This state may in part be caused by an imbalance in the somatostatin/somatomedine axis resulting in increased catabolism . During an attempt to correct this catabolic state by administration of exogenous growth hormone , cardiac muscle mass and performance were studied . METHODS In a double-blind , placebo-controlled 6-month study comprising 20 adult enfeebled hemodialysis patients , 9 patients were treated with a single daily subcutaneous injection of recombinant human growth hormone ( rhGH ) 4 IU/m2 and 11 with placebo injections . Left ventricular muscle mass ( LVM ) and ejection fraction ( EF ) were evaluated by echocardiography and the maximal working capacity ( MWC ) was measured by a bicycle exercise test performed before and after the treatment period . Supplementary electrocardiography ( ECG ) was performed before and after 6-month treatment . RESULTS Median LVM increased significantly from 172 to 220 g ( p = 0.03 ) in the rhGH-treated group , while an insignificant decrease was observed in the placebo group from 281 to 200 g ( p = 0.3 ) . The EF showed no significant changes in the two groups . MWC showed a slight , insignificant decrease in both groups . From ECG no significant ST deviations were found and no significant changes regarding B-Hb , blood pressure or pulse were observed in the two groups . Irregular heart rhythm aggravated in one patient during the first month of treatment with rhGH , but was overcome by a -blocking agent . CONCLUSION The treatment with rhGH of adult chronic hemodialysis patients for 6 months increased the left ventricular mass significantly , but without any effect on ejection fraction or maximal working capacity . No electrocardiographic signs of ischemia were associated with the increasing muscle mass and only one patient developed symptoms that might relate to ischemia . No changes in B-Hb , blood pressure or pulse were observed during the treatment period .
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Intervention_Pharmacological
growth hormone treatment
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Intervention_Pharmacological
exogenous growth hormone
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Intervention_Control
placebo-controlled
2595
Intervention_Surgical
hemodialysis
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Intervention_Pharmacological
recombinant human growth hormone ( rhGH )
2597
Intervention_Control
placebo
2598
Intervention_Physical
bicycle exercise test
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Outcome_Physical
cardiac muscle mass
2600
Outcome_Physical
Left ventricular muscle mass ( LVM )
2601
Outcome_Physical
ejection fraction ( EF )
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Outcome_Other
electrocardiography ( ECG )
2603
Outcome_Other
Median LVM
2604
Outcome_Physical
EF
2605
Outcome_Physical
MWC
2606
Outcome_Other
ST deviations
2607
Outcome_Physical
Irregular heart rhythm
2608
Outcome_Physical
the left ventricular mass
2609
Outcome_Physical
B-Hb
2610
Outcome_Physical
blood pressure
2611
Participant_Condition
hemodialysis
2612
Participant_Condition
growth hormone treatment
2613
Participant_Age
Adult
2614
Participant_Condition
chronic renal failure ( CRF )
2615
Participant_Sample-size
20
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Participant_Age
adult
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Participant_Condition
enfeebled hemodialysis