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Two Cases of Growth Hormone Therapy in Idiopathic Dilated Cardiomyopath

Journal of the Korean Pediatric Society 2001;44(8):942-947.
Published online August 15, 2001.
Two Cases of Growth Hormone Therapy in Idiopathic Dilated Cardiomyopath
Jeong Won Shin, Hong Ryang Kil, Jae Hong Yu
Department of Pediatrics, College of Medicine, Chungnam National University, Daejon, Korea
특발성 확장성 심근병증에서 성장호르몬의 치험 2례
신정원, 길홍량, 유재홍
충남대학교 의과대학 소아과학교실
Correspondence: 
Jae Hong Yu, Email: jhongyu@cuvic.cnu.ac.kr
Abstract
Growth hormone receptor gene is expressed in the myocardium and growth hormone(GH) administration has been shown to increase cardiac insulin-like growth factor-I(IGF-1) contents. The cardiac myocyte express IGF-I receptors and IGF-I promotes cardiac hypertrophy. Furthermore GH therapy has been reported to have beneficial effects in the treatment of dilated cardiomyopathy in adults. We have studied the effect of short term growth hormone treatment in two cases of a 5 year-old girl and a 15 year-old boy presenting idiopathic dilated cardiomyopathy. Transthoracic echocardiography revealed that the left ventricular chamber was markedly dilated and the global left ventricular systolic function was severely reduced in both. Medical treatments such as inotropic agents, diuretics and angiotensin converting enzyme(ACE) inhibitor were tried but we could not attain remarkable improvement. Finally, we started growth hormone treatment (0.35 U/kg/week, Eutropin, LGCI, Korea) and after treatment for 3 months, we attained a remarkable hemodynamic improvement in the 5 year-old girl with remarkable IGF-I increase after GH treatment, but not in the 15 year-old boy without IGF-I increase. The treatment was safe without side effects. However, no beneficial effects on cardiac function or structure were detected at 6 months of post-treatment.
Key Words: Idiopathic dilated cardiomyopathy, Growth hormone therapy


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