Long-term growth hormone deficiency as a cause of cardiomyopathy and its reversibility with specific replacement therapy

The current case report provides additional, and hopefully convincing, evidence in terms of cause and effect relation of GH deficiency to cardiomyopathy. In line with previous reports (16,17), our data highlight the rapid improvement of cardiac function after specific treatment. It would be interesting to determine whether GH therapy for longer than 3 months results in a more complete reversal of cardiac disease. The treatment period was necessarily short in our patient because we were also interested in the consequences of GH therapy discontinuation, which could provide an additional element to support the specificity of cardiomyopathy. Indeed, our observation of a rapid worsening of cardiac function after GH withdrawal substantiates the specificity of the disease and indicates that long term substitutive treatment is imperative in GH-deficient patients with evidence of cardiac failure. This recommendation is also supported by the epidemiological finding of increased cardiovascular mortality in GH-deficient patients, explained by their greater propensity to develop coronary artery disease and heart failure