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European Heart Journal 2003 24(7):664-672; doi:10.1016/S0195-668X(02)00740-6
Copyright © 2003 by the European Society of Cardiology.
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A preliminary randomized study of growth hormone administration in Becker and Duchenne muscular dystrophies

Antonio Cittadinia,*, Lucia Ines Comib, Salvatore Longobardia, Vito Rocco Petrettab, Cosma Casaburia, Luigia Passamanob, Bartolomeo Merolac, Emanuele Durante-Mangonid, Luigi Saccàa and Luisa Politanob

a Department of Internal Medicine and Cardiovascular Sciences, University Federico II,Via Sergio Pansini 5, Naples 80131, Italy
b Department of Clinical and Experimental Medicine, Second University, Naples, Italy
c Department of Endocrinology, University Federico II, Via Sergio Pansini 5, Naples 80131, Italy
d Department of Internal Medicine, Second University, Naples, Italy

* Corresponding author. Tel.: +39-081-746-4375; fax: +39- 081-746-3199
E-mail address: cittadin{at}unina.it

Received 22 July 2002; revised 8 October 2002; accepted 9 October 2002

Aim Since growth hormone (GH) has proven beneficial in experimental heart failure, and the natural history of Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD) is frequently complicated by the development of dilated cardiomyopathy, we administered GH to six patients with DMD and 10 with BMD, with the evidence of cardiac involvement.

Methods and results Patients were randomized to receive for 3 months either placebo or recombinant human GH, in a double-blind fashion. In GH-treated patients, left ventricular (LV) mass increased by 16% in BMD and by 29% in DMD (both ), with a significant increase of relative wall thickness (+19%). Systemic blood pressure remained unchanged, while LV end-systolic stress fell significantly by 13% in BMD and by 33% in DMD, with a slight increase of systolic function indexes. No changes were observed related to cardiac arrhythmias and skeletal muscle function in the patient groups during the treatment period, nor any side effects were observed. Brain natriuretic peptide, interleukin-6, and tumor necrosis factor-{alpha} circulating levels were elevated at baseline. While brain natriuretic peptide decreased by 40%, cytokine levels did not exhibit significant variations during the treatment period.

Conclusions The 3-month GH therapy in patients with DMD and BMD induces a hypertrophic response associated with a significant reduction of brain natriuretic peptide plasma levels and a slight improvement of systolic function, no changes in skeletal muscle function, and no side effects.

Key Words: Growth hormone • X-linked muscular dystrophy • Cytokines


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