To investigate cardiac effects of excess and deficiency of growth hormone (GH) 20 acromegalic subjects and 11 adult patients with GH deficiency were studied by means of a non invasive method, the Doppler echocardiography. The results obtained in the group of patients were compared with those of 2 groups of 20 and 12 normal subjects, respectively, age and sex matched. The age of the acromegalic patients ranged from 20 to 62 years. Nineteen patients were considered to have active acromegaly at the time of the study. Mean duration of disease since treatment was 12 +/- 5 years (range 5 to 24 years). The age of GH deficient adults ranged from 21 to 33 years. All these patients have been treated with extractive GH over 9 years and the therapy withdrawal was performed at least 3 years before entering the study. In the acromegalic patient group, a subgroup including 9 patients with mild to moderate hypertension was considered. All subjects gave informed consent and the study protocol was approved by the Ethical Committee of the Medical School of Naples. Right ventricular free wall thickness resulted significantly increased in acromegalic patients (8 +/- 2 versus 4 +/- 1 mm; p < 0.001). Left ventricular mass index was augmented both in the whole group and in the subgroup of normotensive acromegalics as compared with normals (134 +/- 33 and 115 +/- 20 versus 80 +/- 18 g.m-2; p < 0.01). Ejection phase indices were normal in patient group, while impaired left and right ventricular diastolic filling was found.(ABSTRACT TRUNCATED AT 250 WORDS)