Evaluation of cardiac structure, exercise capacity and electrocardiography parameters in children with partial and complete growth hormone deficiency and their changes with short term growth hormone replacement therapy
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2023
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Abstract
Purpose: To evaluate cardiac structure, exercise capacity and electrocardiography (ECG) parameters of children with complete and partial growth hormone (GH) deficiency (GHD) and the effect of 12 months GH treatment on these. Methods: M-mode echocardiography, ECG and exercise test expressed as metabolic equivalent (MET) were performed in children with GHD, aged 9–14 years, divided into those with a peak GH response < 7 µg/L (complete GHD; n = 30) and 7–10 µg/L (partial GHD; n = 17) after two GH stimulation tests, at baseline and 12 months after GH initiation. Forty-eight healthy peers underwent the same tests once. Results: Left ventricular mass (LVM) was significantly lower before treatment in both groups with GHD compared to healthy peers (p = 0.015 and p = 0.032) but LVM in the GHD groups was similar to controls after 12 months of treatment. The increase in LVM in the complete GHD group was significant (p = 0.044). LVM index was significantly reduced with treatment in children with partial GHD (p = 0.035). Max METs, VO2max and exercise duration were significantly increased in children with complete GHD after treatment (p = 0.022, p = 0.015 and p = 0.002, respectively). Significant changes in P wave and QTc dispersion on ECG between groups were within physiological limits. Conclusion: This study showed that children with both partial and complete GHD had smaller cardiac structures and less exercise capacity compared to their healthy peers prior to GH treatment but this improved with 12 months of treatment. The cardiac trophic effect of GH, as well as the effect of increasing exercise capacity, is greater in those with complete GHD than in those with partial GHD. © 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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Child , Electrocardiography , Exercise Tolerance , Growth Hormone , Hormone Replacement Therapy , Human Growth Hormone , Humans , Hypopituitarism , Insulin-Like Growth Factor I , creatinine , growth hormone , hemoglobin A1c , growth hormone , human growth hormone , somatomedin C , adolescent , aerobic capacity , Article , ataxia , body mass , child , childhood disease , clinical article , congenital heart disease , controlled study , depression , diastolic blood pressure , dispersion , dizziness , Doppler echocardiography , echocardiography , electrocardiogram , electrocardiography , endothelial dysfunction , exercise , exercise test , female , gestational age , growth hormone deficiency , heart atrium conduction , heart left ventricle mass , heart rate , hormone response , hormone substitution , human , hypertension , hypotension , hypothyroidism , hypoxia , insulin tolerance test , interventricular septum , M mode echocardiography , male , metabolic equivalent , nuclear magnetic resonance imaging , oxygen consumption , P wave , peripheral arterial disease , QRS complex , QRS interval , QT interval , QTc interval , short stature , sleep disordered breathing , substitution therapy , systolic blood pressure , thorax pain , tissue Doppler imaging , transthoracic echocardiography , treadmill exercise , electrocardiography , exercise tolerance , hormone substitution , hypopituitarism , metabolism