Cardiac functions in children with growth hormone deficiency: Effects of one year of GH replacement therapy
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2021
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Introduction: Children with Growth Hormone deficiency (GHD) are prone to heart dysfunction and, if left untreated, will result in marked cardiac dysfunction in adulthood. The aim was to evaluate the effect of GHD and growth hormone (GH) therapy on cardiac structure in children and adolescents, and to investigate the role of insulin like growth factor-1 (IGF-1) in this. Methods: M-mode, pulse-wave Doppler echocardiography and tissue Doppler imaging (TDI) were performed in 49 children with GHD who were divided into those with a peak GH response < 7 μg/L and 7–10 μg/L after two GH stimulation tests, aged 8–16 years at baseline and at six and 12 months after GH initiation, and 49 healthy peers. IGF-1 concentration was measured. Results: Although the left ventricular end diastolic and systolic diameters in both GH deficient groups were significantly lower than controls (p < 0.01), both diameters increased significantly with one year of treatment and achieved normal values (p > 0.05). Using TDI in both two patients group revealed increased E/A, prolonged isovolumic relaxation time, shortened ejection time, and a significant increase in myocardial performance index compared to controls (p < 0.001). Significant improvement was observed in these parameters from the sixth month of GH treatment (p < 0.001), this improvement does not match parameters measured in healthy peers, even after one year of treatment in both patients group. (p < 0.001). No correlation was found between IGF-1 concentration and any echocardiographic parameter. Conclusion: Echocardiographic parameters were similar in children with a GH peak < 7 μg/L and 7–10 μg/L. In TDI, both systolic and diastolic function was impaired in GHD children compared to controls. These parameters improved after one year of GH therapy but did not recover to healthy control levels. © 2021 Elsevier Ltd
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Cardiovascular Diseases , Case-Control Studies , Child , Dwarfism, Pituitary , Echocardiography , Female , Follow-Up Studies , Hormone Replacement Therapy , Human Growth Hormone , Humans , Insulin-Like Growth Factor I , Male , Prognosis , Prospective Studies , Risk Factors , growth hormone , somatomedin C , human growth hormone , IGF1 protein, human , somatomedin C , adolescent , Article , body height , body weight , child , clinical article , clinical effectiveness , controlled study , descriptive research , diastolic blood pressure , Doppler echocardiography , echocardiography , growth hormone deficiency , heart function , heart left ventricle enddiastolic diameter , heart left ventricle endsystolic diameter , heart performance , heart ventricle ejection time , hormone substitution , human , M mode echocardiography , pediatric patient , systolic blood pressure , tissue Doppler imaging , treatment duration , adverse event , cardiovascular disease , case control study , female , follow up , hormone substitution , male , metabolism , pathology , pituitary dwarfism , prognosis , prospective study , risk factor