Cardiac functions in children with growth hormone deficiency: Effects of one year of GH replacement therapy. (October 2021)

• Record Type: Journal Article
• Authors: Alkan, Fatos; Ersoy, Betul; Kızılay, Deniz Ozalp; Coskun, Senol
• Is Part Of: Growth hormone & IGF research. Volume 60/61(2021)
• Publication Date: 2021-10
• Subjects: Growth hormone -- Growth hormone deficiency -- Tissue Doppler imaging -- Myocardial performance index; IGHD Isolated Growth Hormone deficiency -- IGF-1 Insulin like growth factor-1 -- TDI tissue Doppler imaging -- GH Growth Hormone -- ECG electrocardiogram -- IVS intraventricular septum thickness -- LVPWT left ventricular posterior wall thickness -- LVEDD left ventricular end diastolic diameter -- LVESD left ventricular end systole diameter -- EF ejection fraction -- BMI body mass index -- RVEDD right ventricular end diastolic diameter -- RVESG right ventricular end systolic diameter -- E wave velocity early diastolic peak flow velocity -- A wave velocity late diastolic peak flow velocity -- E/A ratio ratio of early and late diastolic flow velocities -- IVCT isovolumic ventricular contraction time -- IVRT isovolemic ventricular relaxation time -- ET (ms) ejection time -- MPI myocardial performance index -- S peak systolic velocity -- IGFBP-3 Insulin like growth factor binding globulin-3; Growth regulators -- Periodicals; Growth -- Regulation -- Periodicals; Somatomedin -- Periodicals; Somatomedins -- Periodicals; Growth Hormone -- Periodicals; Growth Substances -- Periodicals; Croissance -- Régulation -- Périodiques; Croissance -- Régulateurs -- Périodiques; Somatotrophine -- Périodiques; Somatomédine -- Périodiques; Growth -- Regulation; Growth regulators; Electronic journals; Periodicals; Electronic journals; 612.4
• DOI: 10.1016/j.ghir.2021.101432
• Languages: English
• ISSNs: 1096-6374

Abstract

Abstract: 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. Highlights: Cardiac functions are similar in children with a peak GH response of <7 μg/L and children with a peak GH response of 7–10 μg/L to GH stimulation tests. Cardiac functions are impaired in children with isolated and partial GHD compared to their healthy peers. One year of GH treatment improves cardiac function but does not lead to complete recovery .