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Cardiac performance in Turner's syndrome patients on growth hormone therapy
G Radetti1, R Crepaz, O Milanesi
1Department of Pediatrics, Regional Hospital of Bolzano, Italy. G.Radetti@ntt.it
Insights
Growth hormone (GH) therapy in Turner
Area of Science:
- Cardiology
- Endocrinology
- Pediatrics
Background:
- Turner's syndrome (TS) is a genetic condition affecting females, often treated with growth hormone (GH).
- Potential cardiac effects of long-term, high-dose GH therapy in TS patients require thorough investigation.
Purpose of the Study:
- To assess cardiac morphofunctional alterations in Turner's syndrome patients undergoing prolonged high-dose growth hormone therapy.
- To compare cardiac parameters between TS patients on GH therapy and healthy controls.
Main Methods:
- Echocardiography (2D and Doppler) was used to evaluate cardiac function in 26 TS patients on rhGH therapy and 37 healthy girls.
- Key parameters assessed included left ventricular volumes, mass, systolic and diastolic function, cardiac index, and systemic vascular resistance.
Main Results:
- TS patients on GH therapy exhibited higher heart rate and systolic blood pressure, with lower diastolic blood pressure compared to controls.
- Left ventricular morphology and cardiac index were similar; however, slight increases in fractional shortening and velocity of circumferential shortening were noted in TS.
- Diastolic function showed shortened relaxation and filling times, with increased atrial contribution, suggesting adaptation rather than pathology.
Conclusions:
- Cardiac morphology remains similar between Turner's syndrome patients on GH therapy and healthy controls.
- Observed functional changes are likely adaptive responses to GH-induced alterations in heart rate and peripheral vascular resistance.
Objectives:
To investigate possible cardiac morphofunctional alterations observed in 26 Turner's syndrome (TS) patients on prolonged high-dose growth hormone (GH) therapy.
Study Design:
We examined 26 TS subjects treated with rhGH (1 U/kg/week) for a mean period of 4.9 years (range 1-7.8) and 37 age-, weight- and height-matched healthy girls. Left ventricular volume, mass, systolic function, cardiac index, systemic vascular resistance and diastolic function were evaluated by two-dimensional and Doppler echocardiography.
Results:
Heart rate and systolic blood pressure (BP) were higher in TS patients than in controls, while diastolic BP was lower. Left ventricular volumes, ejection fraction, mass index, M/V ratio and cardiac index did not differ significantly; systemic vascular resistance was slightly decreased. Left ventricular fractional shortening and mean velocity of circumferential shortening were slightly increased while end-systolic meridional stress was decreased in TS. Contractile state was normal in TS. Diastolic function assessment showed a shortening of isovolumetric relaxation and diastolic filling times with an increased atrial contribution and a normal pulmonary venous flow.
Conclusion:
Cardiac morphology in TS patients on GH therapy is similar to controls. The observed changes in left ventricular systolic and diastolic function should be interpreted as an adaptation to the higher heart rate and reduced peripheral vascular resistance induced by GH therapy.