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Evaluation of cardiac function in a group of small for gestational age school-age children treated with growth
Esther Aurensanz Clemente1, Ariadna Ayerza Casas2, Pilar Samper Villagrasa3
1Departamento de Pediatría, Hospital de Barbastro, Barbastro, Huesca, España.
Insights
Children born small for gestational age (SGA) and treated with growth hormone (GH) show cardiac changes. Further follow-up is needed to assess long-term cardiovascular risks in this SGA population.
Area of Science:
- Pediatric Cardiology
- Endocrinology
- Growth Disorders
Background:
- Children born small for gestational age (SGA) face increased risks for cardiovascular pathology and metabolic syndrome.
- Growth hormone (GH) therapy is used to address growth deficits in SGA children.
Purpose of the Study:
- To evaluate cardiac morphology and function in school-age SGA children treated with GH.
- To identify potential long-term cardiovascular consequences in this patient group.
Main Methods:
- A cohort of 23 SGA school-age patients treated with GH was compared to 23 healthy children.
- Transthoracic echocardiography assessed cardiac chamber size, aortic diameters, and ventricular systolic/diastolic function.
- Blood pressure and heart rate were also measured.
Main Results:
- SGA children exhibited higher systolic and diastolic blood pressure compared to controls.
- Significant differences included a thicker interventricular septum and impaired right ventricular systolic function (lower TAPSE) in SGA patients.
- SGA patients showed altered aortic diameters, with a larger ascending aorta and smaller abdominal aorta.
Conclusions:
- Growth hormone treatment in SGA children is associated with functional and morphological cardiac alterations.
- Long-term cardiovascular monitoring is crucial for SGA patients to determine future cardiac morbidity risks.
Introduction And Objectives:
Small for gestational age (SGA) patients have an increased risk of developing a cardiovascular pathology, as well as a metabolic syndrome. Our objective is to evaluate the cardiac morphology and function of SGA children treated with growth hormone (GH), identifying changes that could potentially have long-term consequences.
Methods:
We selected 23 SGA school-age patients and 23 healthy children. We measured their weight, height, blood pressure and heart rate. Using transthoracic echocardiography, we evaluated cardiac chamber size, ascending and abdominal aortic diameter as well as the systolic and diastolic function of both ventricles.
Results:
SGA children have a higher systolic and diastolic blood pressure (P<.05) without significant changes in their heart rate. They also have a thicker interventricular septum (SGA Z-score 1.57 vs. 0.89; P=.026) and a worse right ventricular systolic function, with a lower TAPSE (SGA Z-score -0.98 vs. 0.95; P=.000), as well as a lower blood flow rate in the pulmonary artery (SGA 0.85m/s vs. 0.97m/s; P=.045). No significant difference was observed in the patients' left ventricular function. SGA patients' ascending aortic diameter was greater (SGA Z-score -1.09 vs. -1.93; P=.026), whereas the systolic abdominal aortic diameter was smaller (SGA Z-score-0.89 vs. -0.19; P=.015).
Conclusions:
We found functional and morphological cardiac changes in SGA school-age patients treated with GH. It is important to follow-up this patient group in order to determine if these changes contribute to an increased cardiac morbidity in adulthood.
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