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Cardiovascular effects of high-dose growth hormone treatment in growth hormone-deficient children
R Crepaz1, W Pitscheider, G Radetti
1Department of Cardiology, General Hospital of Bolzano, Italy.
Insights
Children receiving growth hormone (GH) therapy showed no adverse cardiovascular effects. Long-term treatment with biosynthetic GH did not impact left ventricular function or mass in pediatric patients.
Area of Science:
- Pediatric Endocrinology
- Cardiovascular Physiology
Background:
- Growth hormone (GH) hypersecretion is linked to cardiac issues.
- Increasing biosynthetic GH dosages in children necessitates cardiovascular safety evaluation.
Purpose of the Study:
- To assess the cardiovascular effects of chronic GH treatment in children with GH deficiency.
- To compare left ventricular (LV) function and mass between GH-treated children and healthy controls.
Main Methods:
- Echocardiography (2D-guided M-mode and Doppler) was used to evaluate LV systolic and diastolic function, volume, mass, cardiac output, and systemic vascular resistance.
- A cohort of 22 children receiving chronic GH treatment was compared with 22 matched healthy controls.
Main Results:
- No significant differences were observed in LV volume, mass, ejection fraction, or mean velocity of circumferential shortening between the GH group and controls.
- Cardiac output and systemic vascular resistance also showed no significant differences between the groups.
- All GH-treated patients maintained a normal contractile state.
Conclusions:
- Chronic growth hormone therapy in children with GH deficiency does not appear to negatively affect left ventricular structure or function.
- Current therapeutic dosages of biosynthetic GH seem safe from a cardiovascular perspective in pediatric patients.
Abstract:
Growth hormone (GH) hypersecretion is associated with an increased incidence of cardiac hypertrophy and subclinical abnormalities of left ventricular (LV) function. The unlimited availability of biosynthetic GH has led to progressively increased dosage when treating GH-deficient children, raising the question of its cardiovascular effects during long-term therapy. We compared 22 children (8 girls, 14 boys), mean age 12.1 years (range 3-17 years) with GH deficiency who were receiving chronic GH treatment (GH group) with 22 normal controls matched for sex and body size in order to evaluate: (1) LV volume, mass, and systolic function by two-dimensional guided M-mode echocardiography; (2) LV diastolic function by pulsed-wave Doppler sampling of the transmitral flow; and (3) cardiac output and systemic vascular resistance by Doppler echocardiography. All patients had been on chronic GH therapy for 13.8 +/- 7.6 months (range 5-30 months) with an average dose of 0.95 +/- 0.12 IU/kg per week (range 0.69-1.17 IU/kg per week). Blood pressure did not differ between the two groups. LV volume, mass, ejection fraction, and mean velocity of circumferential shortening did not differ significantly between the GH group and controls; nor did the peak- and end-systolic meridional stress. All patients had a normal contractile state as estimated by the relation between mean velocity of circumferential shortening and end-systolic meridional stress. The LV filling parameters did not differ between the two groups, and there was no difference in cardiac index and systemic vascular resistance.(ABSTRACT TRUNCATED AT 250 WORDS)