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Left ventricular volume and mass in children on growth hormone therapy compared with untreated children
D Heuschmann1, O Butenandt, M Vogel
1Pädiatrische Auxologie, Haunersches Kinderspital, München, Germany.
Insights
Growth hormone (GH) therapy in children may increase myocardial mass, but does not cause cardiac hypertrophy. This study found GH normalized low cardiac mass in children, particularly those with Ullrich-Turner syndrome (UTS).
Area of Science:
- Pediatric Endocrinology
- Cardiology
- Growth Hormone Therapy
Background:
- Growth hormone (GH) excess, as seen in acromegaly, is linked to circulatory issues like cardiac hypertrophy.
- Cardiac hypertrophy has not been previously reported as a complication of GH therapy in children.
Purpose of the Study:
- To assess the potential for cardiac hypertrophy in children undergoing GH therapy.
- To investigate the effects of GH therapy on myocardial mass and volume in pediatric patients.
Main Methods:
- Echocardiographic studies were performed on 54 children receiving GH therapy.
- Left ventricular volume and mass were determined using Simpson's rule on bisectional images.
- Special focus was placed on 47 girls with Ullrich-Turner syndrome (UTS) treated with supraphysiological GH doses.
Main Results:
- Children on GH therapy showed a significant increase in myocardial mass compared to untreated children.
- A dose-related effect of GH was observed on cardiac mass in girls and cardiac volume in boys.
- No instances of cardiac hypertrophy were found; the observed increase in muscle mass normalized previously low values.
Conclusions:
- GH therapy in children does not lead to cardiac hypertrophy.
- GH therapy can normalize myocardial mass in children, particularly those with conditions like Ullrich-Turner syndrome (UTS).
- The observed increases in cardiac mass are within normal physiological limits and represent a normalization of previously reduced values.
Abstract:
The myotropic effects of growth hormone (GH) have long been known. An excess of GH as in acromegaly, causes various problems within the circulatory system including cardiac hypertrophy. Although the latter has not been reported as a complication of GH therapy in children, we assessed this possibility in 54 children. Ninety-six echocardiographic studies were performed, in which bisectional images were analysed by Simpson's rule to determine left ventricular volume and mass. Of special interest were 47 results obtained from girls with Ullrich-Turner-syndrome (UTS) treated with supraphysiological doses of GH. Our results showed a significant increase of the myocardial mass in children on GH therapy compared with untreated children, as well as a dose related effect of GH on cardiac mass in girls and cardiac volume in boys. No cardiac hypertrophy, however, could be observed; the increase in muscular mass merely amounting to a normalization of previously low values.