] Effects of growth hormone (rhGH) replacement on growth, cardiac structure and function in children with GH deficiency (GHD)

ANA C KESELMAN; ALICIA MARTINEZ; H VASQUEZ; ISABEL TORRES; INES ABELLA; HECTOR JASPER; JUAN J HEINRICH

New York, NY, USA

Congreso; 8th Joint Meeting, LWPES & European Society for Pediatric Endocrinology; 2009

LWPES & ESPE

Patients with GHD have an increased cardiovascular risk. GH appears to have a trophic effect on cardiac growth, and its deficiency has been associated with low cardiac mass and function. Improvement of cardiac mass and performance has been demonstrated in GHD adults receiving GH, this is unclear in children. To clarify whether GH will affect cardiac size and function we prospectively evaluated the cardiac mass and its performance in a group of GHD children before and during GH treatment. Patients and methods: 12 prepubertal GHD males (10 idiopathic) (Mean age: 8.5 ± 4.3 years) were evaluated. Anthropometry, echocardiograms- Doppler and the Bruce Treadmill test were performed basally and at 12 and 24 months of rhGH treatment (0.33 mg/Kg/week). Left Ventricular Mass (LVM) was compared with the percentiles calculated for normal male children. Lipid profile was also measured. Results: Growth velocity (cm/year): 2.8 ± 1.8 vs. 12.6 ± 1.9 vs. 8.0 ± 1.5 and height (SDS): -4.2 ± 1.4 vs. 1º st year: -2.7 ± 1.6, 2 vs. 2º nd year: -2.2 ± 1.6 improved significantly during treatment. Blood pressure remained normal and no arrhythmias were detected. Cardiac performance showed a significant improvement of exercise capacity during the first and second year of treatment (p< 0.01). (8.66 ± 2.4 vs. 11.6 ± 2 vs. 13.06 ± 2.57 min). Left ventricular mass was in the lower normal percentile at baseline and increased significantly (p< 0,01) to the higher percentiles after 2 years of treatment (50 ±15 vs 69 ± 14 g/m2 body surface.) No cardiac hypertrophy was found. Systolic and diastolic function remained in normal levels Lipid profile was always within the normal range Conclusion: GHD patients showed reduced left ventricular mass which increased significantly during two years of rhGH therapy. Endurance time improved significantly during treatment. No adverse effects were detected.