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Rapid Cardiovascular Effects of Growth Hormone treatment in short prepubertal children. Impact of treatment duration.

Journal article
Authors Anders Nygren
Jan Sunnegårdh
Dag Teien
Anders Jonzon
Gudrun Björkhem
Sven Lindell
Kerstin Albertsson-Wikland
Berit Kriström
Published in Clinical Endocrinology
Volume 77
Issue 6
Pages 877-884
ISSN 0300-0664
Publication year 2012
Published at Institute of Clinical Sciences, Department of Pediatrics
Pages 877-884
Language en
Links dx.doi.org/10.1111/j.1365-2265.2012...
Subject categories Pediatrics

Abstract

OBJECTIVE: Previous studies show that growth hormone (GH) treatment increases cardiac dimensions in short children with GH deficiency (GHD) and has diverse cardiac effects in children with idiopathic short stature (ISS). This study was performed to assess the effect of GH on the cardiovascular system in short children with a broad range of GH secretion and GH sensitivity/responsiveness. DESIGN AND PATIENTS: In this prospective, multicentre study, short prepubertal children diagnosed with isolated GHD (89) or ISS (38) were followed during two years of GH treatment. They were randomized to receive either a standard (43 μg/kg/d) or individualized GH dose (range 17-100 μg/kg/d) based on GH responsiveness estimated by a prediction model and distance to target height. Echocardiography, blood pressure and electrocardiography were performed at baseline, 3, 12 and 24 months. RESULTS: Left ventricular mass (LVM) indexed to body surface area increased significantly during two years of GH treatment in both GHD and ISS irrespective of randomized dose. This change was already apparent at three months, when standard deviation scores (SDS) of wall thickness and diameter were increased. At 24 months, left ventricular diameter SDS remained increased whereas myocardial thickness SDS returned to baseline values. There was no impairment of systolic or diastolic function. There was no correlation with treatment dose and LVM SDS at 24 months. CONCLUSIONS: Irrespective of GH status, there was a rapid increase in LVM during GH treatment in short children. At 3 months, wall thickness and diameter were increased whereas only diameter remained increased at 24 months. © 2012 Blackwell Publishing Ltd.

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