Cardiac structural and functional abnormalities in growth hormone deficient children before and after growth hormone replacement therapy

ABSTRACT

This study included 45 patients [30 males and 15 females] with GH deficiency with mean age of 11.5 +/- 4.6 years. All patients were subjected to thorough clinical examination with special emphasis on the resting heart rate and blood pressure, auxological evaluation including the height standard deviation [SD], height velocity SD, body mass index [BMI] and body surface area [BSA], laboratory investigations [CBC, s. sodium, potassium and kidney functions] as well as one and two dimensional echocardiography to determine the left ventricular diastolic dimension [EDD], end systolic dimension [ESD], posterior wall and interventricular septal thickness, left ventricular mass and mass index. Thirty patients received recombinant human GH [rhGH] therapy for six months [rhGH group], while the remaining fifteen patients [matching the rhGH group in both age and sex] were considered as an index group for comparative purposes. The same initial evaluations were repeated for both groups six months later. It was concluded that although children with GH deficiency had cardiac structure and function within the normal ranges for their age and sex, GH replacement therapy improved their cardiac performance and ventricular mass with subsequent favorable effect on their life and cost-benefit ratio. However, long term studies are needed to guard against and early detect cardiac hypertrophy that may accompany prolonged GH therapy