Cardiac performance in Turner's syndrome patients on growth hormone therapy.
OBJECTIVE
To investigate possible cardiac morphofunctional alterations observed in 26 Turner's syndrome (TS) patients on prolonged high-dose growth hormone (GH) therapy.


METHODS
We examined 26 TS subjects treated with rhGH (1 U/kg/week) for a mean period of 4.9 years (range 1-7.8) and 37 age-, weight- and height-matched healthy girls. Left ventricular volume, mass, systolic function, cardiac index, systemic vascular resistance and diastolic function were evaluated by two-dimensional and Doppler echocardiography.


RESULTS
Heart rate and systolic blood pressure (BP) were higher in TS patients than in controls, while diastolic BP was lower. Left ventricular volumes, ejection fraction, mass index, M/V ratio and cardiac index did not differ significantly; systemic vascular resistance was slightly decreased. Left ventricular fractional shortening and mean velocity of circumferential shortening were slightly increased while end-systolic meridional stress was decreased in TS. Contractile state was normal in TS. Diastolic function assessment showed a shortening of isovolumetric relaxation and diastolic filling times with an increased atrial contribution and a normal pulmonary venous flow.


CONCLUSIONS
Cardiac morphology in TS patients on GH therapy is similar to controls. The observed changes in left ventricular systolic and diastolic function should be interpreted as an adaptation to the higher heart rate and reduced peripheral vascular resistance induced by GH therapy.
Radetti
G
G
Department of Pediatrics, Regional Hospital of Bolzano, Italy. G.Radetti@ntt.it
Crepaz
R
R
Milanesi
O
O
Paganini
C
C
Cesaro
A
A
Rigon
F
F
Pitscheider
W
W
D000293:Adolescent; D002302:Cardiac Output; D002648:Child; D003971:Diastole; D004452:Echocardiography; D005260:Female; D013006:Growth Hormone / Q000627:therapeutic use*; D006321:Heart / Q000503:physiopathology*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D009200:Myocardial Contraction; D012016:Reference Values; D013599:Systole; D014424:Turner Syndrome / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology*; D014655:Vascular Resistance / Q000187:drug effects; D016277:Ventricular Function, Left
D013006:Growth Hormone