Cardiac dimension and function in patients with childhood onset growth hormone deficiency, before and after growth hormone retreatment in adult age.
BACKGROUND
Growth hormone (GH) replacement during childhood has been shown to increase stature; however, there is little information on its long-term effect on the heart is not yet clear. The aim of this study was to assess cardiac size and function in patients with childhood-onset GH deficiency in whom GH treatment had been stopped at the achievement of final height and the effect of a second course of GH replacement in adult age.


METHODS
Cardiac dimensions and function, obtained with echocardiography, of 21 patients (5 women and 16 men, mean age 28 +/- 8 years), all of whom were treated during childhood, were compared with 21 age- and sex-matched healthy control subjects. Eight of these patients (2 women and 6 men, mean age 28 +/- 8 years) were given a second course of GH replacement therapy for 15 +/- 3 months.


RESULTS
The stature and all cardiac dimensions of patients with GH deficiency who were treated during childhood were significantly smaller than those of the control subjects. After the second course of GH in adulthood, the only significant change observed was an increase in left ventricular (LV) mass (93 +/- 21 vs 106 +/- 24 g, P =.007) and LV mass index (59 +/- 12 vs 66 +/- 13 g/body surface area, P =.005).


CONCLUSIONS
The stature and cardiac dimensions of patients with childhood-onset GH deficiency measured in adult age were smaller than those of control subjects, despite long-term GH replacement therapy during childhood. A second course of GH treatment during adulthood caused a significant increase in the estimated LV mass index in patients with both isolated and multiple pituitary hormone deficiency.
Feinberg
Micha S
MS
Heart Institute, Sheba Medical Center, Tel Hashomer, Israel. feinberg@netvision.net.il
Scheinowitz
Mickey
M
Laron
Zvi
Z
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D001827:Body Height / Q000187:drug effects; D002648:Child; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004452:Echocardiography; D005260:Female; D006128:Growth / Q000187:drug effects*; D006130:Growth Disorders / Q000188:drug therapy*; D006321:Heart / Q000187:drug effects / Q000254:growth & development* / Q000502:physiology; D020249:Hormone Replacement Therapy / Q000379:methods*; D019382:Human Growth Hormone / Q000172:deficiency* / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011994:Recombinant Proteins / Q000494:pharmacology / Q000627:therapeutic use; D016896:Treatment Outcome
D011994:Recombinant Proteins; D019382:Human Growth Hormone