title: Left ventricular mass and function in children with GH deficiency before and during 12 months GH replacement therapy.
abstract: OBJECTIVE
  This open, prospective study was designed to evaluate the effect of GH deficiency (GHD) on left ventricular (LV) mass (LVM) and performance, by echocardiography, and on lipid profile during childhood.
  
  
  METHODS
  Twelve prepubertal children with GHD (eight boys and four girls) aged 8.1 +/- 1.7 years were studied before and after 6 and 12 months of GH replacement therapy at a dose of GH of 30 micro g/kg/day. Twelve healthy children sex-, height-, weight- and body surface area-matched with the patients, served as controls.
  
  
  METHODS
  Echocardiography was performed at study entry and after 12 months both in GHD children and in controls. Only in GHD children, echocardiography was repeated also after 6 months of GH replacement. In all subjects, we measured LV posterior wall thickness (LVPWT), LV end-diastolic diameter (LVEDD), LVM index (LVMi), LV systolic and diastolic function.
  
  
  RESULTS
  At study entry, LVPWT (5.3 +/- 0.8 vs. 6.2 +/- 1.1 mm, P < 0.05), LVEDD (34.0 +/- 2.4 vs. 36.7 +/- 2.1 mm, P < 0.007) and LVMi (47.0 +/- 6.9 vs. 59.6 +/- 9.5 g/m2, P < 0.005) were significantly lower in GHD children than in controls. Lipid profile, heart rate, blood pressure, LV systolic function and indices of ventricular filling were similar in patients and controls. After 12 months of GH replacement therapy, LVPWT (6.1 +/- 0.7 mm, P < 0.0005), LVEDD (38.8 +/- 4.3 mm, P < 0.002) and LVMi (71.5 +/- 12.7 g/m2, P < 0.0005) significantly increased in GHD children compared to pretreatment values. In particular, after 12 months of therapy GHD children achieved a normal LVMi when compared to controls (60.7 +/- 8.6, P = ns). LVMi increase was significantly correlated with the increase in IGF-I level (r = 0.49; P < 0.004). LV systolic performance, diastolic filling and blood pressure did not change significantly during GH therapy. After 12 months of treatment, the atherogenic index, measured as total/high-density lipoprotein-cholesterol ratio (2.7 +/- 0.8) was significantly lower than both pretreatment (3.4 +/- 0.3, P < 0.03) and control values (3.8 +/- 1.1, P < 0.04).
  
  
  CONCLUSIONS
  GH deficiency in children affects heart morphology, by inducing a significant decrease in cardiac size, but does not modify cardiac function and lipid profile. Twelve months of GH replacement treatment normalizes cardiac mass, and reduces the atherogenic index.
authors.affiliation: Department of Pediatrics, University Frederico II of Naples, Naples, Italy. salerno@unina.it
authors.forename: Mariacarolina
authors.initials: M
authors.lastname: Salerno
authors.forename: Valentina
authors.initials: V
authors.lastname: Esposito
authors.forename: Letizia
authors.initials: L
authors.lastname: Spinelli
authors.forename: Carolina
authors.initials: C
authors.lastname: Di Somma
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Farina
authors.forename: Stefania
authors.initials: S
authors.lastname: Muzzica
authors.forename: Laura Tanturri
authors.initials: LT
authors.lastname: de Horatio
authors.forename: Gaetano
authors.initials: G
authors.lastname: Lombardi
authors.forename: Annamaria
authors.initials: A
authors.lastname: Colao
mesh_terms: D016022:Case-Control Studies; D002648:Child; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D004452:Echocardiography; D005260:Female; D006339:Heart Rate; D006352:Heart Ventricles / Q000473:pathology; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone / Q000172:deficiency* / Q000627:therapeutic use*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies; D013599:Systole; D013997:Time Factors; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D008076:Cholesterol, HDL; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D002784:Cholesterol