title: Evaluation of cardiac function in a group of small for gestational age school-age children treated with growth hormone.
abstract: OBJECTIVE
  Small for gestational age (SGA) patients have an increased risk of developing a cardiovascular pathology, as well as a metabolic syndrome. Our objective is to evaluate the cardiac morphology and function of SGA children treated with growth hormone (GH), identifying changes that could potentially have long-term consequences.
  
  
  METHODS
  We selected 23 SGA school-age patients and 23 healthy children. We measured their weight, height, blood pressure and heart rate. Using transthoracic echocardiography, we evaluated cardiac chamber size, ascending and abdominal aortic diameter as well as the systolic and diastolic function of both ventricles.
  
  
  RESULTS
  SGA children have a higher systolic and diastolic blood pressure (P<.05) without significant changes in their heart rate. They also have a thicker interventricular septum (SGA Z-score 1.57 vs. 0.89; P=.026) and a worse right ventricular systolic function, with a lower TAPSE (SGA Z-score -0.98 vs. 0.95; P=.000), as well as a lower blood flow rate in the pulmonary artery (SGA 0.85m/s vs. 0.97m/s; P=.045). No significant difference was observed in the patients' left ventricular function. SGA patients' ascending aortic diameter was greater (SGA Z-score -1.09 vs. -1.93; P=.026), whereas the systolic abdominal aortic diameter was smaller (SGA Z-score-0.89 vs. -0.19; P=.015).
  
  
  CONCLUSIONS
  We found functional and morphological cardiac changes in SGA school-age patients treated with GH. It is important to follow-up this patient group in order to determine if these changes contribute to an increased cardiac morbidity in adulthood.
authors.affiliation: Departamento de Pediatría, Hospital de Barbastro, Barbastro, Huesca, España. Electronic address: estheraurensanz@gmail.com.
authors.forename: Esther
authors.initials: E
authors.lastname: Aurensanz Clemente
authors.affiliation: Departamento de Pediatría, Hospital Universitario Miguel Servet, Zaragoza, España.
authors.forename: Ariadna
authors.initials: A
authors.lastname: Ayerza Casas
authors.affiliation: Departamento de Pediatría, Hospital Clínico Universitario de Zaragoza, Zaragoza, España.
authors.forename: Pilar
authors.initials: P
authors.lastname: Samper Villagrasa
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario Miguel Servet, Zaragoza, España.
authors.forename: Pablo
authors.initials: P
authors.lastname: Ruiz Frontera
authors.affiliation: Departamento de Pediatría, Hospital Clínico Universitario de Zaragoza, Zaragoza, España.
authors.forename: Gloria
authors.initials: G
authors.lastname: Bueno Lozano
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D004452:Echocardiography; D005260:Female; D006130:Growth Disorders / Q000150:complications / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology*; D013006:Growth Hormone / Q000627:therapeutic use*; D006321:Heart / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D008297:Male; D009206:Myocardium / Q000473:pathology
chemical_list: D013006:Growth Hormone
keywords: Echocardiography; Ecocardiografía; Estructura; Hormonas; Hormones; Pediatrics; Pediatría; Right ventricle; Structure; Ventrículo derecho