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Erschienen in: Pediatric Cardiology 8/2013

01.12.2013 | Original Article

The Effect of Recombinant Human Growth Hormone Therapy on Left-Ventricular Chamber Size and Function in Children With Growth Hormone Deficiency

verfasst von: Ihsan Esen, Ilker Cetin, Fatma Demirel, Filiz Ekici

Erschienen in: Pediatric Cardiology | Ausgabe 8/2013

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Abstract

This study was designed to assess the effect of recombinant human growth hormone (rhGH) therapy on left-ventricular (LV) chamber size and function in children with idiopathic isolated growth hormone deficiency (GHD) using conventional echocardiography and tissue Doppler imaging (TDI). Thirty patients (19 boys and 11 girls) with idiopathic isolated GHD were followed-up for 12 months. Mean age of patients was 11.0 ± 2.6 years (range 6.3–15.5). At baseline and at 3, 6, and 12 months of treatment, the structure of the left ventricle was assessed by conventional echocardiography and myocardial rates and time intervals by TDI. There was a significant increase in LV mass (LVM) compared with pretreatment values. Like LVM, relative wall thickness (RWT) was also increased significantly. The significant increase in LVM indexed to body surface area and RWT became apparent at month 3 of treatment with a significant increase in LVM indexed to height2.7 at treatment month 6. Normalized LVM increased as early month 3 of treatment, and a steady increase was observed until month 12. However, no patient had LVM > +2 standard deviation scores at month 12 of treatment. No significant differences were observed in functional parameters of the left ventricle and the interventricular septum. The results of this study showed that rhGH therapy causes an increase in myocardial mass without changing the geometry or function of the myocardium. Therefore, the increase in myocardial mass appears to be concentric, thus causing remodeling instead of hypertrophy.
Literatur
2.
Zurück zum Zitat Amato G, Carella C, Fazio S, La Montagna G, Cittadini A, Sabatini D et al (1993) Body composition, bone metabolism, and heart structure and function in growth hormone (GH)-deficient adults before and after GH replacement therapy at low doses. J Clin Endocrinol Metab 77(6):1671–1676PubMed Amato G, Carella C, Fazio S, La Montagna G, Cittadini A, Sabatini D et al (1993) Body composition, bone metabolism, and heart structure and function in growth hormone (GH)-deficient adults before and after GH replacement therapy at low doses. J Clin Endocrinol Metab 77(6):1671–1676PubMed
4.
Zurück zum Zitat Capalbo D, Lo Vecchio A, Farina V, Spinelli L, Palladino A, Tiano C et al (2009) Subtle alterations of cardiac performance in children with growth hormone deficiency: results of a two-year prospective, case–control study. J Clin Endocrinol Metab 94(9):3347–3355. doi:10.1210/jc.2008-2639 CrossRefPubMed Capalbo D, Lo Vecchio A, Farina V, Spinelli L, Palladino A, Tiano C et al (2009) Subtle alterations of cardiac performance in children with growth hormone deficiency: results of a two-year prospective, case–control study. J Clin Endocrinol Metab 94(9):3347–3355. doi:10.​1210/​jc.​2008-2639 CrossRefPubMed
5.
Zurück zum Zitat Colao A, di Somma C, Cuocolo A, Spinelli L, Tedesco N, Pivonello R et al (2001) Improved cardiovascular risk factors and cardiac performance after 12 months of growth hormone (GH) replacement in young adult patients with GH deficiency. J Clin Endocrinol Metab 86(5):1874–1881PubMed Colao A, di Somma C, Cuocolo A, Spinelli L, Tedesco N, Pivonello R et al (2001) Improved cardiovascular risk factors and cardiac performance after 12 months of growth hormone (GH) replacement in young adult patients with GH deficiency. J Clin Endocrinol Metab 86(5):1874–1881PubMed
6.
Zurück zum Zitat Colao A, Marzullo P, Di Somma C, Lombardi G (2001) Growth hormone and the heart. Clin Endocrinol 54(2):137–154CrossRef Colao A, Marzullo P, Di Somma C, Lombardi G (2001) Growth hormone and the heart. Clin Endocrinol 54(2):137–154CrossRef
7.
Zurück zum Zitat Colao A, di Somma C, Pivonello R, Cuocolo A, Spinelli L, Bonaduce D et al (2002) The cardiovascular risk of adult GH deficiency (GHD) improved after GH replacement and worsened in untreated GHD: a 12-month prospective study. J Clin Endocrinol Metab 87(3):1088–1093CrossRefPubMed Colao A, di Somma C, Pivonello R, Cuocolo A, Spinelli L, Bonaduce D et al (2002) The cardiovascular risk of adult GH deficiency (GHD) improved after GH replacement and worsened in untreated GHD: a 12-month prospective study. J Clin Endocrinol Metab 87(3):1088–1093CrossRefPubMed
8.
Zurück zum Zitat Crepaz R, Pitscheider W, Radetti G, Paganini C, Gentili L, Morini G et al (1995) Cardiovascular effects of high-dose growth hormone treatment in growth hormone-deficient children. Pediatr Cardiol 16(5):223–227CrossRefPubMed Crepaz R, Pitscheider W, Radetti G, Paganini C, Gentili L, Morini G et al (1995) Cardiovascular effects of high-dose growth hormone treatment in growth hormone-deficient children. Pediatr Cardiol 16(5):223–227CrossRefPubMed
9.
Zurück zum Zitat Daubeney PE, McCaughey ES, Chase C, Walker JM, Slavik Z, Betts PR et al (1995) Cardiac effects of growth hormone in short normal children: results after four years of treatment. Arch Disease Child 72(4):337–339CrossRef Daubeney PE, McCaughey ES, Chase C, Walker JM, Slavik Z, Betts PR et al (1995) Cardiac effects of growth hormone in short normal children: results after four years of treatment. Arch Disease Child 72(4):337–339CrossRef
10.
Zurück zum Zitat Du Bois D, Du Bois EF (1989) A formula to estimate the approximate surface area if height and weight be known. 1916. Nutrition 5(5):303–311 discussion 312–303PubMed Du Bois D, Du Bois EF (1989) A formula to estimate the approximate surface area if height and weight be known. 1916. Nutrition 5(5):303–311 discussion 312–303PubMed
11.
Zurück zum Zitat Feinberg MS, Scheinowitz M, Laron Z (2003) Cardiac dimension and function in patients with childhood onset growth hormone deficiency, before and after growth hormone retreatment in adult age. Am Heart J 145(3):549–553. doi:10.1067/mhj.2003.175 CrossRefPubMed Feinberg MS, Scheinowitz M, Laron Z (2003) Cardiac dimension and function in patients with childhood onset growth hormone deficiency, before and after growth hormone retreatment in adult age. Am Heart J 145(3):549–553. doi:10.​1067/​mhj.​2003.​175 CrossRefPubMed
13.
16.
17.
Zurück zum Zitat Kampmann C, Wiethoff CM, Wenzel A, Stolz G, Betancor M, Wippermann CF et al (2000) Normal values of M mode echocardiographic measurements of more than 2000 healthy infants and children in central Europe. Heart 83(6):667–672PubMedCentralCrossRefPubMed Kampmann C, Wiethoff CM, Wenzel A, Stolz G, Betancor M, Wippermann CF et al (2000) Normal values of M mode echocardiographic measurements of more than 2000 healthy infants and children in central Europe. Heart 83(6):667–672PubMedCentralCrossRefPubMed
18.
Zurück zum Zitat Lanes R, Gunczler P, Lopez E, Esaa S, Villaroel O, Revel-Chion R (2001) Cardiac mass and function, carotid artery intima-media thickness, and lipoprotein levels in growth hormone-deficient adolescents. J Clin Endocrinol Metab 86(3):1061–1065CrossRefPubMed Lanes R, Gunczler P, Lopez E, Esaa S, Villaroel O, Revel-Chion R (2001) Cardiac mass and function, carotid artery intima-media thickness, and lipoprotein levels in growth hormone-deficient adolescents. J Clin Endocrinol Metab 86(3):1061–1065CrossRefPubMed
19.
Zurück zum Zitat Longobardi S, Cuocolo A, Merola B, Di Rella F, Colao A, Nicolai E et al (1998) Left ventricular function in young adults with childhood and adulthood onset growth hormone deficiency. Clin Endocrinol 48(2):137–143CrossRef Longobardi S, Cuocolo A, Merola B, Di Rella F, Colao A, Nicolai E et al (1998) Left ventricular function in young adults with childhood and adulthood onset growth hormone deficiency. Clin Endocrinol 48(2):137–143CrossRef
20.
Zurück zum Zitat Merola B, Cittadini A, Colao A, Longobardi S, Fazio S, Sabatini D et al (1993) Cardiac structural and functional abnormalities in adult patients with growth hormone deficiency. J Clin Endocrinol Metab 77(6):1658–1661PubMed Merola B, Cittadini A, Colao A, Longobardi S, Fazio S, Sabatini D et al (1993) Cardiac structural and functional abnormalities in adult patients with growth hormone deficiency. J Clin Endocrinol Metab 77(6):1658–1661PubMed
22.
Zurück zum Zitat Nygren A, Sunnegardh J, Teien D, Jonzon A, Bjorkhem G, Lindell S et al (2012) Rapid cardiovascular effects of growth hormone treatment in short prepubertal children: impact of treatment duration. Clin Endocrinol 77(6):877–884. doi:10.1111/j.1365-2265.2012.04456.x CrossRef Nygren A, Sunnegardh J, Teien D, Jonzon A, Bjorkhem G, Lindell S et al (2012) Rapid cardiovascular effects of growth hormone treatment in short prepubertal children: impact of treatment duration. Clin Endocrinol 77(6):877–884. doi:10.​1111/​j.​1365-2265.​2012.​04456.​x CrossRef
23.
Zurück zum Zitat Ozdemir O, Abaci A, Hizli S, Razi CH, Akelma AZ, Kocak M et al (2011) Cardiac functions in children with growth hormone deficiency before and during growth hormone-replacement therapy. Pediatr Cardiol 32(6):766–771. doi:10.1007/s00246-011-9969-9 CrossRefPubMed Ozdemir O, Abaci A, Hizli S, Razi CH, Akelma AZ, Kocak M et al (2011) Cardiac functions in children with growth hormone deficiency before and during growth hormone-replacement therapy. Pediatr Cardiol 32(6):766–771. doi:10.​1007/​s00246-011-9969-9 CrossRefPubMed
24.
Zurück zum Zitat Radetti G, Crepaz R, Paganini C, Gentili L, Pitscheider W (1999) Medium-term cardiovascular effects of high-dose growth hormone treatment in growth hormone-deficient children. Hormone Res 52(5):247–252CrossRefPubMed Radetti G, Crepaz R, Paganini C, Gentili L, Pitscheider W (1999) Medium-term cardiovascular effects of high-dose growth hormone treatment in growth hormone-deficient children. Hormone Res 52(5):247–252CrossRefPubMed
26.
Zurück zum Zitat Salerno M, Esposito V, Spinelli L, Di Somma C, Farina V, Muzzica S et al (2004) Left ventricular mass and function in children with GH deficiency before and during 12 months GH replacement therapy. Clin Endocrinol 60(5):630–636. doi:10.1111/j.1365-2265.2004.02026.x CrossRef Salerno M, Esposito V, Spinelli L, Di Somma C, Farina V, Muzzica S et al (2004) Left ventricular mass and function in children with GH deficiency before and during 12 months GH replacement therapy. Clin Endocrinol 60(5):630–636. doi:10.​1111/​j.​1365-2265.​2004.​02026.​x CrossRef
27.
Zurück zum Zitat Salerno M, Esposito V, Farina V, Radetti G, Umbaldo A, Capalbo D et al (2006) Improvement of cardiac performance and cardiovascular risk factors in children with GH deficiency after two years of GH replacement therapy: an observational, open, prospective, case–control study. J Clin Endocrinol Metab 91(4):1288–1295. doi:10.1210/jc.2005-0981 CrossRefPubMed Salerno M, Esposito V, Farina V, Radetti G, Umbaldo A, Capalbo D et al (2006) Improvement of cardiac performance and cardiovascular risk factors in children with GH deficiency after two years of GH replacement therapy: an observational, open, prospective, case–control study. J Clin Endocrinol Metab 91(4):1288–1295. doi:10.​1210/​jc.​2005-0981 CrossRefPubMed
28.
Zurück zum Zitat Shulman DI, Root AW, Diamond FB, Bercu BB, Martinez R, Boucek RJ Jr (2003) Effects of one year of recombinant human growth hormone (GH) therapy on cardiac mass and function in children with classical GH deficiency. J Clin Endocrinol Metab 88(9):4095–4099CrossRefPubMed Shulman DI, Root AW, Diamond FB, Bercu BB, Martinez R, Boucek RJ Jr (2003) Effects of one year of recombinant human growth hormone (GH) therapy on cardiac mass and function in children with classical GH deficiency. J Clin Endocrinol Metab 88(9):4095–4099CrossRefPubMed
29.
Zurück zum Zitat Stamoyannou L, Georgacopoulos D, Trapali C, Neou P, Bartsocas CS, Margetakis A (2000) M-mode echocardiographic evaluation of systolic function, LV volume and mass in children on growth hormone therapy. J Pediatr Endocrinol Metab 13(2):157–161CrossRefPubMed Stamoyannou L, Georgacopoulos D, Trapali C, Neou P, Bartsocas CS, Margetakis A (2000) M-mode echocardiographic evaluation of systolic function, LV volume and mass in children on growth hormone therapy. J Pediatr Endocrinol Metab 13(2):157–161CrossRefPubMed
30.
Zurück zum Zitat Svensson J, Tivesten A, Isgaard J (2005) Growth hormone and the cardiovascular function. Minerva Endocrinol 30(1):1–13PubMed Svensson J, Tivesten A, Isgaard J (2005) Growth hormone and the cardiovascular function. Minerva Endocrinol 30(1):1–13PubMed
31.
Zurück zum Zitat ter Maaten JC, de Boer H, Kamp O, Stuurman L, van der Veen EA (1999) Long-term effects of growth hormone (GH) replacement in men with childhood-onset GH deficiency. J Clin Endocrinol Metab 84(7):2373–2380PubMed ter Maaten JC, de Boer H, Kamp O, Stuurman L, van der Veen EA (1999) Long-term effects of growth hormone (GH) replacement in men with childhood-onset GH deficiency. J Clin Endocrinol Metab 84(7):2373–2380PubMed
32.
Zurück zum Zitat Valcavi R, Gaddi O, Zini M, Iavicoli M, Mellino U, Portioli I (1995) Cardiac performance and mass in adults with hypopituitarism: effects of one year of growth hormone treatment. J Clin Endocrinol Metab 80(2):659–666PubMed Valcavi R, Gaddi O, Zini M, Iavicoli M, Mellino U, Portioli I (1995) Cardiac performance and mass in adults with hypopituitarism: effects of one year of growth hormone treatment. J Clin Endocrinol Metab 80(2):659–666PubMed
Metadaten
Titel
The Effect of Recombinant Human Growth Hormone Therapy on Left-Ventricular Chamber Size and Function in Children With Growth Hormone Deficiency
verfasst von
Ihsan Esen
Ilker Cetin
Fatma Demirel
Filiz Ekici
Publikationsdatum
01.12.2013
Verlag
Springer US
Erschienen in
Pediatric Cardiology / Ausgabe 8/2013
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-013-0727-z

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