Cardiac functions in children with growth hormone deficiency: Effects of one year of GH replacement therapy

IF 1.6 4区 医学 Q4 CELL BIOLOGY Growth Hormone & Igf Research Pub Date : 2021-10-01 DOI:10.1016/j.ghir.2021.101432
Fatos Alkan , Betul Ersoy , Deniz Ozalp Kızılay , Senol Coskun
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引用次数: 3

Abstract

Introduction

Children with Growth Hormone deficiency (GHD) are prone to heart dysfunction and, if left untreated, will result in marked cardiac dysfunction in adulthood. The aim was to evaluate the effect of GHD and growth hormone (GH) therapy on cardiac structure in children and adolescents, and to investigate the role of insulin like growth factor-1 (IGF-1) in this.

Methods

M-mode, pulse-wave Doppler echocardiography and tissue Doppler imaging (TDI) were performed in 49 children with GHD who were divided into those with a peak GH response < 7 μg/L and 7–10 μg/L after two GH stimulation tests, aged 8–16 years at baseline and at six and 12 months after GH initiation, and 49 healthy peers. IGF-1 concentration was measured.

Results

Although the left ventricular end diastolic and systolic diameters in both GH deficient groups were significantly lower than controls (p < 0.01), both diameters increased significantly with one year of treatment and achieved normal values (p > 0.05). Using TDI in both two patients group revealed increased E/A, prolonged isovolumic relaxation time, shortened ejection time, and a significant increase in myocardial performance index compared to controls (p < 0.001). Significant improvement was observed in these parameters from the sixth month of GH treatment (p < 0.001), this improvement does not match parameters measured in healthy peers, even after one year of treatment in both patients group. (p < 0.001). No correlation was found between IGF-1 concentration and any echocardiographic parameter.

Conclusion

Echocardiographic parameters were similar in children with a GH peak < 7 μg/L and 7–10 μg/L. In TDI, both systolic and diastolic function was impaired in GHD children compared to controls. These parameters improved after one year of GH therapy but did not recover to healthy control levels.

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生长激素缺乏症儿童的心功能:一年生长激素替代治疗的影响
患有生长激素缺乏症(GHD)的儿童容易出现心功能障碍,如果不及时治疗,将导致成年后明显的心功能障碍。目的是评估GHD和生长激素(GH)治疗对儿童和青少年心脏结构的影响,并探讨胰岛素样生长因子-1 (IGF-1)在其中的作用。方法对49例GHD患儿进行sm模式、脉冲波多普勒超声心动图和组织多普勒成像(TDI)检查。年龄为8-16岁,基线时为7 μg/L,生长激素启动后6和12个月为7 - 10 μg/L, 49名健康同龄人。测定IGF-1浓度。结果两组患者左心室舒张末期和收缩末期直径均显著低于对照组(p <0.01),治疗一年后,两种直径均显著增加,达到正常值(p >0.05)。与对照组相比,两组患者经TDI后E/A增加,等容松弛时间延长,射血时间缩短,心肌功能指数显著增加(p <0.001)。从生长激素治疗的第6个月开始,观察到这些参数有显著改善(p <0.001),即使在两组患者治疗一年后,这种改善与健康同龄人的测量参数不符。(p & lt;0.001)。IGF-1浓度与超声心动图参数无相关性。结论:GH峰值患儿超声心动图参数相似;7 μg/L和7 - 10 μg/L。在TDI中,与对照组相比,GHD儿童的收缩和舒张功能均受损。经过一年的生长激素治疗,这些参数有所改善,但没有恢复到健康控制水平。
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来源期刊
Growth Hormone & Igf Research
Growth Hormone & Igf Research 医学-内分泌学与代谢
CiteScore
3.30
自引率
0.00%
发文量
38
审稿时长
57 days
期刊介绍: Growth Hormone & IGF Research is a forum for research on the regulation of growth and metabolism in humans, animals, tissues and cells. It publishes articles on all aspects of growth-promoting and growth-inhibiting hormones and factors, with particular emphasis on insulin-like growth factors (IGFs) and growth hormone. This reflects the increasing importance of growth hormone and IGFs in clinical medicine and in the treatment of diseases.
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