Abstract
Growth hormone hypersecretion, as in acromegaly, features heart hypetrophy. Despite long experience, heart changes are not regarded as adverse effects of GH therapy: however, increasing doses are being used, owing to increased availability and extension to indications other than GH deficiency. In order to ensure the safety of hGH at higher dose than in the past, we have performed echocardiography in 71 children and adolescents: 22 before treatment, 49 having received hGH (0.4-0.96 IU/kg/wk) for a period ranging 0.5 to 15.5 yrs. M-mode (left ventricle diameter, LV Posterior Wall [LVPW] and Septum [LVSW] in diastole and systole, systolic shortening [LVS] and thickening, aonic root diameter) and Doppler mode (cardiac output and index, protodiastolic to end-diastolic mitral flow ratio) have been recorded and evaluated for relationship to body size, duration of therapy, weekly and cumulated GH dose. The M-mode parameters of left heart size (LV, LVPW, LVSW) were well related to the body growth, and hence indirectly to the therapy. The cardiac index showed a negative correlation with the body size. The other dynamic parameters (LVS, LVPW and LVSW thickening) were, by contrast, not related to the body size. Univariate and multivariate linear regression analysis did not show any correlation between dynamic parameters and duration and dose of GH therapy. However, when the subjects were divided into five groups according to the duration of therapy (A, baseline; B. up to 1 year; C. 1 to 2 years; D. 2 to 4; E, over 4), analysis of variance disclosed a trend of decrease of the LVS and wall thickening during the first period of therapy (groups B and C), and subsequent return to baseline values or above. This phenomenon, which was somewhat unexpected, can hardly be explained by a direct negative inotropic effect of GH. A positive correlation between the LVS and the systolic blood pressure suggests the tentative explanation that the improvement of the lean body mass, due to the therapy, may explain the reduction of the peripheral resistance. A prospective study is in progress.
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Tonini, G., Marinoni, S., Benettoni, A. et al. EFFECTS OF THE hGH THERAPY ON THE HEART SIZE AND CONTRACTION. Pediatr Res 33 (Suppl 5), S35 (1993). https://doi.org/10.1203/00006450-199305001-00192
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DOI: https://doi.org/10.1203/00006450-199305001-00192