Abstract
Modest changes in bloodpressure (BP) and LV dimensions have been reported after only 1 yr GH-Rx on idiopathic short children (1). GH excess, as in acromegalic pts, may load to (e)symmetrical cardiac hypertrophy and hypertension. We evaluated LV dimensions in TS before, alter 1 and 2 yrs hGH Rx in increasing) dosages.
PATIENTS: In a multicenter dosa-response study, 68 girls with TS (Tanner stage B1), age 6.5 (2.3) yr (range 2.1-11.0 yr) wero randomized into 3 groups according to CA und H·SDSCA: A (n = 23) 4 IU hGH/m2 b.s. for 4 yr, B (n = 23) 1st yr 4 IU and 2nd-4th yr 6 IU/m2, C In = 22) Isl yr 4 ID, 2nd yr 6 IU, 3rd and 4th yr 8 lU/m2 (NorditropinR) daily s.c. During the 1st end 2nd yr B und C were ovaluated as one group. Girls with a previous (n = 2) were included; 2 girls (B + C) were excluded because ol stenosis.
METHODS: All ecg and echocardiogiaphic tracings were evaluated by the same investigator (AvT). On ecg LV activity (-RV6 t SV1) was assessed and on M mode echocardiography end-diastolic (od) end und systolic (es) measurements of septal (IVS) and posterior wall (PW) thickneus and LV internal dimensions (LVID) were used to calculate relative wall thickness (RWT = I(PW + IVS)/2I/ LVID) and shortening fraction (SF = (LVIDed-LVIDos)/LVIDed 100%). BP was determined with a Dinamap Critikon 18465X in sitting position. Values are expressed as mean (SD).
After 1 and 2 yrs, changes from preRx were not significantly different between groups. LV act values after 2 yr and RWTed values after 1 and 2 yr differed from preRx (p<0.03), but remained within the normal range. Systolic BP in Bn C alter 2 yts was higher than proRx (p=0.02).
CONCLUSIONS: In girls with TS prior to and during GH treatment, irrespective of the two dosages:
1 There were no signs of LV hypertrophy, although a slight, but significant increase in RWTed was observed.
2 BP remained within normal age related limits and did not differ between groups.
REF (1); Barton et al 1992, Actu Paediatr Suppl 383: 358.
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Dijkhuis, A., van Teunenbroek, A., Keizer-Schroma, S. et al. EFFECT OF GROWTH HORMONE (GH) TREATMENT ON LEFT VENTRICULAR (LV) CARDIAC DIMENSIONS IN TURNER SYNDROME (TS). Pediatr Res 33 (Suppl 5), S66 (1993). https://doi.org/10.1203/00006450-199305001-00377
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DOI: https://doi.org/10.1203/00006450-199305001-00377