Background: Growth Hormone (GH) therapy has a positive effect on many parameters including metabolic and physiologic functions as well as its effect on growth. It has also been shown that GH therapy exerts a significant effect on cardiac morphology and function as evidenced by echocardiographic findings.
Aim: To investigate left and right ventricle (LV, RV) diastolic function by Tissue Doppler imaging (TDI) in pre-pubertal growth hormone deficient (GHD) children before and one year after GH therapy versus the standard M-mode and Doppler echocardiographic imaging techniques.
Patients and methods: A prospective casecontrol study performed on 23 pre-pubertal GHD patients and 14 age, sex and body mass index (BMI) matched controls. Anthropometric measurements and TDI were done before and one year after therapy with GH.
Results: GHD patients showed significant impairment in RV and LV diastolic functions by TDI when compared to controls as shown by lower levels of maximum wave velocity of early filling across tricuspid annulus (Et), and maximum wave velocity of late filling (atrial wave) across tricuspid annulus (At) (P=0.00 and 0.00 respectively) as well as higher ratios of maximum wave velocity of early filling across mitral annulus to maximum wave velocity of late filling across mitral annulus (Em/Am) and ratio of maximum wave velocity of early filling across tricuspid valve to maximum wave velocity of early filling across tricuspid annulus (Et/Et) in cases compared to controls (P=0.0001 and 0.0001 respectively). One-year therapy with GH significantly decreased both ratios denoting improvement in the net diastolic functions.
Conclusion: GH improves RV and LV ventricle diastolic functions as shown by TDI.
Key Words: GHD, ventricular function, TDI
10 - 12 Sep 2016
European Society for Paediatric Endocrinology