ESPE Abstracts

Introduction: Aromatase inhibitors (AIs) are increasingly used in children and adolescents to augment adult height. Given the potential risks of these drugs in women with breast cancer, detailed cardiovascular examinations in adolescents using these treatments are needed to ensure their safety in the pediatric group. The aim of this study was to investigate the effects AIs on cardiac morphology, functions and their relation to several metabolic parameters in adolescent boys.

Methods: Three groups matched for sex (boys, n=67), age (median age 13.5 years), weight, height, body mass index, and puberty stages were enrolled: (i) Group 1: 23 patients using AIs (only AI (n=6) or in combination with growth hormone (GH) (n=17)) for at least 6 months; (ii) Group 2: 22 patients using only GH, and (iii) Group 3: 22 healthy individuals. Two-dimensional, M-mode conventional Doppler and tissue Doppler examinations of the left ventricle (LV) were performed. Bioelectrical bioimpedance analyses was conducted and follicle-stimulating hormone, luteinizing hormone, total testosterone, lipid, and hemogram parameters were obtained. An a priori power analysis was conducted to determine the minimum sample size required to test the study hypothesis.

Results: Patients in Group 1 had significantly higher serum total testosterone (P<0.001) and hemoglobin (P<0.001) levels, fat free mass (P=0.005), LV mass (LVM) (P=0.002), with increased LV posterior wall diameter (LVPWD) (P=0.0016), interventricular septum diameter (IVSD) (P=0.019), and myocardial systolic wave velocity (Sm) (P=0.02) compared to the two other control groups. No significant differences were observed in terms of diastolic and systolic functions and lipid profiles (P>0.05). There were positive correlations between total testosterone, hemoglobin levels, and LVM, LVPWD and IVSD (P<0.05).

Conclusion: This is the first study to date evaluating the cardiac morphology and functions of adolescent boys using AIs. In this study, we found that (i) LVM, LVPWD, IVSD and Sm were significantly higher in the patient group receiving AI therapy compared to the control groups and that (ii) these parameters were significantly correlated with serum total testosterone and hemoglobin levels. These significant differences and correlations were evaluated as potential side effects of AIs.