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Evaluation of cardiac structure, exercise capacity and electrocardiography parameters in children with partial and complete growth hormone deficiency and their changes with short term growth hormone replacement therapy

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Abstract

Purpose

To evaluate cardiac structure, exercise capacity and electrocardiography (ECG) parameters of children with complete and partial growth hormone (GH) deficiency (GHD) and the effect of 12 months GH treatment on these.

Methods

M-mode echocardiography, ECG and exercise test expressed as metabolic equivalent (MET) were performed in children with GHD, aged 9–14 years, divided into those with a peak GH response < 7 µg/L (complete GHD; n = 30) and 7–10 µg/L (partial GHD; n = 17) after two GH stimulation tests, at baseline and 12 months after GH initiation. Forty-eight healthy peers underwent the same tests once.

Results

Left ventricular mass (LVM) was significantly lower before treatment in both groups with GHD compared to healthy peers (p = 0.015 and p = 0.032) but LVM in the GHD groups was similar to controls after 12 months of treatment. The increase in LVM in the complete GHD group was significant (p = 0.044). LVM index was significantly reduced with treatment in children with partial GHD (p = 0.035). Max METs, VO2max and exercise duration were significantly increased in children with complete GHD after treatment (p = 0.022, p = 0.015 and p = 0.002, respectively). Significant changes in P wave and QTc dispersion on ECG between groups were within physiological limits.

Conclusion

This study showed that children with both partial and complete GHD had smaller cardiac structures and less exercise capacity compared to their healthy peers prior to GH treatment but this improved with 12 months of treatment. The cardiac trophic effect of GH, as well as the effect of increasing exercise capacity, is greater in those with complete GHD than in those with partial GHD.

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Acknowledgements

We thank Mr Jeremy Jones for his contribution to the English grammar used in this article.

Funding

This research did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector.

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Authors and Affiliations

  1. School of Medicine, Division of Pediatric Cardiology, Manisa Celal Bayar University, Manisa, Turkey

    Fatos Alkan & Senol Coskun

  2. School of Medicine, Division of Pediatric Endocrinology and Metabolism, Manisa Celal Bayar University, Manisa, Turkey

    Betul Ersoy & Deniz Ozalp Kızılay

  3. School of Medicine, Department of Public Health, Manisa Celal Bayar University, Manisa, Turkey

    Beyhan Cengız Ozyurt

Authors
  1. Fatos Alkan
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  2. Betul Ersoy
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  3. Deniz Ozalp Kızılay
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  4. Beyhan Cengız Ozyurt
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  5. Senol Coskun
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Contributions

Fatos Alkan: Study concept, study design, material acquisition, data collection, literature search, writing, critical reviewing. Betul Ersoy: Study design, supervision, critical reviewing, literature search, data analysis and interpretation, writing. Deniz Ozalp Kızılay: Material acquisition, data collection. Beyhan Cengiz Ozyurt: The statistical analysis of the study. Senol Coskun: Study concept.

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Correspondence to Fatos Alkan.

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Ethics approval

The study was conducted in accordance with the principles of the Declaration of Helsinki and was approved by the Ethics in Research Committee of the School of Medicine of the Celal Bayar University of Manisa.Informed consent: Informed consent was obtained from all individual participants included in the study.

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All participants provided written informed consent.

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statement The authors declare that they have no competing interests.

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Alkan, F., Ersoy, B., Kızılay, D.O. et al. Evaluation of cardiac structure, exercise capacity and electrocardiography parameters in children with partial and complete growth hormone deficiency and their changes with short term growth hormone replacement therapy. Pituitary 26, 115–123 (2023). https://doi.org/10.1007/s11102-022-01295-z

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