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

Alkan, Fatoş; Ersoy, Betül; Kızılay, Deniz Özalp; Özyurt, Beyhan Cengiz; Coşkun, Şenol

doi:10.1007/s11102-022-01295-z

Cited by 1 publication

(4 citation statements)

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“…Long QT and QTc intervals and increased QT and QTc dispersions are well-known risk factors for all-cause mortality and morbidity [15,28]. In the study of Alkan et al [21], although QTc and QT dispersion were longer in children with GH deficiency compared to the control group, no statistically significant difference was found. Nygren et al [22], in their study evaluating 89 children with GH deficiency, reported that the QTc interval did not change before and after GH treatment.…”

Section: Discussionmentioning

confidence: 94%

“…It has been suggested that Pd, believed to reflect non-homogeneous atrial conduction, is useful in determining the risk of supraventricular arrhythmias, particularly paroxysmal AF [ 18 , 19 , 25 ]. In the study of Alkan et al [ 21 ], in which they evaluated 47 children with GH deficiency (30 complete GH deficiency and 17 partial GH deficiency), the P wave interval was found to be shorter in children with partial GH deficiency. On the other hand, Pd was found to be similar in children with complete and partial GH deficiency and in the healthy control group.…”

Section: Discussionmentioning

confidence: 99%

“…Tp-e interval and Tp-e/QT ratios have been investigated in many diseases that affect the cardiovascular system, such as diabetes and hypothyroidism, and have been reported to be risk factors for ventricular arrhythmias [ 29 , 30 ]. Alkan et al [ 21 ] found a longer Tp-e interval in children with complete GH deficiency compared to children with partial GH deficiency and the control group. In the same study, although the Tp-e/QTc ratio was higher in children with complete GH deficiency, no statistically significant difference was found.…”

Section: Discussionmentioning

confidence: 99%

“…There are only two studies in the literature evaluating ECG in children with GH deficiency. In the study of Alkan et al [ 21 ], in which they evaluated ECG parameters in children with complete and partial GH deficiency and in the control group, changes were found in the P wave and QTc dispersion on the ECG between the groups. On the other hand, Nygren et al [ 22 ] showed that the QTc interval did not change before and after GH treatment.…”

Section: Introductionmentioning

confidence: 99%

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Electrocardiographic Findings in Children With Growth Hormone Deficiency

Yılmaz¹,

Gürses²,

Ata³

2023

Cureus

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Introduction It has been shown that cardiac functions begin to deteriorate in growth hormone (GH) deficiency even in childhood. However, little is known about how GH deficiency affects arrhythmogenesis. The aim of this study was to evaluate the parameters of P wave dispersion (Pd), QT dispersion (QTd), corrected QT (QTc) dispersion (QTcd), T wave peak-to-end (Tp-e) interval, Tp-e/QT ratio, and Tp-e/QTc ratio in children with GH deficiency. This study also aimed to evaluate the relationship of these parameters with insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP-3). Method In the study, records of children diagnosed with GH deficiency in Adana City Training and Research Hospital Pediatric Endocrine Outpatient Clinic between September 2021 and December 2022 were retrospectively reviewed. The control group consisted of children in the same age group who applied to the Emergency Outpatient Clinic with a complaint of chest pain and no pathological finding was detected. The electrocardiograms (ECGs) of all patients were retrospectively evaluated. Results There were a total of 82 children in the study, 41 of whom were diagnosed with GH deficiency and 41 in the healthy control group. The age and male/female ratio of children with GH deficiency were similar to those in the control group (p>0.05). There were 27 (66%) children with complete GH deficiency and 14 (34%) children with partial GH deficiency. P wave dispersion was similar in both GH-deficient children and control group children. It was also similar in children with complete and partial GH deficiency (p>0.05). QT and QTc dispersions were found to be increased in children with GH deficiency, although not statistically significant, compared to the control group (p>0.05). Tp-e interval, Tp-e/QTmax (longest QT interval), and Tp-e/QTcmax (longest QTc interval) ratios were increased in children with GH deficiency compared to the control group (p=0.001, p=0.003, and p=0.001, respectively). QT and QTc dispersion, Tp-e interval, Tp-e/QTmax, and Tp-e/QTcmax ratios were found to be increased in children with complete GH deficiency compared to children with partial GH deficiency, but the difference was not significant (p>0.05). No correlation was found between these ECG parameters and IGF-1, IGFBP-3, and peak GH levels after stimulation tests (p>0.05). Conclusion We found in our study that the Tp-e interval was longer and Tp-e/QT and Tp-e/QTc ratios were increased in children with GH deficiency. These results suggest that the risk of ventricular arrhythmias in children with GH deficiency may start to increase from childhood. However, further prospective studies are needed to confirm our results.

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