Evaluation of cardiac function in a group of small for gestational age school-age children treated with growth hormone

Abstract Introduction and objectives Small for gestational age (SGA) patients have an increased risk of developing a cardiovascular pathology, as well as a metabolic syndrome. Our objective is to evaluate the cardiac morphology and function of SGA children treated with growth hormone (GH), identifying changes that could potentially have long-term consequences. Methods We selected 23 SGA school-age patients and 23 healthy children. We measured their weight, height, blood pressure and heart rate. Using transthoracic echocardiography, we evaluated cardiac chamber size, ascending and abdominal aortic diameter as well as the systolic and diastolic function of both ventricles. Results SGA children have a higher systolic and diastolic blood pressure ( p Z -score 1.57 vs. 0.89; p  = .026) and a worse right ventricular systolic function, with a lower TAPSE (SGA Z -score −0.98 vs. 0.95; p  = .000), as well as a lower blood flow rate in the pulmonary artery (SGA 0.85 m/s vs. 0.97 m/s; p  = .045). No significant difference was observed in the patients’ left ventricular function. SGA patients’ ascending aortic diameter was greater (SGA Z -score −1.09 vs. −1.93; p  = .026), whereas the systolic abdominal aortic diameter was smaller (SGA Z -score−0.89 vs. −0.19; p  = .015). Conclusions We found functional and morphological cardiac changes in SGA school-age patients treated with GH. It is important to follow-up this patient group in order to determine if these changes contribute to an increased cardiac morbidity in adulthood.