Objectives: Growth hormone (GH) secretory status and GH therapy influence cardiac muscle mass and function. Most patients with Prader-Willi syndrome (PWS) are GH-deficient (GHD), and are at risk to develop obesity-related cardiac problems. Few data exist on the development of cardiac dimensions under GH treatment in PWS.
Study design: in a retrospective study, cardiac dimensions measured echocardiographically in 26 children with PWS before and after 22.9 ± 11.0 months of GH therapy (0.035 mg/kg/day) were compared to those of 13 GHD children treated with GH (0.025-0.035 mg/kg/day) over 13.5 ± 4.2 months.
Results: low-normal left ventricular end-systolic [diastolic] diameter SDS increased in PWS patients (1.41, p < 0.0001 [1.23, p < 0.0001]) and in controls (0.61, p = 0.04 [0.78, p = 0.013]), becoming elevated above normal in 2/26 PWS patients. There was a trend for a higher GH effect on left ventricular end-systolic diameter in PWS (p = 0.071). Mean values of all echocardiographic dimensions remained in the normal range in both PWS patients and controls, before and under GH therapy.
Conclusion: the response of cardiac dimensions to GH treatment is similar in PWS patients and GHD controls, with a trend towards more elevated left ventricular parameters in PWS. Therefore, regular echocardiographic assessment may be considered in PWS children with longer treatment duration.
2010 S. Karger AG, Basel.