Cardiac changes associated with growth hormone therapy among children treated with anthracyclines

Steven E. Lipshultz, Sarah A. Vlach, Stuart R. Lipsitz, Stephen E. Sallan, Marcy L. Schwartz, Steven D. Colan

Research output: Contribution to journalArticle

58 Scopus citations

Abstract

Objective. The objective was to assess the cardiac effects of growth hormone (GH) therapy. Anthracycline-treated childhood cancer survivors frequently have reduced left ventricular (LV) wall thickness and contractility, and GH therapy may affect these factors. Methods. We examined serial cardiac findings for 34 anthracycline-treated childhood cancer survivors with several years of GH therapy and baseline cardiac z scores similar to those of a comparison group (86 similar cancer survivors without GH therapy). Results. LV contractility was decreased among GH-treated patients before, during, and after GH therapy (-1.08 SD below the age-adjusted population mean before therapy and -1.88 SD 4 years after therapy ceased, with each value depressed below normal). Contractility was higher in the control group than in the GH-treated group, with this difference being nearly significant. The GH-treated children had thinner LV walls before GH therapy (-1.38 SD). Wall thickness increased during GH therapy (from -1.38 SD to -1.09 SD after 3 years of GH therapy), but the effect was lost shortly after GH therapy ended and thickness diminished over time (-1.50 SD at 1 year after therapy and -1.96 SD at 4 years). During GH therapy, the wall thickness for the GH-treated group was greater than that for the control group; however, by 4 years after therapy, there was no difference between the GH-treated group and the control group. Conclusions. GH therapy among anthracycline-treated survivors of childhood cancer increased LV wall thickness, but the effect was lost after therapy was discontinued. The therapy did not affect the progressive LV dysfunction.

Original languageEnglish (US)
Pages (from-to)1613-1622
Number of pages10
JournalPediatrics
Volume115
Issue number6
DOIs
StatePublished - Jun 2005

Keywords

  • Anthracyclines
  • Cardiac changes
  • Cardiomyopathy
  • Congestive heart failure
  • Growth hormone
  • Pediatric cancer

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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