PMID- 9078821
OWN - NLM
STAT- MEDLINE
DCOM- 19970512
LR  - 20180529
IS  - 0142-6338 (Print)
IS  - 0142-6338 (Linking)
VI  - 43
IP  - 1
DP  - 1997 Feb
TI  - Growth parameters and endocrine function in relation to echocardiographic 
      parameters in children and adolescents with compensated rheumatic heart disease.
PG  - 4-9
LID - 10.1093/tropej/43.1.4 [doi]
AB  - To determine the effect of left ventricular and endocrine functions on linear 
      growth in children with rheumatic heart disease (RHD) we studied 100 children and 
      adolescents with RHD over a period of 1 year. The mean +/- SD for age of onset 
      and duration of RHD were 7.3 +/- 3.8 years and 4.4 +/- 2.8, respectively. The 
      cardiac lesions were mitral incompetence (n = 31), combined mitral and aortic 
      incompetence (n = 64), and mitral stenosis (n = 5). Growth was assessed by 
      determining both height standard deviation scores (HtSDS) and growth velocity 
      standard deviation score (GVSDS) every 4 months, and sexual maturity was assessed 
      according to Tanner's criteria. Two-hundred age-matched normal children served as 
      controls for the growth data. Endocrine evaluation was performed in the 30 
      children with RHD who had age above 14 years (mean age 15.4 +/- 1.5 years), 20 
      age- and sex-matched normal children, and 20 age-matched children with 
      constitutional delay of growth (normal variant short stature) (NVSS). Circulating 
      concentrations of estradiol (E2) in girls, testosterone (T) in boys, and free T4 
      (FT4) were measured. Growth hormone (GH) response to clonidine provocation, LH 
      and FSH response to LHRH stimulation, and in boys testosterone (T) response to 
      HCG were evaluated. Echocardiographic evaluation of the left ventricular 
      parameters was performed using a colour-coded echodoppler. The HtSDS and GVSDS of 
      children with RHD were significantly lower than those for the normal control 
      group. Delayed onset of puberty was evident in 16/30 of the children with RHD, 
      and 6/ 30 more had sexual maturity score below 10th percentile for age and 
      gender. In comparison with the age-matched normal group, those with RHD had 
      significantly lower sexual maturity score (1.8 +/- 0.4 v. 3.25 +/- 0.8). All the 
      children had normal GH response to clonidine provocation and normal FT4 
      concentrations. Basal and HCG stimulated T concentrations were significantly low 
      in adolescents with RHD and E2 levels were non-significantly lower in girls with 
      RHD compared to normal controls. LH response to LHRH was significantly decreased 
      in RHD patients v. controls denoting delayed maturation of the 
      hypothalamic-pituitary gonadal axis. HtSDS and GVSDS were correlated 
      significantly with the left ventricular echocardiographic parameters, including 
      left ventricular end diastolic diameter (LVEDD) (r = 0.57, and 0.617, 
      respectively; P < 0.01), left ventricular end systolic diameter (LVESD) (r = 
      0.49, and 0.546, respectively; P < 0.01), left ventricular end diastolic volume 
      (LVEDV) (r = 0.33 and 0.31, respectively; P < 0.05), left ventricular end 
      systolic volume (LVESV) (r = 0.325 and 0.33, respectively; P < 0.05), peak 
      velocity of circumferential fibres (Vcf) (r = 0.25 and 0.38, respectively; P < 
      0.05), and with pre-ejection period/ejection time (PEP/ET) (r = 0.14 and 0.47, 
      respectively; P < 0.05). It appears that linear growth of children with RHD, 
      without heart failure, depends on the left ventricular function. In addition, 
      they have high incidence of delayed sexual development secondary to delayed 
      maturation of their hypothalamic-pituitary gonadal axis.
FAU - Soliman, A T
AU  - Soliman AT
AD  - Department of Pediatrics, Universitie of Alexandria, Egypt.
FAU - el Nawawy, A
AU  - el Nawawy A
FAU - el Azzoni, O
AU  - el Azzoni O
FAU - el Ashmawy, H
AU  - el Ashmawy H
FAU - Marzook, S
AU  - Marzook S
FAU - Amer, E S
AU  - Amer ES
LA  - eng
PT  - Journal Article
PL  - England
TA  - J Trop Pediatr
JT  - Journal of tropical pediatrics
JID - 8010948
RN  - 0 (Hormones)
SB  - IM
MH  - Adolescent
MH  - Case-Control Studies
MH  - Child
MH  - Child Development
MH  - Echocardiography
MH  - Female
MH  - Growth Disorders/*etiology
MH  - Hormones/*analysis
MH  - Humans
MH  - Hypothalamo-Hypophyseal System/physiopathology
MH  - Male
MH  - Pituitary-Adrenal System/physiopathology
MH  - Radioimmunoassay
MH  - Rheumatic Heart Disease/*complications
MH  - Ventricular Dysfunction, Left/*complications
EDAT- 1997/02/01 00:00
MHDA- 2000/05/12 09:00
CRDT- 1997/02/01 00:00
PHST- 1997/02/01 00:00 [pubmed]
PHST- 2000/05/12 09:00 [medline]
PHST- 1997/02/01 00:00 [entrez]
AID - 10.1093/tropej/43.1.4 [doi]
PST - ppublish
SO  - J Trop Pediatr. 1997 Feb;43(1):4-9. doi: 10.1093/tropej/43.1.4.