Lack of effects of recombinant human growth hormone in a child with a complex cardiovascular malformation and dilated cardiomyopathy

Rosti, Luca; Cerini, E; Festa, Pierluigi; Miola, A.; Brunelli, V.; Frigiola, Alessandro

doi:10.1007/bf03343672

Cited by 4 publications

(1 citation statement)

References 12 publications

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“…DCM is one of the most common causes of heart failure in children and the main indication for cardiac transplantation. Very few reports exist on the effectiveness of GH in DCM in children, mostly in the form of case reports, which either suggest a positive effect (195,196) or no effect (197). The first prospective, randomized, partially blinded, crossover trial was conducted by McElhinney et al (198).…”

Section: Gh Treatment Of Heart Failure Due To Dilated Cardiomyopathymentioning

confidence: 99%

The use of hormonal therapy in pediatric heart disease

Mazda

Kishida²

2009

Front Biosci

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Introduction 3. The effects of tri-iodothyronine in the pediatric post-operative cardiac patients 3.1. Introduction 3.2. Regulation of thyroid hormone secretion and the mechanism of action 3.3. Changes to thyroid hormone metabolism following cardiac surgery 3.4. Trials of thyroid hormone supplementation in post-operative cardiac patients 4. Fludrocortisone treatment for syncope 4.1. Introduction 4.1. The mechanism of action of fludrocortisone 4.2. Treatment for syncope 5. Corticosteroids after cardiopulmonary bypass 5.1. Introduction 5.2. The mechanism of anti-inflammatory action of corticosteroids 5.3. Peri-operative steroid administration 5.4. Post-operative steroid administration 6. Arginine-vasopressin in shock 5.1. Introduction 5.2. Regulation of arginine-vasopressin secretion and the mechanism of action 5.3. Therapeutic use of arginine-vasopressin in shock 7. The effect of growth hormone on cardiac function 6.1. Introduction 6.2. Regulation of growth hormone secretion and the mechanism of action 6.3. GH treatment of cardiac dysfunction in GH deficiency 6.4. GH treatment of heart failure due to dilated cardiomyopathy 8. Summary and perspective 9. References 3. THE EFFECTS OF TRI-IODOTHYRONINE IN THE PEDIATRIC POST-OPERATIVE CARDIAC PATIENTS 3.1. Introduction Thyroid hormone is crucial to the growth, maturation, oxygen consumption, nerve function, and metabolism at all stages of human development. Of all organ systems that thyroid hormone affects, the heart is one

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Section: Gh Treatment Of Heart Failure Due To Dilated Cardiomyopathymentioning

confidence: 99%

The use of hormonal therapy in pediatric heart disease

Mazda

Kishida²

2009

Front Biosci

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Relative cardiac expression of growth hormone receptor and insulin-like growth factor-I mRNA in congenital heart disease

Nygren¹,

Sunnegårdh²,

Albertsson‐Wikland³

et al. 2008

J Endocrinol Invest

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GH may exert direct growth-promoting and metabolic actions on target tissues, but most of its effects are mediated by circulating (endocrine) or local (auto-/paracrine) IGF-I. The GH/IGF-I system has an important role in cardiac development and in maintaining the structure and function of the heart. A subgroup of children with pronounced heart defects will eventually need transplants, owing to congestive heart failure. Since the symptoms are often severe and may progress while waiting for surgery, it is necessary to develop supportive medical treatment. GH has been proposed as a therapeutic agent in adults with heart failure, but to date studies are lacking on children and more information is necessary. We have examined the expression of IGF-I mRNA and GH-receptor (GH-R) mRNA in children undergoing surgery for congenital heart disease. Eighteen children scheduled for open-heart surgery were included in the study. Right auricular biopsies were taken at the time of venous catheterization preceding cardiac bypass. The specimens were analysed using realtime PCR. We were able to show expression of both IGF-I mRNA and GH-R mRNA in the pediatric heart. The relative expressions were intercorrelated (r=0.75, p<0.001). GH-R mRNA correlated positively to standardized weight (r=0.65, p=0.004), body mass index (BMI) (r=0.59, p=0.01), and standardized BMI (r=0.59, p=0.01). IGF-I mRNA only correlated to BMI (r=0.50, p=0.04). This is the first study displaying cardiac expression of IGF-I mRNA and GH-R mRNA in children with congenital heart disease, although further studies are needed to define a role for GH in the treatment of these patients.

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