Endocrine Abstracts

JOINT781

Background: Children with congenital acyanotic heart disease (CAHD), including atrial septal defect (ASD) and ventricular septal defect (VSD), frequently experience growth failure due to energy deficits, malnutrition, and altered hemodynamics. Growth hormone (GH) therapy is a potential treatment for short stature in this population; however, its effects on cardiac function warrant careful evaluation.

Objectives: To assess the real impact of GH therapy on growth velocity and cardiac function in children with CAHD and short stature, focusing on benefits and risks to inform safe and effective treatment practices.

Methods: A systematic review of 20 studies published between 2000 and 2025 was conducted, involving 2, 300 children with CAHD and short stature. Real impacts on growth outcomes (height velocity and z-scores), cardiac stability, and adverse events were calculated based on pooled study data.

Results: • Growth Outcomes: GH therapy improved height velocity by an average of 39. 1%, demonstrating significant benefits for growth failure in this population.

• Cardiac Stability: Cardiac function remained stable in 86. 6% of cases, with no significant deterioration in ejection fraction or ventricular dimensions reported.

• Mild Cardiac Changes: Transient mild cardiac changes, such as slight increases in left ventricular mass, were observed in 13. 4% of cases but did not impact overall heart function.

• Metabolic Risks: Mild metabolic side effects, including fluid retention and insulin resistance, occurred in 10. 2% of cases and were manageable with routine monitoring.

Discussion: GH therapy significantly benefits growth outcomes in children with CAHD while maintaining an acceptable safety profile. The findings underscore that cardiac changes are mostly mild and transient, particularly when therapy is monitored appropriately. Improved growth outcomes contribute to better overall health and quality of life in this population. Coordination between pediatric cardiologists and endocrinologists is crucial to optimize treatment outcomes.

Conclusion: GH therapy is a safe and effective intervention for short stature in children with CAHD when administered with careful cardiac monitoring. Its significant growth benefits and manageable risks make it a valuable option for addressing growth deficits in this vulnerable population.