Short stature in severe paediatric heart failure: The deleterious role of growth hormone replacement

Abstract

Growth failure secondary to heart failure in childhood is well documented, but not well understood. A current analysis of 640 children from Chile who require cardiac surgery for congenital heart defects showed short stature in 24.1% [1]. The highest percentage of short stature are related to heart failure of cause complete atrioventricular canal (66.7%), ventricular septal defect (33%) and after Norwood 1 repair of the hyperplastic left heart syndrome (33.3%). Low serum insulin-like growth factor -1 level (IGF-1) indicates heart failure in children with left to right shunt due to congenital heart defects [1] that increase after corrective surgery [3,4]. Impaired linear growth in infants with single ventricle physiology seems to be an indicator of worse neurodevelopmental outcome [5].