The use of hormonal therapy in pediatric heart disease

Brandon Nathan, Joseph Sockalosky, Lara Nelson, Sarah Lai, Consolato Sergi, Anna Petryk

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

The endocrine system plays an intricate role in the regulation and modulation of cardiovascular function. Several hormones including thyroid, mineralocorticoid, glucocorticoid, arginine-vasopressin (AVP), and growth hormone (GH) have been investigated as adjunctive therapies in pediatric cardiac disease. Thyroid hormone supplementation appears to be safe in neonatal and pediatric post-operative cardiac patients, but the benefits have been modest and inconsistent. Glucocorticoids appear to decrease the inflammatory response associated with cardiopulmonary bypass in children, but have little effect on clinical outcomes. The role of AVP in pediatric shock remains limited due to inconsistent trial results and its potential side effect profile. Although mineralcorticoids are commonly used to treat neurocardiogenic syncope, little to no benefit has been demonstrated in controlled trials. GH normalizes altered cardiac function in children who are GH deficient, but its effectiveness in the treatment of heart failure has been variable. Overall, the use of these hormones in a variety of pediatric cardiac conditions generally appears to be safe, but their efficacy for relieving symptoms, improving cardiac function, and improving clinical outcomes remains unclear.

Original languageEnglish (US)
Pages (from-to)358-375
Number of pages18
JournalFrontiers in Bioscience - Scholar
Volume1 S
Issue number1
DOIs
StatePublished - Jan 6 2009

Keywords

  • Cardiac surgery
  • Cardiopulmonary bypass
  • Dilated cardiomyopathy
  • Fludrocortisone
  • Growth hormone
  • Heart failure
  • Shock
  • Syncope
  • Thyroid hormone
  • Vasopressin

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    Nathan, B., Sockalosky, J., Nelson, L., Lai, S., Sergi, C., & Petryk, A. (2009). The use of hormonal therapy in pediatric heart disease. Frontiers in Bioscience - Scholar, 1 S(1), 358-375. https://doi.org/10.2741/e31