Context: In Turner syndrome (TS) growth hormone (GH) treatment is well established. Data on cardiac status following discontinuation of treatment are scarce. This study aimed to assess biventricular size and function in TS at least 6 months after discontinuation of GH-treatment.

Methods: TS patients and healthy women prospectively underwent cardiac MRI. Ventricular 2D tomographic cine data were acquired to obtain biventricular volume, mass and ejection fraction. Atrioventricular valve flow measurements were performed using a 2D flow-sensitized sequence. Flow velocity curves were calculated and indices of biventricular diastolic filling were derived.

Results: Thirty-one patients (mean (SD) age 20(2) years, BSA 1.75(0.15) m², 5(2) years after GH discontinuation) and 23 normal control women (age 21(2) years, BSA 1.80(0.13) m²) were included. Compared to controls patients had smaller mean end-diastolic volumes (RV, 84(11) ml/m² versus 79(10), p= 0.02; LV, 81(10) versus 72(9), p< 0.001), end-systolic volumes (RV, 38(7) ml/m² versus 36(6), p= 0.04; LV, 34(5) versus 29(4), p< 0.001) and stroke volumes (RV 46(6) ml/m² versus 43(6), p= 0.03; LV, 47(7) versus 44(4), p= 0.02). Patients had a higher mean heart rate (79(13) beats/min versus 71(10), p< 0.05). Biventricular ejection fraction, mass, cardiac output and diastolic filling pattern were comparable.

Conclusion: After discontinuation of GH-treatment TS patients showed no myocardial hypertrophy and well-preserved biventricular function. Ventricular volumes were smaller in Turner patients compared to controls, while mean heart rate was higher. These last observations may be part of the natural development in TS and not linked to GH-treatment, which at this point we consider safe.