Title:Cardiovascular Complications in Patients with Turner’s Syndrome
Volume: 26
Issue: 43
Author(s): Eirini Kostopoulou*, Julia K. Bosdou, Panagiotis Anagnostis, John C. Stevenson and Dimitrios G. Goulis
Affiliation:
- Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics, University of Patras School of Medicine, Patras, 26500,Greece
Keywords:
Dyslipidaemia, diabetes mellitus, arterial hypertension, aortic coarctation, aortic dilatation; aortic dissection, turner syndrome.
Abstract: Turner’s or Turner syndrome (TS) is the most prevalent chromosomal abnormality in live female
births. Patients with TS are predisposed to an increased risk of cardiovascular diseases (CVD), mainly due to the
frequently observed congenital structural cardiovascular defects, such as valvular and aortic abnormalities (coarctation,
dilatation, and dissection). The increased prevalence of cardiometabolic risk factors, such as arterial hypertension,
insulin resistance, diabetes mellitus, dyslipidaemia, central obesity, and increased carotid intima-media
thickness, also contribute to increased morbidity and mortality in TS patients. Menopausal hormone therapy
(MHT) is the treatment of choice, combined with growth hormone (GH). Although MHT may, in general, ameliorate
CVD risk factors, its effect on CVD mortality in TS has not yet been established. The exact effect of GH on
these parameters has not been clarified. Specific considerations should be provided in TS cases during pregnancy,
due to the higher risk of CVD complications, such as aortic dissection. Optimal cardiovascular monitoring, including
physical examination, electrocardiogram, CVD risk factor assessment, and transthoracic echocardiography,
is recommended. Moreover, the cardiac magnetic resonance from the age of 12 years is recommended due to
the high risk of aortic aneurysm and other anatomical vascular complications.