Evaluation of Electrocardiographic Changes in Girls Receiving Gonadotropin-Releasing Hormone Analogs for Precocious Puberty

INTRODUCTION: Gonadotropin-releasing hormone analogs (GnRHa) are standard medical treatments for precocious puberty. Studies on their side effects in adults have shown that these drugs can cause changes in electrocardiography (ECG), along with some cardiovascular effects; however, the number of studies on children is limited. This study investigated the effects of these drugs on ECG parameters in children diagnosed with central precocious puberty(CPP).

METHODS: This prospective study included 44 girls who were initiated on GnRHa treatment and diagnosed with CPP. ECG was performed before treatment and repeated after 6 months of treatment.
RESULTS: The mean age of the children was 9.13±1.55 years. Leuprolide acetate (3.75 mg IM) was administered to all the patients following the standard protocol. The comparison of the pretreatment and 6-month ECG parameters revealed a prolonged QT interval after treatment, with a statistically significant difference(p<0.001). There were no significant differences in the pre- and post-treatment values of PR, QRS, QT interval, QTc interval, QT dispersion, and QTc dispersion (p>0.05).
DISCUSSION AND CONCLUSION: Despite a significant increase in QT interval on ECG with GnRHa compared to pretreatment ECGs, this increase was attributed to variability in heart rate. Even if regular ECG monitoring is considered after GnRHa treatment initiation, they are believed to be safe drugs in children.