Key result
High-dose corticotropin is linked to reversible cardiac hypertrophy in ~72% of children with infantile spasms.
Why the study?
The incidence and clinical features of abnormal cardiac hypertrophy during corticotropin treatment for infantile spasms were not well characterized.
Does high-dose corticotropin therapy cause abnormal cardiac hypertrophy in children with infantile spasms?
Observational (n=18)
No
Does high-dose corticotropin therapy cause abnormal cardiac hypertrophy in children with infantile spasms?
High-dose corticotropin therapy for infantile spasms frequently causes reversible abnormal ventricular hypertrophy, including asymmetric septal hypertrophy, without significant left ventricular outflow obstruction.
May warrant echocardiography monitoring during high-dose corticotropin; leaves open need for prospective trials on long-term cardiac outcomes.
OBJECTIVE: To evaluate the incidence and clinical features of abnormal cardiac hypertrophy during treatment of infantile spasms with corticotropin. DESIGN: A prospective, echocardiographic study. PARTICIPANTS: Eighteen children treated for infantile spasms with high-dose corticotropin at a large tertiary children's hospital. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Abnormal cardiac hypertrophy was seen in 13 (72%) of 18 patients. Five of 18 patients (group 1) developed hypertrophic cardiomyopathy with asymmetric septal hypertrophy; none developed significant left ventricular outflow obstruction. Concentric left ventricular hypertrophy was seen in eight patients (group 2), whereas no changes were observed in five (group 3). CONCLUSION: Abnormal ventricular hypertrophy occurs in the majority of patients treated with corticotropin for infantile spasms. In our study, many of these patients developed hypertrophic cardiomyopathy with dramatic asymmetric septal hypertrophy; however, none developed significant obstruction to left ventricular outflow. All changes were reversible, and did not require premature discontinuation of therapy.
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Gary B. Bobele (1993) conducted an observational in Infantile spasms (n=18). High-dose corticotropin was evaluated on Abnormal cardiac hypertrophy. High-dose corticotropin therapy for infantile spasms was associated with abnormal cardiac hypertrophy in 72% of children, though all changes were reversible.
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