Hypertrophic cardiomyopathy during corticotropin therapy for infantile spasms. A clinical and echocardiographic study
G. B. Bobele, K. E. Ward and J. B. Bodensteiner
Department of Neurology, University of Oklahoma Health Science Center, Oklahoma City 73126.
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.
