Hypertrophic cardiomyopathy during corticotropin therapy for infantile spasms. A clinical and echocardiographic study.

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.