STEROID-INDUCED HYPERTROPHIC CARDIOMYOPAT HY IN 4 PRETERM INFANTS

Background. - The steroid treatment used to prevent bronchopulmonary d ysplasia (BD) in the preterm babies may be the cause of several compli cations, one of them being hypertrophic cardiomyopathy. Case report. - Four infants developed hupertrophic cardiomyopathy during glucocortic oid (dexamethasone and/or betamethasone) treatment for bronchopulmonar y dysplasia. In one of them, septal hypertrophy led to left ventricula r outflow tract obstruction and congestive heart failure. All four wer e premature infants born after 2 weeks of gestation and weighing 780 t o 1,080 g. The first echocardiographic changes appeared between the 4t h and the 15th day of the glucocorticoid course when the cumulated dos e was respectively 1.82 - 1-87 - 3.51 and 3.86 mg/kg. Hypertrophic car diomyopathy resolved completely between 2 and 4 weeks after cessation of the treatment. Conclusion. - The glucocorticoid dosage to prevent B D should be reduced to 0.3 mg/kg/j and the myocardial function should be monitored by reported echocardiograms during the first 15 days of t reatment.