Ba. Israel et al., HYPERTROPHIC CARDIOMYOPATHY ASSOCIATED WITH DEXAMETHASONE THERAPY FORCHRONIC LUNG-DISEASE IN PRETERM INFANTS, American journal of perinatology, 10(4), 1993, pp. 307-310
To assess whether long-term dexamethasone therapy for chronic lung dis
ease (CLD) in infancy is associated with any deleterious cardiac struc
tural effects, we conducted a retrospective review of all preterm infa
nts with CLD born between October 1, 1989, and October 1, 1990, who ha
d serial echocardiographic data available. These infants were divided
into three groups based on the length of their exposure to dexamethaso
ne. Group 1 contained nine infants with CLD who did not receive dexame
thasone. Group 2 was comprised of six infants who received dexamethaso
ne for less than 8 days. Group 3 contained one infant who received a 2
6-day course, and 13 infants who received at least one 42-day course o
f dexamethasone for CLD. Left ventricular hypertrophy was noted in 8 o
f 14 (57%) infants in group 3; hypertrophy usually was noted near the
end of the treatment course. Five of these eight affected infants died
; the hypertrophic cardiomyopathy was considered to have contributed t
o mortality in three of these five infants. Regression of the hypertro
phy was noted in the three surviving infants in group 3 after the dexa
methasone course was completed. We speculate that prolonged dexamethas
one treatment for CLD is associated with hypertrophic cardiomyopathy i
n a significant portion of preterm infants.