HYPERTROPHIC CARDIOMYOPATHY ASSOCIATED WITH DEXAMETHASONE THERAPY FORCHRONIC LUNG-DISEASE IN PRETERM INFANTS

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.