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Retrospective Echocardiographic Analysis of West Syndrome During Adrenocorticotropic Hormone Therapy

BACKGROUND: Ventricular hypertrophy is a well-known side effect of adrenocorticotropic hormone (ACTH) therapy in patients with West syndrome (WS), but there are only a few reports of echocardiographic evaluation of these patients’ diastolic function. METHODS: The present, retrospective study analyze...

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Autores principales: Ikuta, Yoji, Miura, Masaru, Goto, Tomohide, Miyama, Sahoko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9127381/
https://www.ncbi.nlm.nih.gov/pubmed/35620145
http://dx.doi.org/10.3389/fped.2022.889752
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author Ikuta, Yoji
Miura, Masaru
Goto, Tomohide
Miyama, Sahoko
author_facet Ikuta, Yoji
Miura, Masaru
Goto, Tomohide
Miyama, Sahoko
author_sort Ikuta, Yoji
collection PubMed
description BACKGROUND: Ventricular hypertrophy is a well-known side effect of adrenocorticotropic hormone (ACTH) therapy in patients with West syndrome (WS), but there are only a few reports of echocardiographic evaluation of these patients’ diastolic function. METHODS: The present, retrospective study analyzed echocardiographic findings in 24 patients with WS treated with ACTH therapy between April 2010 and December 2014. The therapy protocol involved administering tetracosactide acetate 0.01–0.0125 mg/kg via intramuscular injection once a day for weeks 1–2, then gradually tapering off. Echocardiographic evaluation was done before treatment initiation and at weeks 1, 2, and 4 after the initiation of treatment. RESULTS: The systolic and diastolic blood pressure values were elevated at week 1 after commencement of the therapy and remained elevated throughout its duration. Both the interventricular septal end-diastolic thickness and left ventricular posterior wall end-diastolic diameter increased in thickness at week 1 and remained thickened. None of the patients experienced heart failure or systolic dysfunction. Early diastolic mitral flow velocity (E)/early diastolic mitral annular velocity (E′) increased at week 1 and remained high at weeks 2 and 4. The E wave deceleration time (DcT) was prolonged at week 2 and returned to the baseline at week 4. CONCLUSION: Increased ventricular wall thickness, decreased diastolic capacity, and elevated BP were noted in children with WS during ACTH therapy. Cardiac function, including ventricular wall thickness and diastolic function, should be monitored during ACTH therapy. E/E′ and DcT are useful in evaluating diastolic function.
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spelling pubmed-91273812022-05-25 Retrospective Echocardiographic Analysis of West Syndrome During Adrenocorticotropic Hormone Therapy Ikuta, Yoji Miura, Masaru Goto, Tomohide Miyama, Sahoko Front Pediatr Pediatrics BACKGROUND: Ventricular hypertrophy is a well-known side effect of adrenocorticotropic hormone (ACTH) therapy in patients with West syndrome (WS), but there are only a few reports of echocardiographic evaluation of these patients’ diastolic function. METHODS: The present, retrospective study analyzed echocardiographic findings in 24 patients with WS treated with ACTH therapy between April 2010 and December 2014. The therapy protocol involved administering tetracosactide acetate 0.01–0.0125 mg/kg via intramuscular injection once a day for weeks 1–2, then gradually tapering off. Echocardiographic evaluation was done before treatment initiation and at weeks 1, 2, and 4 after the initiation of treatment. RESULTS: The systolic and diastolic blood pressure values were elevated at week 1 after commencement of the therapy and remained elevated throughout its duration. Both the interventricular septal end-diastolic thickness and left ventricular posterior wall end-diastolic diameter increased in thickness at week 1 and remained thickened. None of the patients experienced heart failure or systolic dysfunction. Early diastolic mitral flow velocity (E)/early diastolic mitral annular velocity (E′) increased at week 1 and remained high at weeks 2 and 4. The E wave deceleration time (DcT) was prolonged at week 2 and returned to the baseline at week 4. CONCLUSION: Increased ventricular wall thickness, decreased diastolic capacity, and elevated BP were noted in children with WS during ACTH therapy. Cardiac function, including ventricular wall thickness and diastolic function, should be monitored during ACTH therapy. E/E′ and DcT are useful in evaluating diastolic function. Frontiers Media S.A. 2022-05-10 /pmc/articles/PMC9127381/ /pubmed/35620145 http://dx.doi.org/10.3389/fped.2022.889752 Text en Copyright © 2022 Ikuta, Miura, Goto and Miyama. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Ikuta, Yoji
Miura, Masaru
Goto, Tomohide
Miyama, Sahoko
Retrospective Echocardiographic Analysis of West Syndrome During Adrenocorticotropic Hormone Therapy
title Retrospective Echocardiographic Analysis of West Syndrome During Adrenocorticotropic Hormone Therapy
title_full Retrospective Echocardiographic Analysis of West Syndrome During Adrenocorticotropic Hormone Therapy
title_fullStr Retrospective Echocardiographic Analysis of West Syndrome During Adrenocorticotropic Hormone Therapy
title_full_unstemmed Retrospective Echocardiographic Analysis of West Syndrome During Adrenocorticotropic Hormone Therapy
title_short Retrospective Echocardiographic Analysis of West Syndrome During Adrenocorticotropic Hormone Therapy
title_sort retrospective echocardiographic analysis of west syndrome during adrenocorticotropic hormone therapy
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9127381/
https://www.ncbi.nlm.nih.gov/pubmed/35620145
http://dx.doi.org/10.3389/fped.2022.889752
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