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 venricular 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.