Dexamethasone given to premature infants and cardiac diastolic function in early childhood.

Abstract

OBJECTIVES:

To determine if dexamethasone given to premature infants with bronchopulmonary dysplasia would result in cardiac diastolic dysfunction in early childhood, a topic unstudied in humans.

STUDY DESIGN:

We compared seven children ages 3 to 8 years born at 26 weeks' gestation and given dexamethasone for bronchopulmonary dysplasia with eight gestation-matched and age-matched control children using echocardiography to assess measures of systolic and diastolic function. All dexamethasone patients had resolved hypertrophic cardiomyopathy.

RESULTS:

Dexamethasone patients had the same normal τ and isovolumic relaxation time (24.9 ± 2.8 and 54.6 ± 6.3 ms) as control patients (22.1 ± 3.0 and 48.8 ± 6.7 ms). Peak A velocities were the same in dexamethasone patients as in control patients (59.5 ± 15 versus 49.4 ± 5.8 cm/s, P = .10), resulting in unchanged E:A ratios (1.89 ± 0.57 versus 2.15 ± 0.43, P = .22). Peak E velocity and E-wave deceleration times were not different. We found no significant differences in measures of systolic function (heart rate-corrected velocity of circumferential fiber shortening, wall stress, and ejection fraction). Left ventricular mass was the same between the groups confirming resolution of hypertrophic cardiomyopathy.

CONCLUSIONS:

These data are consistent with normal myocardial relaxation, suggesting that long-term diastolic function is reassuringly normal in children who received dexamethasone as premature infants with resolution of hypertrophic cardiomyopathy.

• Authors: Ivan H-B Wong, Alyson M Digby, Andrew E Warren, Dion Pepelassis, Michael Vincer, Robert P-C Chen
• Journal: The Journal of pediatrics (J Pediatr) Vol. 159 Issue 2 Pg. 227-31 (Aug 2011) ISSN: 1097-6833 [Electronic] United States
• PMID: 21397911 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2011 Mosby, Inc. All rights reserved.

Chemical References

• Glucocorticoids
• Dexamethasone

Topics

• Bronchopulmonary Dysplasia (complications, drug therapy)
• Cardiomyopathy, Hypertrophic (drug therapy, etiology, physiopathology)
• Child
• Child, Preschool
• Dexamethasone (administration & dosage)
• Diastole
• Female
• Follow-Up Studies
• Glucocorticoids (administration & dosage)
• Humans
• Infant
• Infant, Newborn
• Infant, Premature
• Infant, Premature, Diseases (drug therapy)
• Intensive Care Units, Neonatal
• Male
• Myocardial Contraction (drug effects)
• Recovery of Function
• Retrospective Studies
• Time Factors
• Treatment Outcome
• Ventricular Function (drug effects, physiology)