Retrospective Echocardiographic Analysis of West Syndrome During Adrenocorticotropic Hormone Therapy
BackgroundVentricular 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.MethodsThe present, retrospective study analyzed ech...
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| Format: | Article |
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2022.889752/full |
| _version_ | 1818201691824062464 |
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| author | Yoji Ikuta Yoji Ikuta Masaru Miura Tomohide Goto Tomohide Goto Sahoko Miyama |
| author_facet | Yoji Ikuta Yoji Ikuta Masaru Miura Tomohide Goto Tomohide Goto Sahoko Miyama |
| author_sort | Yoji Ikuta |
| collection | DOAJ |
| description | BackgroundVentricular 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.MethodsThe 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.ResultsThe 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.ConclusionIncreased 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. |
| first_indexed | 2024-12-12T02:57:35Z |
| format | Article |
| id | doaj.art-6bbbe95c45634b9888d0db594c87e027 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-12T02:57:35Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-6bbbe95c45634b9888d0db594c87e0272022-12-22T00:40:41ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602022-05-011010.3389/fped.2022.889752889752Retrospective Echocardiographic Analysis of West Syndrome During Adrenocorticotropic Hormone TherapyYoji Ikuta0Yoji Ikuta1Masaru Miura2Tomohide Goto3Tomohide Goto4Sahoko Miyama5Higashi-Koganei Child Neurology and Epilepsy Clinic, Koganei, JapanDepartment of Neurology, Tokyo Metropolitan Children’s Medical Center, Fuchu, JapanDepartment of Cardiology, Tokyo Metropolitan Children’s Medical Center, Fuchu, JapanDepartment of Neurology, Tokyo Metropolitan Children’s Medical Center, Fuchu, JapanDivision of Pediatric Neurology, Kanagawa Children’s Medical Center, Yokohama, JapanDepartment of Neurology, Tokyo Metropolitan Children’s Medical Center, Fuchu, JapanBackgroundVentricular 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.MethodsThe 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.ResultsThe 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.ConclusionIncreased 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.https://www.frontiersin.org/articles/10.3389/fped.2022.889752/fullWest syndrometreatmentACTHechocardiographyventricular hypertrophydiastolic dysfunction |
| spellingShingle | Yoji Ikuta Yoji Ikuta Masaru Miura Tomohide Goto Tomohide Goto Sahoko Miyama Retrospective Echocardiographic Analysis of West Syndrome During Adrenocorticotropic Hormone Therapy Frontiers in Pediatrics West syndrome treatment ACTH echocardiography ventricular hypertrophy diastolic dysfunction |
| 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 | West syndrome treatment ACTH echocardiography ventricular hypertrophy diastolic dysfunction |
| url | https://www.frontiersin.org/articles/10.3389/fped.2022.889752/full |
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