The etiology of cardiac hypertrophy in infants
Abstract This study aimed to describe the variety of etiologies currently identified in infants with cardiac hypertrophy (CH) and investigate whether there is a relation with hyperinsulinism, echocardiographic characteristics and prognosis. This retrospective cohort study included infants born betwe...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2021-05-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-021-90128-3 |
| _version_ | 1818851055930179584 |
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| author | Raymond Stegeman Nina D. Paauw Rosalie de Graaf Rosa L. E. van Loon Jacqueline U. M. Termote Johannes M. P. J. Breur |
| author_facet | Raymond Stegeman Nina D. Paauw Rosalie de Graaf Rosa L. E. van Loon Jacqueline U. M. Termote Johannes M. P. J. Breur |
| author_sort | Raymond Stegeman |
| collection | DOAJ |
| description | Abstract This study aimed to describe the variety of etiologies currently identified in infants with cardiac hypertrophy (CH) and investigate whether there is a relation with hyperinsulinism, echocardiographic characteristics and prognosis. This retrospective cohort study included infants born between 2005 and 2018 with CH measured by echocardiography [interventricular septum (IVS) and/or left ventricular posterior wall (LVPW) thickness with Z-score ≥ 2.0]. Children with congenital heart disease or hypertension were excluded. Underlying diagnosis, echocardiographic and follow-up data were extracted from patient files. Seventy-one infants with CH were included. An underlying cause of CH was identified in two-thirds (n = 47). Most common etiologies of CH were malformation syndromes (n = 23, including Noonan n = 12) and maternal diabetes mellitus (n = 13). Less common causes were congenital hyperinsulinism (n = 3), metabolic- (n = 5), sarcomeric- (n = 2) and neuromuscular disease (n = 1). In half of the identified causes (n = 22) an association with hyperinsulinism was described, including maternal diabetes mellitus (n = 13), malformation syndromes with insulin resistance (n = 6) and congenital hyperinsulinism (n = 3). CH associated with hyperinsulinism was echocardiographically characterized by lower LVPW thickness, higher IVS:LVPW ratio and more frequent sole involvement of the IVS (all, p ≤ 0.02). CH associated with hyperinsulinism normalized more often (41 vs. 0%) with lower mortality rates (14 vs. 44%) compared to CH not associated with hyperinsulinism (all, p ≤ 0.03). Nowadays, an etiology of CH can be identified in the majority of infants. The development of CH is often associated with hyperinsulinism which is mainly characterized by focal hypertrophy of the IVS on echocardiography. Prognosis depends on the underlying cause and is more favorable in CH associated with hyperinsulinism. |
| first_indexed | 2024-12-19T06:58:57Z |
| format | Article |
| id | doaj.art-8a59adf57ea541cf85c61b74b3c51427 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-19T06:58:57Z |
| publishDate | 2021-05-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-8a59adf57ea541cf85c61b74b3c514272022-12-21T20:31:27ZengNature PortfolioScientific Reports2045-23222021-05-011111910.1038/s41598-021-90128-3The etiology of cardiac hypertrophy in infantsRaymond Stegeman0Nina D. Paauw1Rosalie de Graaf2Rosa L. E. van Loon3Jacqueline U. M. Termote4Johannes M. P. J. Breur5Department of Pediatric Cardiology, Wilhelmina Children’s Hospital, University Medical Center UtrechtDepartment of Pediatric Cardiology, Wilhelmina Children’s Hospital, University Medical Center UtrechtDepartment of Pediatric Cardiology, Wilhelmina Children’s Hospital, University Medical Center UtrechtDepartment of Genetics, University Medical Center UtrechtDepartment of Neonatology, Wilhelmina Children’s Hospital, University Medical Center UtrechtDepartment of Pediatric Cardiology, Wilhelmina Children’s Hospital, University Medical Center UtrechtAbstract This study aimed to describe the variety of etiologies currently identified in infants with cardiac hypertrophy (CH) and investigate whether there is a relation with hyperinsulinism, echocardiographic characteristics and prognosis. This retrospective cohort study included infants born between 2005 and 2018 with CH measured by echocardiography [interventricular septum (IVS) and/or left ventricular posterior wall (LVPW) thickness with Z-score ≥ 2.0]. Children with congenital heart disease or hypertension were excluded. Underlying diagnosis, echocardiographic and follow-up data were extracted from patient files. Seventy-one infants with CH were included. An underlying cause of CH was identified in two-thirds (n = 47). Most common etiologies of CH were malformation syndromes (n = 23, including Noonan n = 12) and maternal diabetes mellitus (n = 13). Less common causes were congenital hyperinsulinism (n = 3), metabolic- (n = 5), sarcomeric- (n = 2) and neuromuscular disease (n = 1). In half of the identified causes (n = 22) an association with hyperinsulinism was described, including maternal diabetes mellitus (n = 13), malformation syndromes with insulin resistance (n = 6) and congenital hyperinsulinism (n = 3). CH associated with hyperinsulinism was echocardiographically characterized by lower LVPW thickness, higher IVS:LVPW ratio and more frequent sole involvement of the IVS (all, p ≤ 0.02). CH associated with hyperinsulinism normalized more often (41 vs. 0%) with lower mortality rates (14 vs. 44%) compared to CH not associated with hyperinsulinism (all, p ≤ 0.03). Nowadays, an etiology of CH can be identified in the majority of infants. The development of CH is often associated with hyperinsulinism which is mainly characterized by focal hypertrophy of the IVS on echocardiography. Prognosis depends on the underlying cause and is more favorable in CH associated with hyperinsulinism.https://doi.org/10.1038/s41598-021-90128-3 |
| spellingShingle | Raymond Stegeman Nina D. Paauw Rosalie de Graaf Rosa L. E. van Loon Jacqueline U. M. Termote Johannes M. P. J. Breur The etiology of cardiac hypertrophy in infants Scientific Reports |
| title | The etiology of cardiac hypertrophy in infants |
| title_full | The etiology of cardiac hypertrophy in infants |
| title_fullStr | The etiology of cardiac hypertrophy in infants |
| title_full_unstemmed | The etiology of cardiac hypertrophy in infants |
| title_short | The etiology of cardiac hypertrophy in infants |
| title_sort | etiology of cardiac hypertrophy in infants |
| url | https://doi.org/10.1038/s41598-021-90128-3 |
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