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- Title
The association of cardiac ventricular hypertrophy with congenital hyperinsulinism.
- Authors
Banerjee, Indraneel; Avatapalle, Bindu; Petkar, Anjali; Skae, Mars; Padidela, Raja; Ehtisham, Sarah; Patel, Leena; Rigby, Lindsey; Flanagan, Sarah; Ellard, Sian; Jones, Caroline; Ciotti, Giovanna; Malaiya, Nilima; Clayton, Peter E.
- Abstract
Objective: Ventricular hypertrophy (VH) has been observed in children with congenital hyperinsulinism (CHI), a condition of hypoglycaemia characterised by dysregulated insulin secretion, but the prevalence is not known. Patients and methods: Cardiac assessment was performed in children (nZ49) with CHI at diagnosis and follow-up. Two dimensional and Doppler echocardiography studies were used to assess cardiac structures, while M-mode study was used to measure left ventricular (LV) dimensions, subsequently converted to Z scores. Where possible, LV hypertrophy was confirmed by LV mass index (g/m2.7) >95th centile. Results: Cardiac structural lesions were found in 14 (28%) children. At initial echocardiography, VH was present in 31 (65%) children with median (range) LV posterior wall dimension in diastole Z scores of +1.6 (-2.4 to +5.8) and interventricular septal wall dimension in end diastole Z scores of C1.9 (-1.7 to +17.2). At follow-up echocardiography, performed after an interval of 178 (45-390) days, VH persisted in 16 (33%) children. In regression analysis, the presence of VH (odds ratio (95% confidence intervals) 1.1 (1.0-1.2), P=0.04) at initial echocardiography was correlated with maximum glucose requirement at diagnosis, indicating that severity of CHI at presentation may play a role in the pathogenesis of VH. Conclusions: A significant proportion of children with CHI have cardiac structural lesions. A majority also have VH, which may be associated with the severity of CHI at diagnosis. VH may persist in some children, which requires careful long-term cardiac review.
- Subjects
ECHOCARDIOGRAPHY; INSULIN shock; PANCREATIC secretions; HYPOGLYCEMIC agents; BIOLOGICAL transport
- Publication
European Journal of Endocrinology, 2012, Vol 167, Issue 5, p619
- ISSN
0804-4643
- Publication type
Article
- DOI
10.1530/EJE-12-0632