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Case Reports
. 2023 Jul;25(4):453-457.
doi: 10.1007/s40272-023-00571-0. Epub 2023 May 19.

Cardiac Hypertrophy Associated with Insulin Therapy in Extremely Preterm Infants

Carlo Dani  1   2 , Michele Luzzati  3 , Iuri Corsini  3 , Chiara Poggi  3 , Venturella Vangi  3 , Caterina Coviello  3 , Simone Pratesi  3
Affiliations
Case Reports

Cardiac Hypertrophy Associated with Insulin Therapy in Extremely Preterm Infants

Carlo Dani et al. Paediatr Drugs. 2023 Jul.

Abstract

Background: In the neonatal period, cardiac hypertrophy (CH) has been commonly associated with hyperinsulinemic pathologies, and the first case of CH in an extremely preterm infant treated with insulin infusion has recently been reported. To confirm this association, we report a case series of patients who developed CH after insulin therapy.

Methods: Infants with gestational age < 30 weeks and birth weight < 1500 g, born from November 2017 to June 2022, were studied if they developed hyperglycemia requiring treatment with insulin and had echocardiographic diagnosis of CH.

Results: We studied 10 extremely preterm infants (24.3 ± 1.4 weeks) who developed CH at a mean age of 124 ± 37 h of life, 98 ± 24 h after the initiation of insulin therapy. All surviving patients had resolution of CH at discharge, while three of four (75%) of the deceased patients had persistent CH.

Conclusions: Our case series supports the association between the development of CH and insulin therapy in extremely preterm infants and suggests further caution and the need for echocardiographic monitoring when treating these fragile patients with insulin.

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Conflict of interest statement

CD received honoraria from Chiesi Farmaceutici Spa and Vyaire Medical Inc. for scientific consultancy. Michele Luzzati, Iuri Corsini, Chiara Poggi, Venturella Vangi, Caterina Coviello, Simone Pratesi declare that they have no competing interests.

References

    1. Paauw ND, Stegeman R, de Vroede MAMJ, et al. Neonatal cardiac hypertrophy: the role of hyperinsulinism—a review of literature. Eur J Pediatr. 2020;179:39–50. doi: 10.1007/s00431-019-03521-6. - DOI - PMC - PubMed
    1. Huang T, Kelly A, Becker SA, et al. Hypertrophic cardiomyopathy in neonates with congenital hyperinsulinism. Arch Dis Child Fetal Neonatal Ed. 2013;98:F351–F354. doi: 10.1136/archdischild-2012-302546. - DOI - PMC - PubMed
    1. Maron BJ, Roberts WC. Quantitative analysis of cardiac muscle cell disorganization in the ventricular septum of patients with hypertrophic cardiomyopathy. Circulation. 1979;59:689–706. doi: 10.1161/01.CIR.59.4.689. - DOI - PubMed
    1. Sutton MGSJ, Lie JT, Anderson KR, et al. Histopathological specificity of hypertrophic obstructive cardiomyopathy. Myocardial fibre disarray and myocardial fibrosis. Br Heart J. 1980;44:433–443. doi: 10.1136/hrt.44.4.433. - DOI - PMC - PubMed
    1. Shirani J, Pick R, Roberts WC, Maron BJ. Morphology and significance of the left ventricular collagen network in young patients with hypertrophic cardiomyopathy and sudden cardiac death. J Am Coll Cardiol. 2000;35:36–44. doi: 10.1016/S0735-1097(99)00492-1. - DOI - PubMed

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