The association of cardiac ventricular hypertrophy with congenital hyperinsulinism

Research output: Contribution to journalArticle

  • External authors:
  • Indraneel Banerjee
  • Bindu Avatapalle
  • Anjali Petkar
  • Mars Skae
  • Raja Padidela
  • Sarah Ehtisham
  • Leena Patel
  • Lindsey Rigby
  • Sarah Flanagan
  • Sian Ellard
  • Caroline Jones
  • Giovanna Ciotti
  • Nilima Malaiya

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 (n=49) 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 +1.9 (-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. © 2012 European Society of Endocrinology.

Bibliographical metadata

Original languageEnglish
Pages (from-to)619-624
Number of pages5
JournalEuropean Journal of Endocrinology
Volume167
Issue number5
DOIs
Publication statusPublished - Nov 2012