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.

中文翻译：

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极早产儿心脏肥大与胰岛素治疗相关

背景

在新生儿期，心脏肥大 (CH) 通常与高胰岛素血症病理相关，最近报道了首例接受胰岛素输注治疗的极早产儿出现 CH 病例。为了证实这种关联，我们报告了胰岛素治疗后发生 CH 的患者的一系列病例。

方法

研究对象为2017年11月至2022年6月出生的胎龄<30周、出生体重<1500g的婴儿是否出现需要胰岛素治疗的高血糖且超声心动图诊断为CH。

结果

我们研究了 10 名极度早产儿（24.3 ± 1.4 周），他们在出生后平均年龄为 124 ± 37 小时（即开始胰岛素治疗后 98 ± 24 小时）发生 CH。所有幸存患者出院时 CH 均得到缓解，而四分之三 (75%) 的死亡患者患有持续性 CH。

结论

我们的病例系列支持极早产儿发生 CH 与胰岛素治疗之间的关联，并建议在使用胰岛素治疗这些脆弱患者时应进一步谨慎并需要进行超声心动图监测。