The impact of methylphenidate treatment on the functional and structural properties of the left ventricle: A medium-term prospective study
Although methylphenidate (MPH) used for treatment of attention deficit hyperactivity disorder (ADHD) are considered safe in healthy children and adolescents in the short and medium term, there is a widespread concern about long-term cardiovascular safety. Interventional, prospective, longitudinal an...
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| Veröffentlicht in: | Anales de Pediatría 2022-01, Vol.96 (1), p.43-50 |
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| description | Although methylphenidate (MPH) used for treatment of attention deficit hyperactivity disorder (ADHD) are considered safe in healthy children and adolescents in the short and medium term, there is a widespread concern about long-term cardiovascular safety.
Interventional, prospective, longitudinal and comparative study with a crossover design to evaluate the cardiovascular impact of the treatment with MPH in healthy children and adolescents diagnosed with ADHD. A protocol for the cardiovascular evaluation was established at a basal point, after the first and the second year of the beginning with treatment based on the monitoring of blood pressure (BP) and echocardiographic follow-up of the systolic and diastolic functions, and structural cardiac properties.
73 patients completed the study, with an average age of 9 ± 2.6 years, 75.3% were male and the majority were thin (64.4%). We found an increase in Systolic and Diastolic BP of 3.7 ± 9 mmHg (P = 0.004) and 2 ± 11,5 mmHg respectively. There were no severe cardiovascular events. We didn’t find any echocardiographic alterations namely on the structural properties or parameters of systolic function. Regarding diastolic function, a significant increase in the isovo-lumic relaxation time (IVRT) (P = 0.046) and deceleration time (P = 0.016) was observed. However, no significant alterations in the parameters related to distensibility of the LV neither in the early diastolic pressure were found.
Further studies are needed to evaluate the impact of psychostimulants as a modifiable long-term Cardiovascular Risk Factor.
El metilfenidato (MTF) es un psicoestimulante que aumenta frecuencia cardiaca (FC) y presión arterial (PA), lo cual a largo plazo podría modificar la geometría del ventrículo izquierdo (VI) y alterar sus propiedades funcionales, principalmente la diastólica.
Estudio prospectivo, longitudinal y comparativo tipo caso-caso en niños y adolescentes sanos diagnosticados de trastorno por déficit de atención e hiperactividad (TDAH) tratados con MTF durante 3 años. Se valoró pre y postratamiento PAS/PAD, geometría ventricular, función sistólica y diastólica.
Incluimos a 112 pacientes, completando 73. El 75,3% varones, entre 4–15 años (9 ± 2,6), con índice de masa corporal de 18,27 ± 3,75 y una dosis media de MTF de 0,9 ± 0,17 mg/kg/día. Objetivamos aumento de PAS/PAD de 3,7 ± 9 mmHg (p = 0,004) y 2 ± 11,5 mmHg, respectivamente. No tuvimos ningún evento cardiovascular grave, cambios estructurales ni variación e |
| doi_str_mv | 10.1016/j.anpede.2020.12.017 |
| format | Article |
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Interventional, prospective, longitudinal and comparative study with a crossover design to evaluate the cardiovascular impact of the treatment with MPH in healthy children and adolescents diagnosed with ADHD. A protocol for the cardiovascular evaluation was established at a basal point, after the first and the second year of the beginning with treatment based on the monitoring of blood pressure (BP) and echocardiographic follow-up of the systolic and diastolic functions, and structural cardiac properties.
73 patients completed the study, with an average age of 9 ± 2.6 years, 75.3% were male and the majority were thin (64.4%). We found an increase in Systolic and Diastolic BP of 3.7 ± 9 mmHg (P = 0.004) and 2 ± 11,5 mmHg respectively. There were no severe cardiovascular events. We didn’t find any echocardiographic alterations namely on the structural properties or parameters of systolic function. Regarding diastolic function, a significant increase in the isovo-lumic relaxation time (IVRT) (P = 0.046) and deceleration time (P = 0.016) was observed. However, no significant alterations in the parameters related to distensibility of the LV neither in the early diastolic pressure were found.
Further studies are needed to evaluate the impact of psychostimulants as a modifiable long-term Cardiovascular Risk Factor.
El metilfenidato (MTF) es un psicoestimulante que aumenta frecuencia cardiaca (FC) y presión arterial (PA), lo cual a largo plazo podría modificar la geometría del ventrículo izquierdo (VI) y alterar sus propiedades funcionales, principalmente la diastólica.
Estudio prospectivo, longitudinal y comparativo tipo caso-caso en niños y adolescentes sanos diagnosticados de trastorno por déficit de atención e hiperactividad (TDAH) tratados con MTF durante 3 años. Se valoró pre y postratamiento PAS/PAD, geometría ventricular, función sistólica y diastólica.
Incluimos a 112 pacientes, completando 73. El 75,3% varones, entre 4–15 años (9 ± 2,6), con índice de masa corporal de 18,27 ± 3,75 y una dosis media de MTF de 0,9 ± 0,17 mg/kg/día. Objetivamos aumento de PAS/PAD de 3,7 ± 9 mmHg (p = 0,004) y 2 ± 11,5 mmHg, respectivamente. No tuvimos ningún evento cardiovascular grave, cambios estructurales ni variación en los parámetros de función sistólica estudiados. Sin embargo,encontramos un aumento discreto, pero progresivo y significativo del tiempo de relajación isovolumétrica del VI (p = 0,046) y del tiempo de desaceleración (p = 0,016) indicativos dealteración en la relajación. No observamos variación en los parámetros relacionados con la distensibilidad ni con las presiones diastólicas tempranas y ningún paciente cumplió criterios de disfunción diastólica.
El incremento de PAS/PAD y las alteraciones de la relajación del VI objetivadas podrían ser un indicador precoz de una posible disfunción diastólica y riesgo cardiovascular a largo plazo.</description><identifier>ISSN: 2341-2879</identifier><identifier>EISSN: 2341-2879</identifier><identifier>DOI: 10.1016/j.anpede.2020.12.017</identifier><identifier>PMID: 34937681</identifier><language>eng</language><publisher>Netherlands: Elsevier España, S.L.U</publisher><subject>Adolescent ; Attention Deficit Disorder with Hyperactivity - drug therapy ; Attention-deficit hyperactivity disorder ; Cardiovascular adverse effects ; Cardiovascular safety ; Central Nervous System Stimulants - adverse effects ; Child ; Deficit de atención e hiperactividad ; Diastolic function ; Efectos adversos cardiovasculares ; Female ; Función diastólica ; Heart Ventricles - diagnostic imaging ; Humans ; Lisdexanfetamina ; Lisdexanfetamine ; Male ; Methylphenidate ; Methylphenidate - adverse effects ; Metilfenidato ; Prospective Studies ; Psicoestimulantes ; Seguridad cardiovascular ; Stimulant medications</subject><ispartof>Anales de Pediatría, 2022-01, Vol.96 (1), p.43-50</ispartof><rights>2021</rights><rights>Copyright © 2021. Published by Elsevier España, S.L.U.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2027-73d52fcb17e7d144b779345cfadb3693adc9a8eaf9d5644846179b2d638e39d23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,864,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34937681$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>García Ron, Adrián</creatorcontrib><creatorcontrib>Rodriguez Mesa, María</creatorcontrib><creatorcontrib>Arias Vivas, Eva</creatorcontrib><creatorcontrib>Bote Gascon, Marta</creatorcontrib><title>The impact of methylphenidate treatment on the functional and structural properties of the left ventricle: A medium-term prospective study</title><title>Anales de Pediatría</title><addtitle>An Pediatr (Engl Ed)</addtitle><description>Although methylphenidate (MPH) used for treatment of attention deficit hyperactivity disorder (ADHD) are considered safe in healthy children and adolescents in the short and medium term, there is a widespread concern about long-term cardiovascular safety.
Interventional, prospective, longitudinal and comparative study with a crossover design to evaluate the cardiovascular impact of the treatment with MPH in healthy children and adolescents diagnosed with ADHD. A protocol for the cardiovascular evaluation was established at a basal point, after the first and the second year of the beginning with treatment based on the monitoring of blood pressure (BP) and echocardiographic follow-up of the systolic and diastolic functions, and structural cardiac properties.
73 patients completed the study, with an average age of 9 ± 2.6 years, 75.3% were male and the majority were thin (64.4%). We found an increase in Systolic and Diastolic BP of 3.7 ± 9 mmHg (P = 0.004) and 2 ± 11,5 mmHg respectively. There were no severe cardiovascular events. We didn’t find any echocardiographic alterations namely on the structural properties or parameters of systolic function. Regarding diastolic function, a significant increase in the isovo-lumic relaxation time (IVRT) (P = 0.046) and deceleration time (P = 0.016) was observed. However, no significant alterations in the parameters related to distensibility of the LV neither in the early diastolic pressure were found.
Further studies are needed to evaluate the impact of psychostimulants as a modifiable long-term Cardiovascular Risk Factor.
El metilfenidato (MTF) es un psicoestimulante que aumenta frecuencia cardiaca (FC) y presión arterial (PA), lo cual a largo plazo podría modificar la geometría del ventrículo izquierdo (VI) y alterar sus propiedades funcionales, principalmente la diastólica.
Estudio prospectivo, longitudinal y comparativo tipo caso-caso en niños y adolescentes sanos diagnosticados de trastorno por déficit de atención e hiperactividad (TDAH) tratados con MTF durante 3 años. Se valoró pre y postratamiento PAS/PAD, geometría ventricular, función sistólica y diastólica.
Incluimos a 112 pacientes, completando 73. El 75,3% varones, entre 4–15 años (9 ± 2,6), con índice de masa corporal de 18,27 ± 3,75 y una dosis media de MTF de 0,9 ± 0,17 mg/kg/día. Objetivamos aumento de PAS/PAD de 3,7 ± 9 mmHg (p = 0,004) y 2 ± 11,5 mmHg, respectivamente. No tuvimos ningún evento cardiovascular grave, cambios estructurales ni variación en los parámetros de función sistólica estudiados. Sin embargo,encontramos un aumento discreto, pero progresivo y significativo del tiempo de relajación isovolumétrica del VI (p = 0,046) y del tiempo de desaceleración (p = 0,016) indicativos dealteración en la relajación. No observamos variación en los parámetros relacionados con la distensibilidad ni con las presiones diastólicas tempranas y ningún paciente cumplió criterios de disfunción diastólica.
El incremento de PAS/PAD y las alteraciones de la relajación del VI objetivadas podrían ser un indicador precoz de una posible disfunción diastólica y riesgo cardiovascular a largo plazo.</description><subject>Adolescent</subject><subject>Attention Deficit Disorder with Hyperactivity - drug therapy</subject><subject>Attention-deficit hyperactivity disorder</subject><subject>Cardiovascular adverse effects</subject><subject>Cardiovascular safety</subject><subject>Central Nervous System Stimulants - adverse effects</subject><subject>Child</subject><subject>Deficit de atención e hiperactividad</subject><subject>Diastolic function</subject><subject>Efectos adversos cardiovasculares</subject><subject>Female</subject><subject>Función diastólica</subject><subject>Heart Ventricles - diagnostic imaging</subject><subject>Humans</subject><subject>Lisdexanfetamina</subject><subject>Lisdexanfetamine</subject><subject>Male</subject><subject>Methylphenidate</subject><subject>Methylphenidate - adverse effects</subject><subject>Metilfenidato</subject><subject>Prospective Studies</subject><subject>Psicoestimulantes</subject><subject>Seguridad cardiovascular</subject><subject>Stimulant medications</subject><issn>2341-2879</issn><issn>2341-2879</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kctq3DAUhkVpaUKaNyhFy2481W0sq4tCCOkFAt2kayFLx4wGW3YleWBeoU_dYyYtXXUl6eg7_7n8hLzlbMcZbz8cdy4tEGAnmMCQ2DGuX5BrIRVvRKfNy3_uV-S2lCNjTEgu96p9Ta6kMlK3Hb8mv54OQOO0OF_pPNAJ6uE8LgdIMbgKtGZwdYKEn4lWRIc1-Rrn5EbqUqCl5tXXNeNzyfMCuUYom9DGjjBUesLkHP0IH-kdyoe4Tk2FPG18WQDFToAyazi_Ia8GNxa4fT5vyI_PD0_3X5vH71--3d89Nh6H1Y2WYS8G33MNOnCleq2NVHs_uNDL1kgXvHEduMGEfatUp1quTS9CKzuQJgh5Q95fdLGDnyuUaqdYPIyjSzCvxYqWS2GYFBxRdUE9NlsyDHbJcXL5bDmzmxH2aC9G2M0Iy4VFIzDt3XOFtceR_yb9WTsCny4A4JynCNkWHyF5XE_Gldgwx_9X-A2x0p39</recordid><startdate>202201</startdate><enddate>202201</enddate><creator>García Ron, Adrián</creator><creator>Rodriguez Mesa, María</creator><creator>Arias Vivas, Eva</creator><creator>Bote Gascon, Marta</creator><general>Elsevier España, S.L.U</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202201</creationdate><title>The impact of methylphenidate treatment on the functional and structural properties of the left ventricle: A medium-term prospective study</title><author>García Ron, Adrián ; Rodriguez Mesa, María ; Arias Vivas, Eva ; Bote Gascon, Marta</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2027-73d52fcb17e7d144b779345cfadb3693adc9a8eaf9d5644846179b2d638e39d23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adolescent</topic><topic>Attention Deficit Disorder with Hyperactivity - drug therapy</topic><topic>Attention-deficit hyperactivity disorder</topic><topic>Cardiovascular adverse effects</topic><topic>Cardiovascular safety</topic><topic>Central Nervous System Stimulants - adverse effects</topic><topic>Child</topic><topic>Deficit de atención e hiperactividad</topic><topic>Diastolic function</topic><topic>Efectos adversos cardiovasculares</topic><topic>Female</topic><topic>Función diastólica</topic><topic>Heart Ventricles - diagnostic imaging</topic><topic>Humans</topic><topic>Lisdexanfetamina</topic><topic>Lisdexanfetamine</topic><topic>Male</topic><topic>Methylphenidate</topic><topic>Methylphenidate - adverse effects</topic><topic>Metilfenidato</topic><topic>Prospective Studies</topic><topic>Psicoestimulantes</topic><topic>Seguridad cardiovascular</topic><topic>Stimulant medications</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>García Ron, Adrián</creatorcontrib><creatorcontrib>Rodriguez Mesa, María</creatorcontrib><creatorcontrib>Arias Vivas, Eva</creatorcontrib><creatorcontrib>Bote Gascon, Marta</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Anales de Pediatría</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>García Ron, Adrián</au><au>Rodriguez Mesa, María</au><au>Arias Vivas, Eva</au><au>Bote Gascon, Marta</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The impact of methylphenidate treatment on the functional and structural properties of the left ventricle: A medium-term prospective study</atitle><jtitle>Anales de Pediatría</jtitle><addtitle>An Pediatr (Engl Ed)</addtitle><date>2022-01</date><risdate>2022</risdate><volume>96</volume><issue>1</issue><spage>43</spage><epage>50</epage><pages>43-50</pages><issn>2341-2879</issn><eissn>2341-2879</eissn><abstract>Although methylphenidate (MPH) used for treatment of attention deficit hyperactivity disorder (ADHD) are considered safe in healthy children and adolescents in the short and medium term, there is a widespread concern about long-term cardiovascular safety.
Interventional, prospective, longitudinal and comparative study with a crossover design to evaluate the cardiovascular impact of the treatment with MPH in healthy children and adolescents diagnosed with ADHD. A protocol for the cardiovascular evaluation was established at a basal point, after the first and the second year of the beginning with treatment based on the monitoring of blood pressure (BP) and echocardiographic follow-up of the systolic and diastolic functions, and structural cardiac properties.
73 patients completed the study, with an average age of 9 ± 2.6 years, 75.3% were male and the majority were thin (64.4%). We found an increase in Systolic and Diastolic BP of 3.7 ± 9 mmHg (P = 0.004) and 2 ± 11,5 mmHg respectively. There were no severe cardiovascular events. We didn’t find any echocardiographic alterations namely on the structural properties or parameters of systolic function. Regarding diastolic function, a significant increase in the isovo-lumic relaxation time (IVRT) (P = 0.046) and deceleration time (P = 0.016) was observed. However, no significant alterations in the parameters related to distensibility of the LV neither in the early diastolic pressure were found.
Further studies are needed to evaluate the impact of psychostimulants as a modifiable long-term Cardiovascular Risk Factor.
El metilfenidato (MTF) es un psicoestimulante que aumenta frecuencia cardiaca (FC) y presión arterial (PA), lo cual a largo plazo podría modificar la geometría del ventrículo izquierdo (VI) y alterar sus propiedades funcionales, principalmente la diastólica.
Estudio prospectivo, longitudinal y comparativo tipo caso-caso en niños y adolescentes sanos diagnosticados de trastorno por déficit de atención e hiperactividad (TDAH) tratados con MTF durante 3 años. Se valoró pre y postratamiento PAS/PAD, geometría ventricular, función sistólica y diastólica.
Incluimos a 112 pacientes, completando 73. El 75,3% varones, entre 4–15 años (9 ± 2,6), con índice de masa corporal de 18,27 ± 3,75 y una dosis media de MTF de 0,9 ± 0,17 mg/kg/día. Objetivamos aumento de PAS/PAD de 3,7 ± 9 mmHg (p = 0,004) y 2 ± 11,5 mmHg, respectivamente. No tuvimos ningún evento cardiovascular grave, cambios estructurales ni variación en los parámetros de función sistólica estudiados. Sin embargo,encontramos un aumento discreto, pero progresivo y significativo del tiempo de relajación isovolumétrica del VI (p = 0,046) y del tiempo de desaceleración (p = 0,016) indicativos dealteración en la relajación. No observamos variación en los parámetros relacionados con la distensibilidad ni con las presiones diastólicas tempranas y ningún paciente cumplió criterios de disfunción diastólica.
El incremento de PAS/PAD y las alteraciones de la relajación del VI objetivadas podrían ser un indicador precoz de una posible disfunción diastólica y riesgo cardiovascular a largo plazo.</abstract><cop>Netherlands</cop><pub>Elsevier España, S.L.U</pub><pmid>34937681</pmid><doi>10.1016/j.anpede.2020.12.017</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Attention Deficit Disorder with Hyperactivity - drug therapy Attention-deficit hyperactivity disorder Cardiovascular adverse effects Cardiovascular safety Central Nervous System Stimulants - adverse effects Child Deficit de atención e hiperactividad Diastolic function Efectos adversos cardiovasculares Female Función diastólica Heart Ventricles - diagnostic imaging Humans Lisdexanfetamina Lisdexanfetamine Male Methylphenidate Methylphenidate - adverse effects Metilfenidato Prospective Studies Psicoestimulantes Seguridad cardiovascular Stimulant medications |
| title | The impact of methylphenidate treatment on the functional and structural properties of the left ventricle: A medium-term prospective study |
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