{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T13:48:38Z","timestamp":1778507318053,"version":"3.51.4"},"reference-count":43,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,12,21]],"date-time":"2020-12-21T00:00:00Z","timestamp":1608508800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Glucocorticoids play an important role in cardiac physiology. Chronic exposure and higher doses may cause adverse effects on the myocardium, especially in young patients receiving long\u2010term therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess cardiac function in children with congenital adrenal hyperplasia (CAH) and its relation to glucocorticoid dose and therapy duration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty\u2010seven patients with CAH due to 21\u2010hydroxylase deficiency were compared to 47 controls. Patients were subdivided according to treatment duration (Group A: less than 6\u00a0years, Group B: more than 6\u00a0years). Mean daily glucocorticoid and cumulative glucocorticoid doses were calculated. Echocardiography was performed for patients and controls to evaluate cardiac functions, chamber dimensions and tissue Doppler valvular status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to controls, patients had cardiac chamber hypertrophy reflected by higher M\u2010mode dimensions. Patients had lower fractional shortening, defective ventricular relaxation, lower average mitral and tricuspid e\u00b4\/a\u00b4 ratios (e\u00b4 early diastolic, a\u00b4 late diastolic) as well as s\u00b4 (systolic) velocities, higher average mitral E\/e ratio and higher left ventricle TDI Tei index (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.05). Group B had lower average mitral e\u00b4\/a\u00b4 and tricuspid s\u00b4 velocities, and higher average mitral E\/e ratio (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.05). Cumulative glucocorticoid dose significantly correlated with different echocardiographic parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Long\u2010term glucocorticoid therapy even within the recommended therapeutic range adversely affects cardiac functions in children with 21\u2010hydroxylase deficiency.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14333","type":"journal-article","created":{"date-parts":[[2020,9,18]],"date-time":"2020-09-18T20:41:05Z","timestamp":1600461665000},"page":"210-218","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Effect of long\u2010term glucocorticoid therapy on cardiac functions in children with congenital adrenal hyperplasia"],"prefix":"10.1111","volume":"94","author":[{"given":"Nermine Hussein","family":"Amr","sequence":"first","affiliation":[{"name":"Department of Pediatrics Ain Shams University Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5048-4651","authenticated-orcid":false,"given":"Rana Abdelhakim Ahmed","family":"Mahmoud","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Ain Shams University Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omneyia","family":"Youssef","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Ain Shams University Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadin Nabil","family":"Toaima","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Ain Shams University Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heba","family":"Elsedfy","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Ain Shams University Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,12,21]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.4274\/jcrpe.1658"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2009.03690.x"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-07-0887"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsbmb.2015.03.009"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1530\/JME-16-0128"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2012.11.086"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tem.2015.10.001"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.0000080521.15238.E5"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2009-2631"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.73.1.25"},{"issue":"12","key":"e_1_2_9_12_1","first-page":"1085","article-title":"Surface area in children: a simple formula","volume":"46","author":"Furqan M","year":"2009","journal-title":"Indian Pediatr"},{"key":"e_1_2_9_13_1","volume-title":"Growth at Adolescence","author":"Tanner JM","year":"1962"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.114.2.S2.555"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.4103\/0971-9784.192617"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(86)90771-X"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejechocard\/jep007"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2003.12.005"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/380729"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.4103\/0974-2069.99622"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1590\/2359-3997000000119"},{"key":"e_1_2_9_22_1","first-page":"63","volume-title":"Cardiovascular Effects of Androgens. 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