Wang Ching-Chia, Hwu Wuh-Liang, Wu En-Ting, Lu Frank, Wang Jou-Kou, Wu Mei-Hwan
Department of Pediatrics, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.
Acta Paediatr. 2007 Jun;96(6):906-9. doi: 10.1111/j.1651-2227.2007.00308.x.
To define the cardiovascular anomalies and the long-term outcomes in an Asian cohort with Williams-Beuren syndrome (WBS).
Data were retrieved from a retrospective chart review of patients who had a definitive diagnosis of WBS by fluorescence in situ hybridization between 1995 and 2005. All patients underwent echocardiography every 3-9 months. Ten patients underwent cardiac catheterization.
Twenty-one patients with a total follow-up of 134 patient-years (median: 72 months) were enrolled. Characteristic dysmorphic facial features were noted in 19 patients (n = 19, 90%). All except one had associated cardiac anomalies, accounting for 0.3% (20/6640) of the patients with congenital heart disease. The spectrum of cardiac anomalies included supravalvular aortic stenosis (SVAS) (n = 15, 71%), peripheral pulmonary stenosis (PPS) (n = 12, 57%), pulmonary valve stenosis (PS) (n = 10, 47%), mitral valve prolapse (MVP) (n = 9, 43%), coarcation of the aorta (n = 4, 19%), ventricular septal defect (n = 2, 10%) and atrial septal defect (n = 1, 5%). Concurrent SVAS and PS/PPS were found in 14 (70%) patients. Only one patient required balloon dilation of PS, which improved. Regression of the stenoses occurred with a probability of 31, 90 and 71% at the age of 10 years for SAVS, PS and PPS, respectively.
Among our WBS patients, SVAS, PPS and PS were common, and were associated with probability of spontaneous regression, especially of right-sided lesions.
明确亚洲威廉斯综合征(WBS)队列中的心血管异常情况及长期预后。
数据来自于1995年至2005年间通过荧光原位杂交确诊为WBS患者的回顾性病历审查。所有患者每3 - 9个月接受一次超声心动图检查。10名患者接受了心导管检查。
纳入21例患者,总随访时间为134患者年(中位数:72个月)。19例患者(n = 19,90%)有典型的面部畸形特征。除1例患者外,其余均伴有心脏异常,占先天性心脏病患者的0.3%(20/6640)。心脏异常谱包括主动脉瓣上狭窄(SVAS)(n = 15,71%)、外周肺动脉狭窄(PPS)(n = 12,57%)、肺动脉瓣狭窄(PS)(n = 10,47%)、二尖瓣脱垂(MVP)(n = 9,43%)、主动脉缩窄(n = 4,19%)、室间隔缺损(n = 2,10%)和房间隔缺损(n = 1,5%)。14例(70%)患者同时存在SVAS和PS/PPS。仅1例患者需要对PS进行球囊扩张,扩张后情况改善。SAVS、PS和PPS在10岁时狭窄消退的概率分别为31%、90%和71%。
在我们的WBS患者中,SVAS、PPS和PS很常见,且与自发消退的可能性相关,尤其是右侧病变。