[应用组织多普勒、应变及应变率超声心动图评估幼年特发性关节炎患儿的左心室功能：一项观察性研究]
[Assessment of left ventricular functions with tissue Doppler, strain and strain rate echocardiography in children with juvenile idiopathic arthritis: An observational study].
作者信息
Yılmaz Osman, Ceylan Ozben, Orün Utku Arman, Ozgür Senem, Karademir Selmin, Doğan Vehbi, Keskin Mahmut, Erdoğan Ozlem
机构信息
Dr. Sami Ulus Kadın Doğum, Çocuk Sağlığı ve Hastalıkları Eğitim ve Araştırma Hastanesi, Pediyatrik Kardiyoloji Bölümü, Ankara, Turkey.
出版信息
Anadolu Kardiyol Derg. 2012 Jun;12(4):339-46. doi: 10.5152/akd.2012.098. Epub 2012 Apr 6.
OBJECTIVE
In juvenile idiopathic arthritis (JIA) cardiac involvement is usually silent without typical symptoms. The purpose of this study was to assess left ventricular functions with tissue Doppler echocardiography (TDE), strain and strain rate in children with JIA.
METHODS
Our study was designed as a cross-sectional observational study. Thirty pediatric patients with JIA and 30 age- and sex-matched healthy controls were studied. In addition to standard echocardiographic methods, tissue Doppler, strain and strain rate imaging's were performed to assess left ventricular functions in all participants. The means of variables that did not distributed normally were compared with Mann-Whitney U test.
RESULTS
In patients with JIA, E' values of mid and apical regions of left ventricular lateral wall were significantly lower than those of the controls (15.76±3.24 vs 17.91±3.29 cm/s, 11.10±2.96 vs12.64± 2.42 cm/s, p<0.05). In longitudinal strain reflecting left ventricular regional systolic functions, apical-lateral, basal and mid-septum peak S values, lateral peak S values in circumferential strain (-17.30±6.22 vs -21.97±4.32, -18.23±4.62 vs -21.53±2.69, -20.35±3.75 vs -22.75±3.50, -9.68±7.12 vs -13.70±6.81 cm/s, p<0.05, r:0.42, 0.41, 0.42), in longitudinal strain reflecting diastolic functions, apical-lateral, mid-lateral, apical-septum, mid-septum peak E values (2.22±1.00 vs 3.17±0.87, 1.62±0.84 vs 2.15±0.72, 2.51±0.76 vs 3.31±0.87, 1.99±0.64 vs 2.47±0.57 cm/s, p<0.05, r:-0.39,-0.55,-0.43) and in circumferential strain lateral and posterior peak E values (1.32±0.83 vs 1.88±0.94, 1.31±0.71 vs 1.85±0.91 cm/s, p<0.05, r:-0.33, -0.22) were significantly lower than those of the controls.
CONCLUSION
Although marked myocardial involvement was not detected with tissue Doppler imaging in JIA patients with subclinical cardiac disease, regional impairments in left ventricular strain and strain rates were found.
目的
在幼年特发性关节炎（JIA）中，心脏受累通常没有典型症状，较为隐匿。本研究的目的是利用组织多普勒超声心动图（TDE）、应变和应变率评估JIA患儿的左心室功能。
方法
本研究设计为横断面观察性研究。研究了30例JIA儿科患者和30例年龄及性别匹配的健康对照。除了标准超声心动图方法外，还进行了组织多普勒、应变和应变率成像，以评估所有参与者的左心室功能。对非正态分布变量的均值采用曼-惠特尼U检验进行比较。
结果
在JIA患者中，左心室侧壁中部和心尖部的E'值显著低于对照组（15.76±3.24 vs 17.91±3.29 cm/s，11.10±2.96 vs 12.64±2.42 cm/s，p<0.05）。在反映左心室局部收缩功能的纵向应变中，心尖-侧壁、基底和室间隔中部的峰值S值，圆周应变中的侧壁峰值S值（-17.30±6.22 vs -21.97±4.32，-18.23±4.62 vs -21.53±2.69，-20.35±3.75 vs -22.75±3.50，-9.68±7.12 vs -13.70±6.81 cm/s，p<0.05，r：0.42，0.41，0.42）；在反映舒张功能的纵向应变中，心尖-侧壁、侧壁中部、心尖-室间隔、室间隔中部的峰值E值（2.22±1.00 vs 3.17±0.87，1.62±0.84 vs 2.15±0.72，2.51±0.76 vs 3.31±0.87，1.99±0.64 vs 2.47±0.57 cm/s，p<0.05，r：-0.39，-0.55，-0.43）；在圆周应变中，侧壁和后壁的峰值E值（1.32±0.83 vs 1.88±0.94，1.31±0.71 vs 1.85±...
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