Balli Sevket, Yucel Ilker Kemal, Kibar Ayse Esin, Ece Ibrahim, Dalkiran Eylem Sen, Candan Sukru
Department of Pediatric Cardiology, Balikesir Ataturk Hospital, Balikesir, Turkey.
Department of Pediatric Cardilogy, Siyami Ersek Education and Research Hospital, Istanbul, Turkey.
World J Pediatr. 2016 Nov;12(4):463-469. doi: 10.1007/s12519-016-0012-3. Epub 2016 Apr 8.
Extra genetic material in patients with Down syndrome (DS) may affect the function of any organ system. We evaluated cardiac functions using conventional tissue Doppler and two-dimensional speckle tracking echocardiography in patients with DS in the absence of congenital and acquired heart disease in patients.
A total of 115 patients with DS between 6 and 13 years of age with clinically and anatomically normal heart and 55 healthy children were included in this cross-sectional study. DS was diagnosed by a karyotype test. Patients with mosaic type were not included in this study. Systolic and diastolic functions were evaluated by echocardiography.
Pulsed waved Doppler transmitral early/late inflow velocity (E/A), tissue Doppler mitral annular early/late diastolic peak velocity (Ea/Aa), transtricuspid E/A and tricuspid valve annulus Ea/Aa, pulmonary venous Doppler systolic/diastolic (S/D) wave ratio were lower in patients with Down syndrome than in the control group (P=0.04, P=0.001, P<0.05, P<0.001, P<0.001, respectively). Mitral and tricuspid annular Ea were lower in patients with DS (P<0.001). The right and left ventricular myocardial performance indexes were higher in patients with DS than in the controls (P<0.01). They had significantly higher left ventricular mass, ejection fraction, the mitral annular plane systolic excursion values. However, the Down syndrome group compared with the controls had a lower strain values examined by two-dimensional longitudinal speckle-tracking strain echocardiography.
These findings suggest conventional tissue Doppler and two-dimensional longitudinal speckletracking strain echocardiography were useful methods of investigating ventricular function and identifying a higher incidence of biventricular dysfunction in patients with Down syndrome compared with the healthy controls.
唐氏综合征（DS）患者的额外遗传物质可能会影响任何器官系统的功能。我们在无先天性和后天性心脏病的DS患者中，使用传统组织多普勒和二维斑点追踪超声心动图评估心脏功能。
本横断面研究纳入了115名6至13岁、临床和解剖学上心脏正常的DS患者以及55名健康儿童。通过核型检测诊断DS。本研究未纳入嵌合型患者。通过超声心动图评估收缩和舒张功能。
DS患者的脉冲波多普勒二尖瓣流入早期/晚期速度（E/A）、组织多普勒二尖瓣环舒张早期/晚期峰值速度（Ea/Aa）、三尖瓣E/A和三尖瓣环Ea/Aa、肺静脉多普勒收缩期/舒张期（S/D）波比值均低于对照组（分别为P = 0.04、P = 0.001、P < 0.05、P < 0.001、P < 0.001）。DS患者的二尖瓣和三尖瓣环Ea较低（P < 0.001）。DS患者的右心室和左心室心肌性能指数高于对照组（P < 0.01）。他们的左心室质量、射血分数、二尖瓣环平面收缩期偏移值显著更高。然而，与对照组相比，DS组通过二维纵向斑点追踪应变超声心动图检测的应变值较低。
这些发现表明，传统组织多普勒和二维纵向斑点追踪应变超声心动图是研究心室功能以及识别DS患者与健康对照组相比双心室功能障碍发生率更高的有用方法。
