Fathy Abeer, Abo-Haded Hany M, Al-Ahmadi Najat, El-Sonbaty Marwa M
Department of Pediatrics, College of Medicine, Taibah University, Madinah, Saudi Arabia.
Department of Pediatrics, College of Medicine, Mansoura University, Mansoura, Egypt.
Saudi J Gastroenterol. 2016 Nov;22(6):441-447. doi: 10.4103/1319-3767.195550.
BACKGROUND/AIMS: Celiac disease (CD)-associated cardiologic disorders is a growing concern. However, data regarding cardiac affection in children with CD are few. This study aimed at assessing the subclinical impact of CD on the global myocardial performance in Saudi children with CD using Doppler tissue imaging (DTI).
Conventional two-dimensional echocardiography was performed among 20 Saudi children with CDas well as 20 age and sex-matched healthy controls. DTI were used to determine right ventricular (RV) and left ventricular (LV) Tei indexes. These findings were correlated with the Modified Marsh Classification of the histologic findings in CD.
LV and RV Tei indexes were significantly higher in children with CD than the control group (mean ± standard deviation: 0.47 ± 0.05 vs. 0.31 ± 0.18; P< 0.0005 and 0.51 ± 0.04 vs. 0.32 ± 0.05; P< 0.0001, respectively). RV Tei index was found to be positively correlated with the Modified Marsh Classification of CD (r = 0.7753, P< 0.0001). LV Tei index tended to be more affected in patients with more severe histologic findings, however, such relation did not reach statistical significance (r = 0.2479, P = 0.292). Fractional shortening did not correlate with the Modified Marsh Classification of histologic findings in CD patients (r= -0.11, P = 0.641).
Subclinical myocardial dysfunction of both ventricles occurs in children with CD. The DTI method appears to be more sensitive than conventional two-dimensional echocardiography in the early detection of myocardial dysfunction in children with CD.
背景/目的:乳糜泻(CD)相关的心脏疾病日益受到关注。然而,关于CD患儿心脏受累情况的数据较少。本研究旨在使用多普勒组织成像(DTI)评估CD对沙特CD患儿整体心肌功能的亚临床影响。
对20名沙特CD患儿以及20名年龄和性别匹配的健康对照者进行常规二维超声心动图检查。使用DTI测定右心室(RV)和左心室(LV)的Tei指数。这些结果与CD组织学结果的改良马什分类相关。
CD患儿的LV和RV Tei指数显著高于对照组(均值±标准差:0.47±0.05对0.31±0.18;P<0.0005;0.51±0.04对0.32±0.05;P<0.0001)。发现RV Tei指数与CD的改良马什分类呈正相关(r = 0.7753,P<0.0001)。组织学结果越严重的患者,LV Tei指数受影响的趋势越明显,然而,这种关系未达到统计学意义(r = 0.2479,P = 0.292)。CD患者的缩短分数与组织学结果的改良马什分类无相关性(r = -0.11,P = 0.641)。
CD患儿存在双心室亚临床心肌功能障碍。DTI方法在早期检测CD患儿心肌功能障碍方面似乎比传统二维超声心动图更敏感。