Demetgul Hasan, Giray Dilek, Delibas Ali, Hallioglu Olgu
1Department of Pediatric Cardiology,Hatay Woman's and Children's Hospital,Hatay,Turkey.
2Department of Pediatric Cardiology,Tokat State Hospital,Tokat,Turkey.
Cardiol Young. 2018 Dec;28(12):1404-1409. doi: 10.1017/S1047951118001397. Epub 2018 Aug 28.
IntroductionThe aim of this study is to determine early changes in cardiac function of children with chronic kidney disease by using 2D-speckle tracking echocardiography.
The study included 38 children - 16 girls and 22 boys - diagnosed as having chronic kidney disease in the nephrology department with a glomerular filtration rate of <90 ml/minute/1.73 m2 for at least 3 months. A total of 37 - 15 girls and 22 boys - age- and sex-matched healthy children were included as the control group. 2D-Speckle tracking echocardiography was performed in all subjects.
The mean age was 13.45±2.8 years in patients and 12.89±3.07 years in controls. Systolic and diastolic blood pressures and left ventricular mass index were significantly higher in patients (p<0.05). The values of mitral e, mitral a, mitral e/a ratio, and mitral deceleration time were not different between the groups. Tricuspid annular plane systolic excursion values were lower in patients (p<0.01). Global strain values in apical long-axis 3-chamber and 2-chamber views were significantly lower in patients (p<0.05). Longitudinal, radial, and circumferential peak systolic strain values were lower in patients, but the difference was statistically significant in all segments of longitudinal view and basal segment of circumferential view (p<0.05). Radial and circumferential systolic strain rates were significantly lower in patients in all three segments (p<0.05). Moreover, early diastolic strain rate was significantly lower in longitudinal and radial apical segments and in all segments of circumferential measurements in patients. Besides, strain rate e/a ratio was significantly lower in all longitudinal segments of patients (p=0.01).
The study concluded that 2D-speckle tracking echocardiography method can determine cardiac involvement earlier than conventional echocardiography in children with chronic kidney disease having preserved ejection fraction.
引言
本研究的目的是通过二维斑点追踪超声心动图确定慢性肾脏病患儿心脏功能的早期变化。
本研究纳入了38名儿童，其中16名女孩和22名男孩，他们在肾病科被诊断为慢性肾脏病，肾小球滤过率<90毫升/分钟/1.73平方米至少3个月。总共37名年龄和性别匹配的健康儿童（15名女孩和22名男孩）作为对照组。所有受试者均接受二维斑点追踪超声心动图检查。
患者的平均年龄为13.45±2.8岁，对照组为12.89±3.07岁。患者的收缩压、舒张压和左心室质量指数显著更高（p<0.05）。两组之间二尖瓣E峰、二尖瓣A峰、二尖瓣E/A比值和二尖瓣减速时间的值没有差异。患者的三尖瓣环平面收缩期位移值较低（p<0.01）。患者在心尖长轴三腔和两腔视图中的整体应变值显著较低（p<0.05）。患者的纵向、径向和圆周方向的收缩期峰值应变值较低，但在纵向视图的所有节段和圆周视图的基底节段差异具有统计学意义（p<0.05）。患者在所有三个节段的径向和圆周方向收缩期应变率显著较低（p<0.05）。此外，患者在纵向和径向心尖节段以及圆周测量的所有节段的舒张早期应变率显著较低。此外，患者所有纵向节段的应变率E/A比值显著较低（p=0.01）。
该研究得出结论，二维斑点追踪超声心动图方法比传统超声心动图能更早地确定射血分数正常的慢性肾脏病患儿的心脏受累情况。
