Demir Semra, Atici Adem, Coskun Raif, Olgac Muge, Unal Derya, Sarikaya Remzi, Gelincik Aslı, Colakoglu Bahattin, Oflaz Huseyin, Sonsoz Mehmet Rasih, Buyukozturk Suna
Department of Internal Medicine, Division of Immunology and Allergic Diseases, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Asia Pac Allergy. 2018 Oct 24;8(4):e40. doi: 10.5415/apallergy.2018.8.e40. eCollection 2018 Oct.
It is not known how cardiac functions are affected during anaphylaxis.
Our aim was to measure the cardiac functions shortly after an anaphylaxis attack using a new technique that detects subclinical left ventricular dysfunction.
Patients in our hospital who experienced anaphylaxis and urticaria (control group) due to any cause were included in the study. Tryptase levels were measured on the third hour of the reaction and 6 weeks later. Left ventricular systolic functions were evaluated with global strain measurement using echocardiography, approximately 4 hours and 6-week post reaction.
Twelve patients were included in the anaphylaxis group (83.3% female; mean age, 43.25 ± 9.9 years). The causes of anaphylaxis were drug ingestion (n = 11) and venom immunotherapy. Eight of the anaphylactic reactions (66.7%) were severe and in 9 reactions (75%) tryptase levels increased. In the anaphylaxis group, strain values measured shortly after anaphylaxis were significantly lower than those calculated 6 weeks later ( < 0.001) and tryptase levels significantly increased ( = 0.002). The strain values measured both shortly after anaphylaxis and 6 weeks later did not differ according to severity of anaphylaxis. In severe anaphylaxis, tryptase levels during anaphylaxis and 6 weeks later were significantly higher ( = 0.019, = 0.035). The control group evidenced no differences regarding strain and tryptase levels measured at reaction and 6 weeks later. At reaction, in the anaphylaxis group, the tryptase levels were higher and the strain values were lower than those in the urticaria group ( = 0.007, = 0.003).
Cardiac dysfunction may develop during an anaphylaxis independent of severity of reaction.
目前尚不清楚过敏反应期间心脏功能如何受到影响。
我们的目的是使用一种检测亚临床左心室功能障碍的新技术，在过敏反应发作后不久测量心脏功能。
纳入我院因任何原因发生过敏反应和荨麻疹的患者（对照组）。在反应后第3小时和6周后测量类胰蛋白酶水平。使用超声心动图通过整体应变测量评估左心室收缩功能，分别在反应后约4小时和6周时进行。
过敏反应组纳入12例患者（女性占83.3%；平均年龄43.25±9.9岁）。过敏反应的原因是药物摄入（n = 11）和毒液免疫疗法。8例过敏反应（66.7%）为严重反应，9例反应（75%）类胰蛋白酶水平升高。在过敏反应组中，过敏反应后不久测量的应变值显著低于6周后计算的值（<0.001），且类胰蛋白酶水平显著升高（=0.002）。过敏反应后不久和6周后测量的应变值根据过敏反应的严重程度无差异。在严重过敏反应中，过敏反应期间和6周后的类胰蛋白酶水平显著更高（=0.019，=0.035）。对照组在反应时和6周后测量的应变和类胰蛋白酶水平无差异。在反应时，过敏反应组的类胰蛋白酶水平高于荨麻疹组，应变值低于荨麻疹组（=0.007，=0.003）。
过敏反应期间可能会出现心脏功能障碍，与反应严重程度无关。
