Department of Cardiology, Society for Continuing Medical Education & Research, Kerala Institute of Medical Sciences, Trivandrum 695029, Kerala, India.
Department of Cardiology, Society for Continuing Medical Education & Research, Kerala Institute of Medical Sciences, Trivandrum 695029, Kerala, India.
Int J Cardiol. 2021 Feb 1;324:180-185. doi: 10.1016/j.ijcard.2020.09.034. Epub 2020 Sep 13.
Dengue fever (DF) is an infectious disease of viral origin common in the tropics. Studies on a large number of patients with dengue infection to assess associated cardiac involvement are rare.
We analyzed the incidence and spectrum of cardiac abnormalities in 320 patients with dengue fever admitted to our hospital located in an endemic area for dengue infection. All patients were evaluated following the WHO guidelines. Those confirmed to have dengue infection by serology had detailed clinical evaluation, 12‑lead electrocardiography (ECG), assay for cardiac markers (troponin T, CK-MB, NT Pro BNP) and 2-D echocardiography.
Among the 320 patients selected for the study 112 (35%) had changes of cardiac involvement as detected by investigations. Changes in ECG were seen in all of them. Sinus bradycardia in spite of fever was the most common abnormality (n = 63;19.7%). Forty-two (13.1%) patients had left ventricular ejection fraction less than 40%. Forty-eight patients (15%) had increased serum levels of troponin-T. Serum levels of CK-MB were elevated in 34 (10.6%) and serum levels of NT-pro BNP was increased in 19 (5.9%). Fourteen patients died and all of them had abnormalities in electrocardiogram, echocardiogram and serum markers.
Our study reveals that cardiac involvement in patients with dengue infection is not uncommon. We found that ECHO or ECG abnormalities or elevated serum levels of markers of cardiac injury are predictors of risk for adverse outcome. Absence of these abnormalities has a 100% negative predictive value.
登革热（DF）是一种起源于病毒的热带传染病。对大量登革热感染患者进行评估以确定相关心脏受累的研究很少。
我们分析了我院位于登革热流行地区的 320 例登革热患者的心脏异常发生率和谱。所有患者均按照世界卫生组织（WHO）的指南进行评估。通过血清学确诊登革热感染的患者进行详细的临床评估、12 导联心电图（ECG）、心脏标志物（肌钙蛋白 T、CK-MB、NT Pro BNP）检测和二维超声心动图检查。
在所选择的 320 例患者中，有 112 例（35%）通过检查发现有心脏受累的变化。他们都出现了心电图改变。尽管发热，但窦性心动过缓是最常见的异常（n=63；19.7%）。42 例（13.1%）患者左心室射血分数<40%。48 例（15%）患者血清肌钙蛋白 T 水平升高。34 例（10.6%）患者 CK-MB 血清水平升高，19 例（5.9%）患者 NT-pro BNP 血清水平升高。14 例患者死亡，所有患者的心电图、超声心动图和血清标志物均有异常。
我们的研究表明，登革热感染患者的心脏受累并不少见。我们发现，ECHO 或 ECG 异常或升高的血清心脏损伤标志物水平是不良预后的预测指标。这些异常的缺失具有 100%的阴性预测值。
