Ece İbrahim, Epçaçan Serdar, Bayhan Gülsüm İclal, Türe Mehmet
Department of Paediatric Cardiology, Yuzuncu Yil University, Faculty of Medicine, Van, Turkey.
Department of Paediatric Cardiology, University of Health Sciences, Van Training and Research Hospital, Van, Turkey.
Cardiol Young. 2020 Dec;30(12):1840-1843. doi: 10.1017/S1047951120002930. Epub 2020 Sep 16.
Brucellosis is an important systemic infectious disease, especially in developing countries. Every organ and system of the human body can be affected; however, cardiovascular complications of brucellosis are rare.
To assess cardiac functions in patients with acute brucellosis without overt cardiac involvement and to answer the following question: Is there any cardiac dysfunction despite the absence of endocarditis in these patients?
This cross-sectional study included 67 children with brucellosis and 40 healthy children. We performed a detailed echocardiographic examination in individuals at the beginning of the treatment. Patients with infective endocarditis were excluded from the study.
Echocardiography revealed no difference of ejection fraction, mitral and tricuspid annular plane systolic excursion, pulsed-wave Doppler-derived early diastolic peak velocity (E)/late diastolic peak velocity (A) ratios in mitral and tricuspid valves between the two groups. The deceleration time of early mitral inflow was longer in patients with brucellosis. Early diastolic peak velocity of the mitral and tricuspid annuluses obtained by tissue Doppler imaging (Ea) was significantly lower in children with brucellosis. The peak velocity obtained by tissue Doppler imaging during late diastole (Aa), Ea and Ea/Aa ratios in the interventricular septum, left ventricle posterior wall and right ventricle free wall was lower in patients with brucellosis than in the control group. The E/Ea ratio, isovolumic relaxation time, right ventricle and left ventricle myocardial performance indices were higher in patients with brucellosis.
Patients with acute brucellosis may have diastolic dysfunction without overt cardiac involvement and infective endocarditis.
布鲁氏菌病是一种重要的全身性传染病，在发展中国家尤为如此。人体的每个器官和系统都可能受到影响；然而，布鲁氏菌病的心血管并发症很少见。
评估无明显心脏受累的急性布鲁氏菌病患者的心脏功能，并回答以下问题：这些患者在没有心内膜炎的情况下是否存在心脏功能障碍？
这项横断面研究纳入了67名布鲁氏菌病患儿和40名健康儿童。在治疗开始时对个体进行了详细的超声心动图检查。感染性心内膜炎患者被排除在研究之外。
超声心动图显示，两组之间的射血分数、二尖瓣和三尖瓣环平面收缩期位移、二尖瓣和三尖瓣脉冲波多普勒衍生的舒张早期峰值速度（E）/舒张晚期峰值速度（A）比值没有差异。布鲁氏菌病患者二尖瓣早期血流减速时间更长。组织多普勒成像（Ea）获得的二尖瓣和三尖瓣环舒张早期峰值速度在布鲁氏菌病患儿中显著更低。组织多普勒成像在舒张晚期获得的峰值速度（Aa）、室间隔、左心室后壁和右心室游离壁的Ea和Ea/Aa比值在布鲁氏菌病患者中低于对照组。布鲁氏菌病患者的E/Ea比值、等容舒张时间、右心室和左心室心肌性能指数更高。
急性布鲁氏菌病患者可能在没有明显心脏受累和感染性心内膜炎的情况下出现舒张功能障碍。
