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大疱性表皮松解症患者的超声心动图结果分析。

The analysis of echocardiographic results in patients suffering from epidermolysis bullosa.

作者信息

Kurnicka Katarzyna, Osipowicz Katarzyna, Dzikowska-Diduch Olga, Wertheim-Tysarowska Katarzyna, Kowalewski Cezary, Pruszczyk Piotr

机构信息

Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland.

Department of Dermatology and Immunodermatology, Medical University of Warsaw, Warsaw, Poland.

出版信息

Postepy Dermatol Alergol. 2020 Dec;37(6):871-878. doi: 10.5114/ada.2020.102101. Epub 2021 Jan 6.

Abstract

INTRODUCTION

Cardiac abnormalities revealed in patients suffering from epidermolysis bullosa (EB) include dilated cardiomyopathy (DC) and aortopathy. DC is a rare but serious complication associated with an increased mortality, predominantly observed in recessive dystrophic EB. Echocardiography is the most available diagnostic tool used to detect heart disease in EB patients.

AIM

To analyse echocardiographic results obtained in Polish EB patients and compare them between the EB group and healthy persons.

MATERIAL AND METHODS

We analysed retrospectively echocardiograms of 23 patients with EB (14 F, mean age 17.3 years) performed from 2017 to 2019. The incidence of left ventricular (LV) systolic and diastolic dysfunction, right heart disease and congenital heart disease was evaluated. A comparison of echo-parameters between EB patients and 20 matched healthy subjects was performed.

RESULTS

We did not find any cases of DC and aortopathy in the EB group. One bicuspid aortic valve case was revealed. Analysis of LV diastolic parameters showed that the mean value of mitral A velocity was significantly higher and the pulmonary venous flow D velocity was lower in the EB group than in controls. Tissue Doppler analysis revealed lower values of E' velocities of mitral annulus in the EB group, what may suggest discreetly slower LV relaxation, however, this will definitely require further research.

CONCLUSIONS

Although most EB patients do not present cardiac symptoms, there is still a risk of developing cardiomyopathy associated with poor prognosis. It seems reasonable to perform a scheduled echocardiographic screening including LV systolic and diastolic function assessment to detect preclinical cardiac abnormalities.

摘要

引言

大疱性表皮松解症(EB)患者中发现的心脏异常包括扩张型心肌病(DC)和主动脉病变。DC是一种罕见但严重的并发症,与死亡率增加相关,主要见于隐性营养不良型EB。超声心动图是用于检测EB患者心脏病的最常用诊断工具。

目的

分析波兰EB患者的超声心动图结果,并将其在EB组和健康人之间进行比较。

材料与方法

我们回顾性分析了2017年至2019年对23例EB患者(14例女性,平均年龄17.3岁)进行的超声心动图检查。评估左心室(LV)收缩和舒张功能障碍、右心疾病和先天性心脏病的发生率。对EB患者和20名匹配的健康受试者的超声参数进行了比较。

结果

我们在EB组中未发现DC和主动脉病变的任何病例。发现1例二叶式主动脉瓣病例。LV舒张参数分析显示,EB组二尖瓣A峰速度的平均值显著高于对照组,而肺静脉血流D峰速度则较低。组织多普勒分析显示,EB组二尖瓣环E'峰速度值较低,这可能提示LV舒张稍慢,然而,这肯定需要进一步研究。

结论

尽管大多数EB患者没有心脏症状,但仍有发生预后不良的心肌病的风险。进行包括LV收缩和舒张功能评估的定期超声心动图筛查以检测临床前心脏异常似乎是合理的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd21/7874876/b5828423bf1f/PDIA-37-42822-g001.jpg

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