ESfandiar Nasrin, Alaei Mastaneh, Alaei Fariba, Vahidshahi Kourosh, Javdani Yecta Sara
Pediatric Cardiology Department, Mofid Children's Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Iran J Kidney Dis. 2022 Mar;16(2):88-95.
Cardiovascular disease (CVD) may accompany chronic kidney disease (CKD), resulting in additional complications and increased death rate. This study was performed to evaluate cardiac structure and function and several risk factors in hospitalized CKD children.
Seventy-four children with CKD were enrolled in this cross-sectional descriptive study. Two-dimensional and M-mode ultrasonography, Doppler flow velocity and Tissue Doppler Imaging (TDI) were used to evaluate cardiac chamber size, left ventricular mass (LVM) and echocardiographic indices of ventricular function.
Advanced stages of CKD showed statistically insignificant increased LVM and LVM indexed to height2.7 (LVMI), and mildly reduced diastolic function. Hypertensive patients had an insignificant increase in the incidence of left ventricular hypertrophy (LVH) defined as LVMI greater than 95th percentile for age and sex and LVH2 as LVMI2 more than 95 gr/m2 for girls and more than 115gr/ m2 for boys older than 8 years. Patients with LVH had lower left ventricular ejection fraction (LVEF) and abnormal right ventricular (RV) function based on the tricuspid valve systolic velocity (TV S') survey. LVH2 cases, however, revealed decreased LV systolic function according to ejection fraction (EF) and abnormal mitral valve systolic velocity (MV S').
LVH related to hypertension and mild systolic and diastolic dysfunction were more prevalent in advanced CKD cases, however TDI showed no statistically significant difference in the prevalence of MV S' and TV S'. We recommend strict blood pressure control and prevention of renal function deterioration as effective tools for cardiac protection in CKD children. DOI: 10.52547/ijkd.6643.
心血管疾病（CVD）可能伴随慢性肾脏病（CKD）出现，导致更多并发症和死亡率上升。本研究旨在评估住院CKD儿童的心脏结构和功能以及多种风险因素。
74例CKD儿童纳入本横断面描述性研究。采用二维和M型超声心动图、多普勒流速和组织多普勒成像（TDI）评估心腔大小、左心室质量（LVM）和心室功能的超声心动图指标。
CKD晚期患者的LVM以及身高指数化的LVM（LVMI）在统计学上有不显著的增加，舒张功能轻度降低。高血压患者中，左心室肥厚（LVH）（定义为LVMI高于年龄和性别的第95百分位数）和LVH2（定义为女孩LVMI2大于95g/m²，8岁以上男孩大于115g/m²）的发生率有不显著的增加。基于三尖瓣收缩期速度（TV S'）测量，LVH患者的左心室射血分数（LVEF）较低且右心室（RV）功能异常。然而，LVH2患者根据射血分数（EF）显示左心室收缩功能降低且二尖瓣收缩期速度（MV S'）异常。
与高血压相关的LVH以及轻度收缩和舒张功能障碍在晚期CKD病例中更为普遍，然而TDI显示MV S'和TV S'的患病率在统计学上无显著差异。我们建议严格控制血压和预防肾功能恶化，作为保护CKD儿童心脏的有效手段。DOI: 10.52547/ijkd.6643
