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常染色体显性遗传性多囊肾病患儿及青年人群中心脏瓣膜异常的发生率。

Prevalence of cardiac valvar abnormalities in children and young people with autosomal dominant polycystic kidney disease.

机构信息

Department of Paediatric Cardiology, Evelina London Children's Hospital, Guys & St Thomas NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK.

Department of Paediatric Nephrology, Evelina London Children's Hospital, Guys & St Thomas NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK.

出版信息

Pediatr Nephrol. 2023 Mar;38(3):705-709. doi: 10.1007/s00467-022-05500-w. Epub 2022 Jun 28.

Abstract

BACKGROUND

Valvar abnormalities in children and adults with autosomal dominant polycystic kidney disease (ADPKD) have previously been reported as a frequent occurrence. Mitral valve prolapse (MVP), in particular, has been reported in almost one-third of adult patients and nearly 12% of children with ADPKD. Our objective in this study was to establish the prevalence of valvar abnormalities in a large, contemporary series of children and young people (CYP) with ADPKD.

METHODS

A retrospective, single centre, cross-sectional analysis of the echocardiograms performed on all consecutive children seen in a dedicated paediatric ADPKD clinic. Full anatomical and functional echocardiograms were performed and analysed for valvar abnormalities.

RESULTS

The echocardiograms of 102 CYP with ADPKD (range 0.25-18 years, mean age 10.3 years, SD ± 5.3 years) were analysed. One (0.98%), 3-year-old boy, had MVP. There was no associated mitral regurgitation. Evaluating variations in normal valvar anatomy, 9 (8.8%) patients, aged 7.1 to 18 years, had minor bowing ± visual elongation of either the anterior or posterior leaflet of the mitral valve, none of which fell within the criteria of true MVP. Three (1.9%) patients, 2 boys and 1 girl aged between 7 and 14 years, had trivial or mild aortic regurgitation. No patients had echocardiographic evidence of tricuspid valve prolapse (TVP).

CONCLUSION

In this contemporary cohort of CYP with ADPKD, the incidence of MVP and other valvar lesions is significantly lower than previously reported. A higher resolution version of the Graphical abstract is available as Supplementary information.

摘要

背景

先前已有报道称,常染色体显性多囊肾病(ADPKD)患儿和成人存在瓣膜异常,较为常见。尤其,将近三分之一的成年患者和近 12%的儿童 ADPKD 患者存在二尖瓣脱垂(MVP)。我们本研究的目的在于确定大量当代儿童和青少年(CYP)ADPKD 患者中瓣膜异常的发生率。

方法

对专门的儿科 ADPKD 诊所就诊的所有连续 CYP 进行回顾性、单中心、横断面分析,对所有连续 CYP 进行超声心动图检查。对所有 CYP 行全解剖和全功能超声心动图检查,以分析瓣膜异常。

结果

分析了 102 例 CYP ADPKD 患者(年龄范围 0.25-18 岁,平均年龄 10.3 岁,标准差±5.3 岁)的超声心动图。1 名(0.98%)3 岁男孩存在 MVP,且无相关的二尖瓣反流。评估正常瓣膜解剖结构的变化,9 名(8.8%)年龄 7.1 至 18 岁的患者存在二尖瓣前叶或后叶轻微弯曲伴视觉延长,但均不符合 MVP 的标准。3 名(1.9%)年龄 7 至 14 岁的男孩和女孩存在轻度或轻度主动脉瓣反流。无一例患者存在三尖瓣脱垂(TVP)的超声心动图证据。

结论

在当代 CYP ADPKD 队列中,MVP 和其他瓣膜病变的发生率明显低于先前的报道。图形摘要的高分辨率版本可作为补充信息提供。

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