Bassi Andrea, Azzarelli Andrea, Vaccaro Angelina, Mazzatenta Carlo
Dermatology Unit, Azienda Toscana Nord Ovest, Lucca, Italy.
Pediatric Cardiology, Azienda Toscana Nord Ovest, Lucca, Italy.
Dermatol Pract Concept. 2022 Jul 1;12(3):e2022150. doi: 10.5826/dpc.1203a150. eCollection 2022 Jul.
to evaluate clinical chart of patients with IH who had cardiologic evaluation before propranolol therapy and to compare our findings with literature data.
Some studies have assessed the incidence of heart defects in children suffering from infantile hemangioma (IH) treated with propranolol, showing a possible higher prevalence of cardiac abnormalities in this group of patients.
We retrospectively reviewed clinical charts of children with infantile hemangiomas referred to our dermatologic division from 2016 to 2021, who underwent our pediatric cardiology protocol screening before starting propranolol therapy.
A total of 60 infants were enrolled. Electrocardiograms were available for all the patients and echocardiography for 50/60 (83.3%) children. Electrocardiogram didn't reveal any alterations in most cases (pathologic in 2/60 ones, 3.3%) while echocardiograms revealed findings in 31/50 (51.7%) patients. Of these, persistent foramenovale, which was found in 14/50 patients (28%), was considered as non-pathologic. Interatrial septal defects were the main pathological finding in 15/50 patients (30%), as single defect or in association with other abnormalities.
Our study confirms the presence of a higher rate of cardiologic findings in patients with infantile hemangioma evaluated before starting oral propranolol, compared to the known rate of those defects in healthy newborns. We also confirm that interatrial septal defects are the most frequent pathologic finding with a higher prevalence compared to published studies. Large prospective studies are needed to clarify a possible association of pathological cardiac findings in all patients with infantile hemangiomas and thereafter to evaluate the possible effect of propranolol therapy on these defects during time.
评估在使用普萘洛尔治疗前接受心脏评估的婴儿血管瘤（IH）患者的临床病历，并将我们的研究结果与文献数据进行比较。
一些研究评估了使用普萘洛尔治疗的婴儿血管瘤（IH）患儿心脏缺陷的发生率，结果显示该组患者心脏异常的患病率可能更高。
我们回顾性分析了2016年至2021年转诊至我们皮肤科的婴儿血管瘤患儿的临床病历，这些患儿在开始普萘洛尔治疗前接受了我们的儿科心脏病学方案筛查。
共纳入60例婴儿。所有患者均有心电图检查结果，50/60（83.3%）例儿童有超声心动图检查结果。大多数情况下，心电图未显示任何异常（60例中有2例异常，占3.3%），而超声心动图在31/50（51.7%）例患者中发现了异常。其中，14/50（28%）例患者发现的持续性卵圆孔未闭被认为是非病理性的。房间隔缺损是15/50（30%）例患者的主要病理发现，可为单一缺损或与其他异常并存。
我们的研究证实，与健康新生儿中已知的心脏缺陷发生率相比，在开始口服普萘洛尔治疗前接受评估的婴儿血管瘤患者中，心脏检查结果的发生率更高。我们还证实，与已发表的研究相比，房间隔缺损是最常见的病理发现，患病率更高。需要进行大规模的前瞻性研究，以阐明所有婴儿血管瘤患者病理性心脏检查结果的可能关联，并在此后评估普萘洛尔治疗随时间推移对这些缺陷的可能影响。
