应用斑点追踪超声心动图评估急性风湿热患者的心肌力学。
Assessment of Myocardial Mechanics in Acute Rheumatic Fever Using Speckle-Tracking Echocardiography.
机构信息
Department of Pediatrics, Division of Pediatric Cardiology, Ankara Training and Research Hospital, Ankara, Türkiye.
Department of Pediatric Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Türkiye.
出版信息
Anatol J Cardiol. 2023 Sep 30;27(10):592-596. doi: 10.14744/AnatolJCardiol.2023.1792. Epub 2023 Jul 19.
BACKGROUND
This study aims to evaluate the role of speckle-tracking echocardiography to identify myocardial deformation in acute rheumatic fever.
METHODS
Twenty-seven patients and 27 healthy children were prospectively evaluated. The patient group was divided into 2 subgroups based on echocardiographic findings, with or without carditis. The left ventricular global longitudinal strain and strain rate, left ventricular global circumferential strain and strain rate, and right ventricular global lon-gitudinal strain and strain rate were assessed by speckle-tracking echocardiography.
RESULTS
In the acute phase of the disease, all values except the right ventricular global longitudinal strain were found to be significantly below the control group in the patient cohort. No significant difference was found between the patients grouped as carditis and non-carditis in the acute period. Comparison of the acute period with the post-treatment period revealed a significant increase in all strain values of the patients with carditis and significant increases observed in all values except left ventricular global longitudinal strain rate, left ventricular global circumferential strain rate, and right ventricular global longitudinal strain rate values in patients without carditis. Apart from the right ventricular global longitudinal strain rate, which was significantly lower in the non-carditis group compared to the control group, there was no significant difference in strain values between the patient and control groups following treatment.
CONCLUSION
In the present study, we found that all patients, including patients in whom no valvular involvement was detected by echocardiography in the acute phase of acute rheumatic fever, had a lower right and left ventricular strain and strain rate measurements and that these findings improved after treatment, suggesting that strain echocardiography may be a helpful diagnostic method, especially in patients without valvular involvement.
背景
本研究旨在评估斑点追踪超声心动图在急性风湿热中的心肌变形识别作用。
方法
对 27 例患者和 27 例健康儿童进行前瞻性评估。根据超声心动图结果，将患者组分为存在或不存在心内膜炎的 2 个亚组。采用斑点追踪超声心动图评估左心室整体纵向应变和应变率、左心室整体圆周应变和应变率以及右心室整体纵向应变和应变率。
结果
在疾病的急性期，患者组除右心室整体纵向应变外，所有值均明显低于对照组。在急性期，心内膜炎和无心内膜炎的患者亚组之间没有发现显著差异。与治疗后时期相比，心内膜炎患者的所有应变值均显著增加，无心内膜炎患者的所有值（除左心室整体纵向应变率、左心室整体圆周应变率和右心室整体纵向应变率外）均显著增加。除右心室整体纵向应变率外，无心内膜炎组明显低于对照组，治疗后患者组与对照组之间的应变值无显著差异。
结论
在本研究中，我们发现所有患者，包括在急性风湿热急性期超声心动图未检测到瓣膜受累的患者，右心室和左心室应变和应变率测量值均较低，且这些发现治疗后有所改善，提示应变超声心动图可能是一种有用的诊断方法，特别是在无瓣膜受累的患者中。
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