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一名患心房扑动的婴儿的心动过速性心肌病及心功能的长期恢复

Tachycardia-Induced Cardiomyopathy in an Infant with Atrial Flutter and Prolonged Recovery of Cardiac Function.

作者信息

Sakai Tomohide, Tsuboi Kaori, Takarada Shinya, Okabe Mako, Nakaoka Hideyuki, Ibuki Keijiro, Ozawa Sayaka W, Hata Yukiko, Ichimata Shojiro, Nishida Naoki, Hirono Keiichi

机构信息

Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama 930-0194, Japan.

Department of Legal Medicine, Faculty of Medicine, University of Toyama, Toyama 930-0194, Japan.

出版信息

J Clin Med. 2024 Jun 4;13(11):3313. doi: 10.3390/jcm13113313.

Abstract

Tachycardia-induced cardiomyopathy (TIC) is caused by prolonged tachycardia, leading to left ventricular dilatation and systolic dysfunction with heart failure. Although TIC is more common in adults, it is rare in early infancy. Clinical testing was performed as part of medical evaluation and management. Next-generation sequencing (NGS) was conducted for a patient with TIC. A literature review on TIC was also conducted. The case involved a 5-month-old infant referred to the hospital due to symptoms of heart failure lasting at least two months. The infant's heart rate was 200 beats per minute, the left ventricular ejection fraction fell below 14%, and electrocardiograms showed atrial flutter, suggesting TIC. After cardioversion, there was no recurrence of atrial flutter, and cardiac function improved 98 days after tachycardia arrest. The NGS did not identify any pathogenic variants. The literature review identified eight early infantile cases of TIC. However, no previous reports described a case with such a prolonged duration of TIC as ours. This is the first report of a case of prolonged TIC in a child with the documented time to recover normal cardiac function. The improvement of cardiac function depends on the duration of TIC. Early recognition and intervention in TIC are essential to improve outcomes for infantile patients, as timely treatment offers the potential for recovery.

摘要

心动过速性心肌病(TIC)由持续性心动过速引起,导致左心室扩张及收缩功能障碍并伴发心力衰竭。尽管TIC在成人中更为常见,但在婴儿早期却较为罕见。临床检测作为医学评估与管理的一部分得以开展。对一名TIC患者进行了二代测序(NGS)。还对TIC进行了文献综述。该病例为一名5个月大的婴儿,因心力衰竭症状持续至少两个月而被转诊至医院。婴儿心率为每分钟200次,左心室射血分数降至14%以下,心电图显示心房扑动,提示为TIC。复律后,心房扑动未再复发,心动过速终止98天后心脏功能得到改善。NGS未发现任何致病变异。文献综述确定了8例婴儿早期TIC病例。然而,此前尚无报告描述过像我们这样TIC病程如此之长的病例。这是首例有记录显示心脏功能恢复正常所需时间的儿童长期TIC病例报告。心脏功能的改善取决于TIC的病程。对TIC的早期识别和干预对于改善婴儿患者的预后至关重要,因为及时治疗有望实现康复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7795/11172730/deeeb9ffe192/jcm-13-03313-g001.jpg

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