Sirozlu çocuklarda kalp fonksiyonlarının doku Doppler görüntüleme ile değerlendirilmesi
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Dosyalar
Tarih
2017
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Akademik Gastroenteroloji Dergisi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Sirotik kardiyomiyopati siroz varlığında oluşan kardiyak
disfonksiyon olarak tanımlanmaktadır. Pediatrik yaş grubunda sirotik
kardiyomiyopati ile ilgili yapılmış çok az sayıda çalışma vardır. Bu çalış-
mada sirozlu çocuklarda kardiyak fonksiyonlar ile pulmoner komplikasyonları
tespit etmek amaçlandı. Gereç ve Yöntem: Bu çalışmada İnö-
nü Üniversitesi Tıp Fakültesi Çocuk Gastroenteroloji Bölümü’nde, Ekim
2011-Aralık 2013 tarihleri arasında retrospektif olarak iki yıllık süreçte
izlenen 52 sirozlu çocuk hasta ile yaş ve cinsiyetleri benzer 30 sağlıklı
çocuk konvansiyonel, renkli Doppler ve doku Doppler ekokardiyorafik
görüntüleme yöntemleriyle değerlendirildi. Bulgular: Çalışmaya alınan
52 olgunun yaş ortalaması 6.5±4.6 yıl, 28’i erkek (%53,3), 24’ü kız
(%47,7) idi. Kontrol grubunun yaşlarının ortalaması 6.88±3.04 yıl, 16’sı
erkek (%53,3), 14’ü kız (%46,6) olmak üzere toplam 30 idi. Hastaların
M-mod değerlendirmelerinde sol ventrikül arka duvarı kontrol grubundan
daha kalındı (5.9±1.7 mm ve 5.1±1.8 mm, p:0.03). Renkli Dopplerle
mitral kapaktan ölçülen E/A oranı hasta grubunda anlamlı derecede
düşüktü (1.46±0.43 ve 1.61±0.46, p: 0.01). Hasta grubu daha uzun
izovolümik relaksasyon süresine (48.5±12.5 ms ve 42.6±11.64 ms,
p: 0.001) ve daha kısa izovolümetrik kontraksiyon süresine (43.6±9.5
ms ve 48.6±11.6 ms, p: 0.001) sahipti. Hasta grubunda sol ventrikü-
lün miyokard performans indeksi anlamlı olarak yüksekti (0.57±0.13
ve 0.50±0.67, p: 0.02). Hastaların 8 tanesine (%15) hepatopulmoner
sendrom tanısı kondu. Hepatopulmoner sendromlu hastaların ekokardiyografik
değerlendirilmelerinde, hepatopulmoner sendromu olmayan
hasta grubuna göre interventriküler septum diastolik kalınlığı (6,9±1.2
mm ve 6.4±1.8 mm, p: 0.04) ve yavaşlama süresi (154.1± 35.6 ms ve
140.4±39.8 ms, p: 0.03) daha fazla idi. Sonuç: Sirotik çocuklarda başta
diyastolik disfonksiyon olmak üzere kardiyak disfonksiyon vardır. hepatopulmoner
sendromlu grupta bu etkilenme daha fazladır. Çalışmamız
doku Doppler ekokardiyografinin, hastalık progresyonunun saptanması
ve izlenmesi için yararlı bir yöntem olduğunu göstermektedir
Cirrhotic cardiomyopathy is defined as cardiac dysfunction in the presence of cirrhosis. Several studies have been conducted on cirrhotic cardiomyopathy in cirrhotic children. The aim of this study was to investigate cardiac functions and pulmonary complications in children with cirrhosis. Materials and Methods: This study included 52 cirrhotic pediatric patients who were followed up for 2 years from October 2011 to December 2013 at İnönü University, Faculty of Medicine, Department of Pediatric Gastroenterology. In addition, 30 healthy children of similar age and sex were recruited and assessed using conventional echocardiography, color Doppler echocardiography, and tissue Doppler echocardiography. Results: Mean age of the 52 patients in the study group was 6.5±4.6 years; 28 patients were males (53.3%), and 24 were females (47.7%). The mean age of the control group children was 6.88±3.04 years; 16 were males (53.3%), and 14 were females (46.6%). M-mode echocardiographic evaluations of the patients showed increased left ventricular posterior wall thickness compared with that in control children (5.9±1.7 and 5.1±1.8 mm, p=0.03). The mean E/A ratio measured using colored dorsal mitral valve was significantly lower in the patient group than that in the control group (1.46±0.43 and 1.61±0.46, p=0.01). The patient group had longer isovolumic relaxation time (48.5±12.5 and 42.6±11.64 ms, p=0.001) and shorter isovolumetric contraction time (43.6±9.5 and 48.6±11.6 ms, p=0.001) than those in the control group. The myocardial performance index of left ventricle was significantly higher in the patient group (0.57±0.13 and 0.50±0.67, p=0.02) than that in the control group. Eight patients (15%) were diagnosed with hepatopulmonary syndrome. Echocardiographic evaluations of patients with hepatopulmonary syndrome showed that the interventricular septum diastolic thickness (6.9±1.2 and 6.4±1.8 mm, p=0.04) and the deceleration time (154.1±35.6 and 140.4±39.8 ms, p=0.03) were greater than those in the non- hepatopulmonary syndrome patient group. Conclusion: Cirrhotic children have cardiac dysfunction, especially diastolic dysfunction. This effect is more pronounced in patients with hepatopulmonary syndrome. Tissue Doppler echocardiography provides a quantifiable indicator that is useful for the detection and monitoring of disease progression.
Cirrhotic cardiomyopathy is defined as cardiac dysfunction in the presence of cirrhosis. Several studies have been conducted on cirrhotic cardiomyopathy in cirrhotic children. The aim of this study was to investigate cardiac functions and pulmonary complications in children with cirrhosis. Materials and Methods: This study included 52 cirrhotic pediatric patients who were followed up for 2 years from October 2011 to December 2013 at İnönü University, Faculty of Medicine, Department of Pediatric Gastroenterology. In addition, 30 healthy children of similar age and sex were recruited and assessed using conventional echocardiography, color Doppler echocardiography, and tissue Doppler echocardiography. Results: Mean age of the 52 patients in the study group was 6.5±4.6 years; 28 patients were males (53.3%), and 24 were females (47.7%). The mean age of the control group children was 6.88±3.04 years; 16 were males (53.3%), and 14 were females (46.6%). M-mode echocardiographic evaluations of the patients showed increased left ventricular posterior wall thickness compared with that in control children (5.9±1.7 and 5.1±1.8 mm, p=0.03). The mean E/A ratio measured using colored dorsal mitral valve was significantly lower in the patient group than that in the control group (1.46±0.43 and 1.61±0.46, p=0.01). The patient group had longer isovolumic relaxation time (48.5±12.5 and 42.6±11.64 ms, p=0.001) and shorter isovolumetric contraction time (43.6±9.5 and 48.6±11.6 ms, p=0.001) than those in the control group. The myocardial performance index of left ventricle was significantly higher in the patient group (0.57±0.13 and 0.50±0.67, p=0.02) than that in the control group. Eight patients (15%) were diagnosed with hepatopulmonary syndrome. Echocardiographic evaluations of patients with hepatopulmonary syndrome showed that the interventricular septum diastolic thickness (6.9±1.2 and 6.4±1.8 mm, p=0.04) and the deceleration time (154.1±35.6 and 140.4±39.8 ms, p=0.03) were greater than those in the non- hepatopulmonary syndrome patient group. Conclusion: Cirrhotic children have cardiac dysfunction, especially diastolic dysfunction. This effect is more pronounced in patients with hepatopulmonary syndrome. Tissue Doppler echocardiography provides a quantifiable indicator that is useful for the detection and monitoring of disease progression.
Açıklama
Akademik Gastroenteroloji Dergisi, 17(3), 101–105.
Anahtar Kelimeler
Karaciğer sirozu, Kardiyomiyopati, Cardiomyopathy, Tissue Doppler imaging
Kaynak
Akademik Gastroenteroloji Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
17
Sayı
3
Künye
Çelik, E., Karakurt, C., Çelik, S. F., Selimoğlu, M. A., & Varol, F. İ. (2017). Sirozlu Çocuklarda Kalp Fonksiyonlarının Doku Doppler Görüntüleme İle Değerlendirilmesi. Akademik Gastroenteroloji Dergisi, 17(3), 101–105.
