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Familial Mediterranean fever is an autosomal recessive autoinflammatory inherited disease. We aimed to evaluate cardiac involvement in children with familial Mediterranean fever during the attack-free period.
Material and Methods:
The prospective study included 75 familial Mediterranean fever patients during the attack-free period and 50 healthy children. Cardiac evaluation was performed using electrocardiography, 24-hour ambulatory Holter monitoring, and conventional and tissue Doppler echocardiography. Aortic stiffness indices were calculated.
Results:
There were no differences between the groups in age, height, sex, body mass index, and arterial blood pressure parameters (p > 0.05). QT and corrected QT dispersion parameters were similar in both groups (p > 0.05). The E wave velocity and the E/A ratio of the mitral and tricuspid valves decreased, and the A wave velocity of the tricuspid and mitral valve increased in familial Mediterranean fever by the Doppler echocardiography (p < 0.05). The myocardial contraction velocities (Sd), early relaxation velocity (Ed), and Ed/late relaxation velocity (Ad) of both ventricles were decreased in familial Mediterranean fever group, whereas the Ad of both ventricles and the interventricular septum was increased in familial Mediterranean fever group. Aortic strain and distensibility were decreased, and pressure strain elastic modules (Ep), pressure strain normalised (Ep*) by diastolic pressure, and aortic stiffness β index were increased in familial Mediterranean fever patients (p < 0.05). When time domain heart rate variability parameters were evaluated, SDNN-i, RMSSD, and PNN50 significantly decreased in familial Mediterranean fever patients (p < 0.05), whereas SDNN and SDANN were similar in both groups (p > 0.05).
Conclusion:
Our findings showed that cardiac involvement could exist in familial Mediterranean fever patients, even during nonattack periods.
We aimed to investigate the effect of Celiac disease on myocardial functions and aortic elasticity parameters.
Materials and Methods:
Thirty children with Celiac disease and 30 healthy children were enrolled in the study. Both the groups were similar in terms of age and gender. Cardiac functions of all children in the patients and control group were evaluated using conventional transthoracic echocardiography and tissue Doppler imaging. Aortic strain, distensibility, and stiffness index were calculated by M-mode echocardiography.
Results:
The demographic findings, height, weight, and body mass index of cases were similar among two groups. No statistical difference was found between E wave velocity for conventional transthoracic echocardiography and tissue Doppler imaging measurements of the mitral valve; early diastolic flow peak velocity, A wave velocity; late diastolic flow peak velocity; and E/A ratio. Isovolumetric relaxation time and isovolumetric contraction time ratios were statistically different between the groups (p = 0.000, p = 0.000, p = 0.000). The myocardial performance index calculated according to the pulse Doppler measurement results was found to be statistically different between the groups (p = 0.000). There was no statistical difference between the groups in terms of aortic strain, distensibility, and stiffness index.
Conclusion:
In this study, both conventional transthoracic echocardiography and tissue Doppler imaging revealed the affection of the myocardial functions during systole and diastole in children with Celiac disease. Therefore, early follow-up and routine cardiac evaluation of celiac patients may be appropriate due to the increased risk of cardiac affection.
To assess neurohormonal activation of cardiac failure in adults with congenitally corrected transposition, and to determine the most sensitive marker for recognition of the cardiac failure.
Background
The onset of morphologically right ventricular dysfunction is unpredictable in patients with congenitally corrected transposition, the combination of discordant atrioventricular and ventriculo-arterial connections, and its markers are unknown.
Methods
We measured amino terminal pro brain natriuretic peptide in 19 patients, aged 35 plus or minus 13.1 years, and in 19 control subjects. Morhologically right ventricular function was assessed by echocardiography, including tissue Doppler echocardiography and magnetic resonance imaging or multislice computed tomography.
Results
The patients showed a highly significant increase in the levels of amino terminal pro brain natriuretic peptide, the levels being significantly elevated even in asymptomatic patients. Left atrial dimensions were larger in patients, and significantly lower tissue Doppler echocardiographic velocities were measured at the lateral site of the tricuspid annulus and at the basal segment of the interventricular septum. The ejection fraction of the morphologically right ventricle correlated significantly with the levels of brain natriuretic peptide, and with left atrial dimensions.
Conclusions
Neurohormonal activation is present in patients with congenitally corrected transposition even when they are asymptomatic. It is correlated with left atrial dimensions and tissue Doppler echocardiographic parameters. Levels of brain natriuretic peptide, and peak tricuspid early diastolic annular velocity, are the earliest and most sensitive markers of morphologically right ventricular dysfunction.
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