Obez çocuklarda sol ventrikül fonksiyonlarının değerlendirilmesinde doku doppler ekokardiyografi

Amaç: Bu çalışmada obez çocuklarda transtorasik doku Doppler ekokardiyografik yöntemle sol ventrikül sistolik ve diyastolik fonksiyonlarının değerlendirilmesi amaçlandı. Gereç ve yöntem: Mitral doku Doppler sinyalleri, mitral annulus lateral duvarlarına yerleştirilen örnek hacmi ile apikal dört boşluktan kaydedildi. Pulse Doppler örneği apikal dört boşluk görüntüde mitral kapak uçlarına, akı- ma paralel olacak şekilde yerleştirilerek mitral akım tra- sesi elde edildi. Çalışmaya 20 obez (161,5±25,8 ay) ve 20 (151,2±33,5 ay) sağlıklı çocuk alınarak gerçekleştirildi. Bulgular: Vücut kitle indeksi (VKİ) obez grupta belirgin yüksekti (30,92±6,87). Sol ventrikül (LV) diyastolik fonk- siyon parametrelerinden izovolemik relaksasyon zamanı (IVRT) obez grupta 66,10±7,30 msn, kontrol grubunda ise 58,70±9,06 msn ile obez grupta anlamlı artış saptandı (p=0,007). Obez grubunda mitral anulus doku Doppler E akım hızı azalmış, A akım hızı artmış ve Em/Am oranının anlamlı derecede azalmış olduğu görüldü. VKİ ile LV Em/ Am oranı arasında anlamlı negatif ilişki saptandı. Miyo- kardiyal performans indeksi (MPİ) obez grupta 0,50±0,07, kontrol grubunda ise 0,41±0,04 (p<0.001) bulundu. MPİ ile LV Em/Am oranı arasında anlamlı negatif ilişki sap- tandı. MPİ ile VKİ arasında anlamlı pozitif ilişki saptandı. Obez grupta kontrol grubuna göre interventriküler septum ve LV arka duvar kalınlığının önemli derecede artmış ol- duğu gösterildi (p<0.001). Sonuç: Bu bulgular, pediatrik yaş grubunda obezite ve kardiyovasküler risk faktörleri arasındaki ilişkiyi belirle- mek için önemli bulgular olabilir. Doku Doppler ekokardi- yografik görüntüleme yöntemi ise aralarındaki bu ilişkinin belirlenmesinde yararlı olabilir.Objective: The aim of this study was to investigate the impact of childhood obesity on ventricular functions using tissue Doppler echocardiography. Materials and methods: The mitral tissue Doppler signals were recorded in the apical four-chamber view, with the sample volume placed at the lateral walls of mitral annulus. The mitral flow was examined with the sample Pulse Dop- pler positioned parallely to flow just at the orifice of the mi- tral leaflets. Twenty obese (mean age, 161.5&plusmn;25.8 months) and 20 healthy children (mean age, 151.2&plusmn;33.5 months) were included to this study.Results: Body mass index (BMI) was significantly higher in obese group (30.92&plusmn;6.87). Isovolumic relaxation time (IVRT) which is one of the left ventricular (LV) diastolic function parameters was 66.10&plusmn;7.30 ms in obese group, and 58.70&plusmn;9.06 ms in the control group. IVRT was sig- nificantly higher in the obese group (p=0.007). In obese group, the mitral annulus tissue Doppler E velocity was decreased, flow velocity was increased and decrement in Em/Am ratio was significant. We found significant negative correlation between BMI and LV Em/Am ratio. Myocardial performance index (MPI) in obese group and control group was 0.50&plusmn;0.07 and 0.41&plusmn;0.04, respectively (p&lt;0.001). Between MPI and LV Em/Am ratio there was a significant negative correlation while MPI showed positive correlation with BMI. In obese group septal and LV posterior wall thick- ness was shown to be significantly increased compared to the control group (p&lt;0.001). Conclusion: Our findings, may be important for determina- tion of the relationship between obesity and cardiovascular risk factors in children. Tissue Doppler echocardiographic imaging may be useful in revealing this relationship

Two cases with isolated and complex cardiac defects together with inferior vena cava anomaly

Systemic venous anomalies are rare congenital anomalies.Although they appear in different symptoms, they areusually asymptomatic and they can be detected incidentallyduring investigation of other congenital heart anomalies.The knowledge of this kind of anomalies before cardiacangiography and open heart surgery is important toprevent time loss and unexpected complications. Echocardiographytransabdominal view is used and angiographyis performed for confirmation. We report two casesin which absent suprarenal inferior vena cava with venaazygos continuity was present. One is isolated and one ispresent with cardiac atrioventricular septal defec

Tissue doppler echocardiography for evaluating left ventricular functions in obese

Objective: The aim of this study was to investigate theimpact of childhood obesity on ventricular functions usingtissue Doppler echocardiography.Materials and methods: The mitral tissue Doppler signalswere recorded in the apical four-chamber view, with thesample volume placed at the lateral walls of mitral annulus.The mitral flow was examined with the sample Pulse Dopplerpositioned parallely to flow just at the orifice of the mitralleaflets. Twenty obese (mean age, 161.5±25.8 months)and 20 healthy children (mean age, 151.2±33.5 months)were included to this study.Results: Body mass index (BMI) was significantly higherin obese group (30.92±6.87). Isovolumic relaxation time(IVRT) which is one of the left ventricular (LV) diastolicfunction parameters was 66.10±7.30 ms in obese group,and 58.70±9.06 ms in the control group. IVRT was significantlyhigher in the obese group (p=0.007). In obesegroup, the mitral annulus tissue Doppler E velocity wasdecreased, flow velocity was increased and decrement inEm/Am ratio was significant. We found significant negativecorrelation between BMI and LV Em/Am ratio. Myocardialperformance index (MPI) in obese group and control groupwas 0.50±0.07 and 0.41±0.04, respectively (p<0.001).Between MPI and LV Em/Am ratio there was a significantnegative correlation while MPI showed positive correlationwith BMI. In obese group septal and LV posterior wall thicknesswas shown to be significantly increased compared tothe control group (p<0.001).Conclusion: Our findings, may be important for determinationof the relationship between obesity and cardiovascularrisk factors in children. Tissue Doppler echocardiographicimaging may be useful in revealing this relationship.Key words: obesity, doppler echocardiography, ventricular dysfunctio

Cardiovascular evaluation and serum paraoxonase-1 levels in adolescents with polycystic ovary syndrome

The aim of our study was to evaluate whether cardiovascular disease risks seen in adults with polycystic ovary syndrome (PCOS) develop in adolescents with PCOS using conventional Doppler echocardiography (CDE) and tissue Doppler echocardiography (TDE) or not. The other aim was to investigate the association of paraoxonase-1 (PON-1) level with cardiovascular parameters. 30 PCOS patients and 30 control patients were included in the study. All patients were evaluated with TDE and CDE. Paraoxonase-1 levels of both groups were studied. In CDE study, myocardial performance index (MPI) was higher in the PCOS group than in the control group (0.54 ± 0.11, 0.50 ± 0.12, p = .049, respectively). In the TDE study, early diastolic myocardial velocity (E)’/late diastolic myocardial velocity (A′) was lower in PCOS group than in the control group (2.07 ± 0.08, 2.44 ± 0.10, p = .008, respectively). PON-1 was higher in PCOS group than in the control group (26.81 ± 3.05, 18.68 ± 1.18, p = .011, respectively). Cardiovascular disease risks, which are among the long-term complications of PCOS, seem to begin from the early stage of PCOS. The high PON-1 level was thought to increase in response to increased oxidative stress in PCOS.Impact statement What is already known on this subject? Polycystic ovary syndrome (PCOS) is one of the most commonly seen endocrinopathy in the adolescent age group. PCOS has detrimental effects on the cardiovascular system in the adult population which is reported in many studies. What the results of this study add? The result of this study showed that cardiovascular effects, which are among the long-term complications of PCOS, seem to begin from the early stage of PCOS. And also, serum paraoxonase-1 level increases in response to the oxidative stress in the adolescent with PCOS. What are the implications of these findings for clinical practice and/or further research? The cardiovascular system evaluation should be started in early phases of PCOS development in the adolescent age group. The potential role of oxidative effect of Paraoxonase-1 on the PCOS needs to be elucidated in further studies

Identification of three novel pathogenic ITGA2B and one novel pathogenic ITGB3 mutations in patients with hereditary Glanzmann’s thrombasthenia living in Eastern Turkey

Glanzmann’s thrombasthenia (GT) is an autosomal recessive disorder in which the underlying problem is the lack or dysfunction of the GpIIb/IIIa receptor on the platelet surface. The present study determines the genetic mutation typology and analyzes the association between mutation types and clinical findings in patients diagnosed with GT who were followed up in Department of Pediatric Hematology of the Yüzüncü Yıl University School of Medicine. The medical charts of 17 patients who underwent therapy and that were followed up in the Department of Pediatric Hematology of the Yüzüncü Yıl University Dursun Odabaş Medical Center between January 2008 and April 2018 were reviewed retrospectively. Data on such patient characteristics as present genetic mutations, age, gender, age at diagnosis, presenting symptoms, clinical findings, and platelet count and volume were garnered from the patient records. Of the 12 patients identified with genetic mutations, six had the same type of mutation, while four were identified with novel mutations that have to date not been defined in literature. Of these four mutations, three were located in the ITGA2B gene and one in the ITGB3 gene. The present study identified no significant association between the genetic and clinical findings of the patients. Novel mutations were identified in four cases in the present study. No association was found between the mutation type, and the bleeding scores and bleeding phenotypes of the patients. Further studies involving a larger number of patients are required to determine the relationship between the genotypes and clinical findings in patients with GT

Incidence and clinical characteristics of acute rheumatic fever in Turkey: Results of a nationwide multicentre study

© 2021 Paediatrics and Child Health Division (The Royal Australasian College of Physicians)Aim: To evaluate the incidence and clinical features of acute rheumatic fever (ARF) in Turkey, following the revised Jones criteria in 2015. Methods: This multicentre study was designed by the Acquired Heart Diseases Working Group of the Turkish Pediatric Cardiology and Pediatric Cardiac Surgery Association in 2016. The data during the first attack of 1103 ARF patients were collected from the paediatric cardiologists between 1 January 2016 and 31 December 2016. Results: Turkey National Institute of Statistics records of 2016 were used for the determination of ARF incidence with regard to various cities and regions separately. The estimated incidence rate of ARF was 8.84/100 000 in Turkey. The ARF incidence varied considerably among different regions. The highest incidence was found in the Eastern Anatolia Region as 14.4/100 000, and the lowest incidence was found in the Black Sea Region as 3.3/100 000 (P < 0.05). Clinical carditis was the most common finding. The incidence of clinical carditis, subclinical carditis, polyarthritis, aseptic monoarthritis, polyarthralgia and Sydenham's Chorea was 53.5%, 29.1%, 52.8%, 10.3%, 18.6% and 7.9%, respectively. The incidences of clinical carditis, subclinical carditis, polyarthritis and polyarthralgia were found to be significantly different among different regions (P < 0.05). Conclusion: The findings of this nationwide screening of ARF suggest that Turkey should be included in the moderate-risk group