ECHOCARDIOGRAPHY PATTERNS OF MYOCARDIAL PATHOLOGY IN CHILDREN WITH JUVENILE ARTHRITIS
Abstract
Juvenile rheumatoid arthritis (JRA) and juvenile spondiloarthritis (JSA) are chronic auto-immune disorders, characterised by various extraarticular pathology, including heart pathology. The most available non-invasive method for diagnosing asymptomatic myocardial pathology is echocardiography. The study included 185 children with JRA and 43 children with JSA. The systemic JRA variant was characterised by high prevalence of left ventricular (LV) hypertrophy (48,2%), LV dilatation (32,9%), and LV diastolic dysfunction (30,6%) with unaffected systolic function. The respective percentages in the arthritic JRA variant were 11%, 13%, and 15%, which pointed to the need for follow-up and possible diagnosis revision, due to systemic character of the disease. In JSA, reduced total LV contractility was the most prevalent sign (27,9%). To identify the reasons for the latter, further detailed examination was necessary.
About the Authors
A. B. Sugak
НИИ педиатрии РАМН; Научный центр здоровья детей, Москва
Russian Federation
Russian Federation
E. I. Alekseeva
НИИ педиатрии РАМН; Научный центр здоровья детей, Москва
Russian Federation
Russian Federation
I. V. Dvoryakovsky
НИИ педиатрии РАМН; Научный центр здоровья детей, Москва
Russian Federation
Russian Federation
References
1. Колотова Г.Б. Особенности морфофункционального состояния и типы ремоделирования левых отделов сердца у пациентов с серопозитивным и серонегативным ревматоидным артритом // Ультразвуковая и функциональная диагностика. – 2008. – №3. – С. 35-41.
2. Bharti B.B., Kumar S., Kapoor A. et al. Assessment of left ventricular systolic and diastolic function in juvenile rheumatoid arthritis // J. Postgrad. Med. – 2004. – V.50(4). – P.262-265.
3. Daniels S.R., Kimball T.R., Morrison J.A. et al. Indexing left ventricular mass to account for differences in body size in children and adolescents without cardiovascular disease // Am.J.Cardiol. – 1995. – V.76(10). – P.699-701.
4. Daniels S.R. Hypertension-induced cardiac damage in children and adolescents // Blood Press. Monit. – 1999. – V.4. – P.165-170.
5. Di Franco M., Paradiso M., Mammarella A. et al. Diastolic function abnormalities in rheumatoid arthritis. Evaluation by echo Doppler transmitral flow and pulmonary venous flow: relation with duration of disease // Ann. Rheum. Dis. – 2000. – V.59(3). – P.227-229.
6. Drazner M.H., Rame J.E., Marino E.K. et al. Increased left ventricular mass is a risk factor for the development of a depressed left ventricular ejection fraction within five years: The Cardiovascular Health Study // J. Am. Coll. Cardiol. – 2004. – V.43. – P.2207-2215.
7. Foster B.J., Mackie A.S., Mitsnefes M. et al. A novel method of expressing left ventricular mass relative to body size in children // Circulation. – 2008. – V.117. – P.2769-2775.
8. Giles J.T., Fernandes V., Lima J.A.C. et al. Myocardial dysfunction in rheumatoid arthritis: epidemiology and pathogenesis // Arthritis Research & Therapy. – 2005. – V.7. – P.195-207.
9. Huppertz H., Voigt I., Muller-Scholden J. et al. Cardiac manifestations in patients with HLA B27-associated juvenile arthritis // Pediatr. Cardiol. – 2000. – V.21(2). – P.141-147.
10. Oguz D. Ocal B. Ertan U. et al. Left ventricular diastolic functions in juvenile rheumatoid arthritis // Pediatr. Cardiol. – 2000. – V.21(4). – P.374-377.
11. Palazzi C., D’Angelo S., Lubrano E. et al. Aortic involvement in ankylosing spondylitis // Clin. Exp. Rheumatol. – 2008. – V.26 (3 Suppl 49). – S.131-134.
12. Vasan R.S., Larson M.G., Benjamin E.J. et al. Left ventricular dilatation and the risk of congestive heart failure in people without myocardial infarction // N. Engl. J. Med. – 1997. – V.336. – P.1350-1355.
13. Wislowska M., Sypula S., Kowalik I. Echocardiographic findings, 24-hour electrocardiographic Holter monitoring in patients with rheumatoid arthritis according to Steinbrocker’s criteria, functional index, value of Waaler-Rose titre and duration of disease // Clin. Rheumatol. – 1998. – V.17. – P.369-377.
14. Wolfe F., Freundlich B., Straus W.L. Increase in cardiovascular and cerebrovascular disease prevalence in rheumatoid arthritis // J. Rheumatol. – 2003. – V.30. – P.36-40.
Review
For citations:
Sugak A.B., Alekseeva E.I., Dvoryakovsky I.V. ECHOCARDIOGRAPHY PATTERNS OF MYOCARDIAL PATHOLOGY IN CHILDREN WITH JUVENILE ARTHRITIS. Russian Journal of Cardiology. 2010;(1):24-29. (In Russ.)
Views:
507
Email this article 