Cardiac functions in children with steroid-sensitive nephrotic syndrome

Nalçacıoğlu H., Ozkaya O., Kafali H. C., Tekcan D., Baysal K.

Pediatrics International, cilt.62, sa.12, ss.1364-1368, 2020 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 62 Sayı: 12
  • Basım Tarihi: 2020
  • Doi Numarası: 10.1111/ped.14285
  • Dergi Adı: Pediatrics International
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, Agricultural & Environmental Science Database, BIOSIS, CAB Abstracts, CINAHL, EMBASE, MEDLINE, Veterinary Science Database
  • Sayfa Sayıları: ss.1364-1368
  • Anahtar Kelimeler: echocardiography, nephrotic syndrome, pediatrics, tissue Doppler echocardiography, ventricular function
  • Ondokuz Mayıs Üniversitesi Adresli: Evet

Özet

Background: The aim of the present study was to evaluate the presence of cardiac systolic and diastolic dysfunction in pediatric patients with steroid-sensitive nephrotic syndrome (NS). Methods: The study population consisted of 19 patients with debut-relapse of NS aged 1–18 years and 30 sex and age-matched healthy controls. Blood and urine samples, two M-mode conventional echocardiograms and tissue Doppler velocity imaging were evaluated in both attack and remission periods. Results: With regard to conventional pulse wave Doppler (cPWD), steroid-sensitive NS patients (both in debut / relapse and in remission periods) had a higher peak of late diastolic flow velocities (A peak), and patients in debut / relapse had a lower E/A ratio than the control group, indicating diastolic dysfunction (overall P = 0.003 and P = 0.006, respectively). Based on tissue Doppler velocity imaging echocardiography results, patients in debut/relapse had a higher A′ and a lower E′/A′ ratio (overall P < 0.001 and P = 0.001, respectively). There was also a significant difference in the cPWD E/TDI E′ ratio between the patients showing an increased cPWD E/TDI E′ ratio in remission periods compared to in debut/relapse periods (P = 0.09). The albumin levels were positively correlated with E′/A′ and E/ E′ ratio (r = 0.609; P = 0.007, r = 0.472; P = 0.041 respectively). Conclusions: Systolic cardiac functions are preserved but diastolic functions are affected in steroid-sensitive NS patients both in debut/relapse and in remission periods in a relatively short time. The persistence of left ventricular (LV) dysfunction during the remission period requires special attention during the follow up for early detection of cardiac abnormalities.