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Assessment of cardiac function and electrocardiographic findings in patients with Wilson's disease
Asuman N Karhan1, Hayrettin H Aykan2, Ersin Gümüş1
1Department of Paediatrics, Division of Gastroenterology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Insights
Children with Wilson's disease show early signs of heart dysfunction, including reduced systolic function and increased QT interval, detected by tissue Doppler echocardiography. These findings suggest subclinical cardiac changes even in asymptomatic young patients.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Research
- Metabolic Diseases
Background:
- Wilson's disease is a genetic disorder of copper metabolism.
- Cardiac involvement in pediatric Wilson's disease is not well-characterized.
- Early detection of cardiac dysfunction is crucial for managing the disease.
Purpose of the Study:
- To evaluate cardiac function in asymptomatic children with Wilson's disease.
- To assess electrocardiographic findings in pediatric Wilson's disease patients.
- To identify subclinical cardiac abnormalities using tissue Doppler echocardiography.
Main Methods:
- Compared 43 asymptomatic Wilson's disease patients with 37 healthy controls.
- Utilized tissue Doppler echocardiography to assess myocardial function.
- Performed standard electrocardiography and conventional echocardiography.
Main Results:
- Significantly lower mitral annular systolic velocity in Wilson's disease patients.
- Increased isovolumetric contraction time and relative left ventricular wall thickness observed.
- Elevated QT interval and P-wave dispersion, indicating potential arrhythmia risk.
Conclusions:
- Tissue Doppler echocardiography reveals subclinical systolic dysfunction in pediatric Wilson's disease.
- Increased QT interval and P-wave dispersion suggest an arrhythmogenic substrate.
- Cardiac monitoring is recommended for early detection of cardiovascular complications.
Background:
This study evaluated cardiac function using tissue Doppler echocardiography and assessed electrocardiographic findings in children diagnosed with Wilson's disease.
Method:
Asymptomatic patients with a diagnosis of Wilson's disease (n = 43) were compared to healthy controls (n = 37) that were age and gender matched.
Results:
The standard electrocardiographic and conventional echocardiographic examinations were similar in both groups. The left ventricular ejection fraction, shortening fraction, and diastolic function were not significantly different between the two groups. The Tei index for mitral lateral, mitral septal, tricuspid lateral, tricuspid septal, and inter-ventricular septum on tissue Doppler echocardiography was higher in the patient group, yet it did not reach statistical significance. Mitral lateral and septal systolic annular velocity values were significantly lower in the patient group when compared to the control group (p = 0.02 and 0.04, respectively). Also, mitral lateral and septal isovolumetric contraction time values were higher in the patient group (p = 0.04). Although the left ventricular values were not significantly different, relative left ventricular wall thickness was higher in the patient group when compared to the control group, and concentric remodelling in the left ventricle was found in 7 (16%) of 42 patients. QT interval (p = 0.02) and P-wave dispersion values (p = 0.04) were significantly higher in the patient group compared to the control group, and these tend to predict arrhythmias.
Conclusion:
Our study based on the tissue Doppler echocardiography assessment indicated a subclinical systolic, rather than diastolic, dysfunction in the myocardium with increased QT interval and P-wave dispersion, despite the young age of the patients and short disease duration.
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