对为MIS-C治疗的患者进行心血管随访
Dayna Zimmerman1,2, Mark Shwayder1,2,3, Andrew Souza1,2,3
1Division of Cardiology.
Pediatrics
|November 15, 2023
概括
儿童多系统炎症性疾病 (MIS-C) 可能导致持久的心脏问题. 随访心脏检查显示频繁的异常,即使没有心脏损伤的初始迹象,表明需要心脏病治疗.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 传染性疾病 传染性疾病
- 心血管成像 - 心血管成像
- 关键护理医学 关键护理医学
背景情况:
- 儿童多系统炎症性疾病 (MIS-C) 是一种严重的疾病,可以影响多个器官,包括心脏.
- 了解MIS-C的长期心血管后果对于有效的患者管理和康复至关重要.
- 在急性疾病后,残留心血管病理可能会持续数月,需要全面评估.
研究的目的:
- 为了确定持续性心血管异常的患病率,大约六个月后MIS-C.
- 评估心脏MRI (CMR),门诊节律监测和心肺运动测试 (CPET) 在检测这些异常方面的实用性.
- 为了比较MIS-C.急性阶段心肌损伤的证据和没有证据的患者之间的发现.
主要方法:
- 诊断为MIS-C的患者被前性地纳入后续评估.
- 心脏MRI (CMR),门诊节律监测和心肺运动测试 (CPET) 在病后六个月左右进行.
- 急性疾病期间的心肌损伤被定义为Troponin-I升高或左心室功能降低在心声图上.
主要成果:
- 在153名MIS-C患者中,有69人接受了至少一个心脏随访研究.
- 在急性疾病期间记录有心肌损伤的患者中,在CMR (46%),节律监测 (12%) 和CPET (82%) 中发现了显著异常.
- 值得注意的是,没有明显急性心肌损伤的患者在CMR (52%) 和CPET (73%) 上也表现出高异常率,两组之间没有统计学上显著的差异.
结论:
- 在接受MIS-C治疗的儿童中,很大一部分在随访测试中表现出心血管异常.
- 异常发现的存在是一致的,不管急性疾病期间是否明显的肌心损伤.
- 这些发现强调了所有MIS-C患者的常规心脏病随访的重要性,以监测和管理潜在的长期心脏瘤.
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