在MIS-C中采用speckle跟踪和常规回声心脏学:跟踪心脏参与和恢复
Nima Mehdizadegan1,2, Sajedeh Omidbakhsh3, Eslam Shorafa4
1Department of Pediatrics, Division of Pediatric Cardiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
BMC pediatrics
|February 26, 2025
概括
儿童多系统炎症综合征 (MIS-C) 可以影响心脏,但心脏功能,包括左心室喷射率 (LVEF) 和全球纵向应变 (GLS),通常在三个月内恢复正常. 建议对持续异常进行长期监测.
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
- 关键护理医学 关键护理医学
背景情况:
- 儿童多系统炎症综合征 (MIS-C) 是一种严重的COVID-19并发症.
- 心脏干扰在MIS-C中很常见,但其对心肌功能的长期影响尚未完全理解.
- 这项研究调查了MIS-C期间有或没有心脏参与的儿童的中期心脏功能.
研究的目的:
- 为了评估MIS-C.儿童的中期心脏功能.
- 为了比较MIS-C患者与没有心脏参与和健康对照之间的心脏功能.
- 评估三个月内心肌异常的恢复情况.
主要方法:
- 一项涉及90名儿童的病例对照研究 (包括30名心脏干扰的MIS-C,30名没有心脏干扰的MIS-C,30名健康对照).
- 胸外心声学 (TTE) 和斑点追踪心声学 (STE) 用于测量左心室喷射率 (LVEF) 和全球纵向应变 (GLS).
- 心脏功能参数在诊断时和诊断后三个月被评估.
主要成果:
- 患有MIS-C和心脏参与的儿童表现出炎症标志物 (费里丁,C反应蛋白) 和素阳性度的升高.
- 与对照组相比,心脏参与组的基线LVEF和GLS显著降低,特别是在基线段.
- 三个月后,大多数MIS-C患者的LVEF和GLS正常化,心力衰竭和冠状动脉异常消失;只有两个病例持续轻度左心室扩张.
结论:
- 与MIS-C相关的心脏功能障碍在三个月内在很大程度上是可逆的.
- 左心室喷射分数 (LVEF) 和全球纵向应变 (GLS) 在大多数受影响儿童中恢复到正常水平.
- 尽管整体康复,但部分患者可能会出现持续的心肌异常,需要持续的心脏监测.
相关概念视频
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