Cardiac findings during uncomplicated acute influenza in ambulatory adults
Cardiac findings during uncomplicated acute influenza in ambulatory adults
复制标题
DOI：
10.1086/427282
复制
发表时间：
2005-02-01
影响因子：
11.8
通讯作者：
Hayden, FG
中科院分区：
文献类型：
--
作者：
Ison, MG;Campbell, V;Hayden, FG
背景资料。以前的研究报告了高达43%的成年流行性感冒患者心脏异常表现。本研究旨在确定此类患者发生心肌功能障碍的频率、程度和持续时间。我们招募了30名先前健康的年轻成年人，他们没有已知的心血管疾病，他们在流感症状出现后不到72小时出现在诊所，并且流感抗原试验呈阳性。大多数患者接受抗病毒治疗，所有患者均于发病后第1、4、11、28天进行连续心电图检查，并于入院后第1、4、11、28天采集血样，测定血清总肌酸激酶(CK)、肌酸激酶同工酶MB(CK-MB)、肌钙蛋白I(Tn I)及部分细胞因子水平。分别于第4、11、28天进行超声心动图检查。所有患者均未发现CK-MB指数或肌钙蛋白I水平升高。在第1天、第4天、第11天和第28天，分别有53%、33%、27%和23%的患者发现异常的心电图，但没有一种发现被认为具有临床意义。无一例患者射血分数或室壁运动异常发生明显改变。大多数患有急性流感的非卧床青年在发病早期都有临床上不明显的异常心电图表现。这些异常迅速消失，与心脏标记物或超声心动图发现的变化无关。
Background. Previous studies have reported abnormal cardiac findings in up to 43% of ambulatory adults with influenza. This study was conducted to determine the frequency, magnitude, and duration of myocardial dysfunction in such persons.Methods. We enrolled 30 previously healthy young adults without known cardiovascular disease who presented to the clinic less than or equal to 72 h after onset of influenza symptoms and had a positive influenza antigen test. Most patients received antiviral therapy, and all underwent serial electrocardiography and had blood specimens collected on days 1, 4, 11, and 28 after presentation for measurement of total creatine kinase (CK) level, CK isoenzyme MB (CK-MB) level, troponin I level, and selected cytokine levels. Echocardiography was performed on days 4, 11, and 28.Results. None of the patients had an elevated CK-MB index or troponin I level. Abnormal electrocardiogram findings were noted in 53%, 33%, 27%, and 23% of patients on days 1, 4, 11, and 28, respectively, but none of the findings were considered to be clinically significant. No patient had significant changes in the ejection fraction or abnormal wall motions.Conclusions. Most ambulatory young adults with acute influenza have clinically insignificant abnormal electrocardiogram findings early during the illness. These abnormalities resolve promptly and are not associated with changes in cardiac markers or echocardiogram findings.