Subclinic cardiac involvement in paediatric patients with celiac disease: a novel sign for a case finding approach.
Subclinic cardiac involvement in paediatric patients with celiac disease: a novel sign for a case finding approach.
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乳糜泻儿科患者的亚临床心脏受累：病例发现方法的新征兆。
DOI：
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发表时间：
2012
影响因子：
3.2
通讯作者：
M. La Rosa
中科院分区：
文献类型：
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作者：
E. Lionetti;C. Catassi;R. Francavilla;M. Miraglia Del Giudice;P. Sciacca;T. Arrigo;S. Leonardi;A. Salpietro;C. Salpietro;M. La Rosa
本研究的目的是评估乳糜泻（CD）儿童早期心脏受累的患病率，以及无麸质饮食（GFD）对这一问题的影响。60例CD儿童与45例健康儿童对照组进行超声心动图检查。CD患者在1年GFD后1年重新评估。主要观察指标为射血分数（EF）、短轴缩短率（FS）、左心室舒张末期内径（LVDD）、左心室收缩末期内径（LVSD）、任何瓣膜损害。在13名CD儿童和1名对照儿童中发现轻度心脏受累（21.7% vs. 2.2%; p=0.003），继发于二尖瓣、主动脉瓣、肺动脉瓣和三尖瓣返流或射血分数受损。CD儿童相比，对照组有显着降低收缩指数，和较高的左心室尺寸。在坚持GFD的患者中，所有瓣膜置换均得到解决，超声心动图参数显著改善。CD儿童的亚临床心脏受累相当频繁，GFD可能对整体心脏性能产生有益影响。
The aim of the present work was to assess the prevalence of early cardiac involvement in children with celiac disease (CD), and the impact of a gluten free diet (GFD) on this issue. Sixty CD children was compared with a control group of 45 healthy children by an echocardiographic examination. CD patients were re-evaluated 1-year after 1-year GFD. Main outcome measures were ejection fraction (EF), fractional shortening (FS), left ventricular end-diastolic diameter (LVDD), left ventricular end-systolic diameter (LVSD), any regurgitating valve lesions. Mild cardiac involvement was found in 13 CD children and in one control (21.7% vs. 2.2%; p=0.003), and was secondary to regurgitation of mitral valve, aortic valve, pulmonary and tricuspid valve, or to impaired ejection fraction. CD children as compared to controls had significantly lower contractility indices, and higher left ventricular dimensions. In patients adhering to the GFD all valve regurgitations resolved, and the echocardiographic parameters significantly improved. Subclinical cardiac involvement in CD children is quite frequent, and GFD may exert a beneficial effect on the overall cardiac performance.