首页> 外文期刊>BMC Cardiovascular Disorders >Novel functional advanced echocardiography for the assessment of myocardial mechanics in children with neurocardiogenic syncope – a blinded prospective speckle tracking head-up tilt-table challenge study
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Novel functional advanced echocardiography for the assessment of myocardial mechanics in children with neurocardiogenic syncope – a blinded prospective speckle tracking head-up tilt-table challenge study

机译:新型功能性先进超声心动图,用于评估神经源性晕厥患儿的心肌力学–前瞻性散斑盲目跟踪平视倾斜表挑战研究

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Data on left ventricular (LV) function in patients with neurocardiogenic syncope (NS) is conflicting in adults and lacking in children. The aim of this study was to analyze LV myocardial performance in children with NS at rest and during head-up tilt-table (HUTT) testing. This is the first study to combine HUTT and speckle-tracking echocardiography (STE) in children with NS. 43 consecutive normotensive pediatric patients with NS (mean age 13.9?±?2.6?years, 51% female) and 41 sex- and age-matched healthy controls were included in the study. The study groups consisted of 21 patients with a positive HUTT reaction (HUTT+) and 22 with a negative HUTT reaction (HUTT-). STE was used to analyze peak systolic LV myocardial strain and strain rate. Conventional echocardiographic parameters were similar in all analyzed groups. When compared to healthy controls, children with NS had depressed levels of circumferential strain rate (p?=?0.032) and significantly depressed longitudinal strain rate (p?< 0.001) at rest. Interestingly, during HUTT testing LV global strain and strain rate were similar in both groups. LV strain rate was lowest in HUTT+ followed by HUTT- and control subjects both at rest and during HUTT. Resting LV longitudinal strain rate is attenuated in children with NS, especially in those with a positive HUTT response. This is further evidence that NS patients feature altered cardiac mechanics rendering them prone to vasovagal perturbations that can ultimately result in collapse. Witten/Herdecke University ethics committee clinical study number: UWH-73-2014.
机译:神经性心源性晕厥(NS)患者的左心室(LV)功能数据在成年人中存在冲突,在儿童中则缺乏。这项研究的目的是分析静止和抬头倾斜台(HUTT)测试中NS患儿的左心室心肌表现。这是首次将HUTT和斑点跟踪超声心动图(STE)结合用于NS患儿的研究。本研究纳入了43例连续降压的小儿NS患者(平均年龄13.9?±?2.6?岁,女性51%)和41个性别和年龄匹配的健康对照者。研究组包括21例HUTT反应阳性(HUTT +)和22例HUTT反应阴性(HUTT-)。 STE用于分析收缩期左室心肌的峰值应变和应变率。所有分析组的常规超声心动图参数均相似。与健康对照组相比,NS患儿在静息时的圆周应变率水平较低(p≥0.032),而纵向应变率则显着较低(p <0.001)。有趣的是,在HUTT测试中,两组的LV总应变和应变率相似。在静息和HUTT期间,HUTT +中的LV应变率最低,其次是HUTT-和对照组。 NS患儿,尤其是HUTT反应阳性的患儿,其静息LV纵向应变率降低。这进一步证明了NS患者的心脏力学改变,使他们易于出现血管迷走神经摄动,最终可能导致虚脱。 Witten / Herdecke大学伦理委员会临床研究编号:UWH-73-2014。

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