Left ventricular assessment in patients with mucopolysaccharidosis using conventional echocardiography and myocardial deformation by two-dimensional speckle-tracking method
Journal Title: Jornal de Pediatria - Year 2019, Vol 95, Issue 4
Abstract
Objective Mucopolysaccharidosis is a rare genetic disease characterized by the intralysosomal deposition of glycosaminoglycans. Cardiovascular impairment is a common feature. Cardiac signs and symptoms are underestimated due to the disease involvement in other organs. Enzyme replacement therapy can be used in mucopolysaccharidosis I, II, IV, and VI. Thus, the knowledge about the use of new echocardiography tools is relevant to improve the care of this population. This study aimed to describe left ventricular function assessment by conventional echocardiography and left ventricular global longitudinal strain analysis and compare the alterations in patients receiving enzyme replacement therapy and who had different ages at the start of therapy. Method Outpatient-based descriptive study. The patients were submitted to conventional echocardiography and left ventricular global longitudinal strain measurement. Results Sixteen patients were evaluated; median age of 14.2 years (SD=5.2 years). Left ventricular hypertrophy was found in nine patients (56.2%). All patients had preserved left ventricular systolic function (Simpson and Teichholz). Nine (56.2%) patients showed alterations in left ventricular global longitudinal strain. The study showed a positive association between left ventricular hypertrophy and alteration in the left ventricular global longitudinal strain, and late start of enzyme replacement therapy and alteration in the left ventricular global longitudinal strain. Conclusion Echocardiographic alterations in patients with mucopolysaccharidosis were frequently observed, especially alterations in the left ventricular geometry and subclinical dysfunction. Patients who had a late enzyme replacement therapy start showed an association with worse left ventricular global longitudinal strain values, reinforcing the need for early diagnosis and treatment. The use of new echocardiographic tools may improve the follow-up of these patients.
Authors and Affiliations
Mirela Andrade
Traveling with children: beyond car seat safety
Objective To spread knowledge and instigate the health professional to give advice on childcare during travels and on child transport safety. Sources of data Literature review through the LILACS and MEDLINE® databases,...
Clinical application of the Newborn Behavioral Observation (NBO) System to characterize the behavioral pattern of newborns at biological and social risk
Objective To compare the behavior of preterm newborns and full-term newborns using the Newborn Behavioral Observation and to evaluate the mothers’ experience when participating in this observation. Method This was a cro...
Growth and mouth breathers
Objective To assess the relationship between mouth breathing and growth disorders among children and teenagers. Data source Search on MEDLINE database, over the last 10 years, by using the following terms: “mouth breath...
Nutritional screening in hospitalized pediatric patients: a systematic review
Objective This systematic review aimed to verify the available scientific evidence on the clinical performance and diagnostic accuracy of nutritional screening tools in hospitalized pediatric patients. Data source A sea...
Role of echocardiography in reducing shock reversal time in pediatric septic shock: a randomized controlled trial
Objective To evaluate the role of echocardiography in reducing shock reversal time in pediatric septic shock. Methods A prospective study conducted in the pediatric intensive care unit of a tertiary care teaching hospit...