Quantification of right ventricular performance and cardiac Troponin I in children with hemophilia
Journal Title: INNOVATIVE JOURNAL OF MEDICAL AND HEALTH SCIENCE - Year 2019, Vol 9, Issue 3
Abstract
Introduction & Aim:There is contradiction regarding the protective effect o f h emophilia a gainst myocardialischemia. Emerging evidences suggest that subjects with hemophilia are at highrisk for cardiovascular disease (CVD)in adults, but insufficient data were reported inpediatrics. Our objective was to evaluate right ventricle(RV) function in children withhemophilia.Subjects and methods:A controlled study included 30 children with hemophilia (GI) compared to30 agematched healthy male children (GII). Different m odalities o f e chocardiography wereused to assess RV function. We investigated the association between clinical data,echocardiographic findings and serum troponin I in the studied children.Results:In comparison to healthy control, hemophilic children had significant i mpairment ofboth systolic and diastolic RV function and elevated troponin I level that was significantlycorrelated with hemophilia severity. (93.33%) of hemophilic children had RVSm<11.5cm/s and (6%) had 2D-RVGLS<-21%;(93.33%) of them had impaired globalRV function byTD-MPI>0.37and (43.33%) by PW-MPI. (86.66%) of hemophilic childrenhad RV diastolic dysfunction measured by E/Em>6 while only (10%) whenmeasured by pulsed Doppler E/A<0.8. At cut off p oint >0.74 ng/ml serum troponinI has 53.33% sensitivity and 71.34% specificity to predict RV dysfunction.Conclusion:Both RV systolic and diastolic functions are impaired in asymptomatic hemophilic children.Regular echocardiographic assessment using different m odalities p rovide valuabletool for detection of RV dysfunction in asymptomatic hemophilic children isrecommended.
Authors and Affiliations
Abeer Ahmed Elmalah*,AsmaaAbd El-Wakeel Ibrahim,Shaimaa A. Habib,Ayman Sadik, Mohamad Ahmad,Aml Gaber,Emansaad Mohamed
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