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Echocardiographic findings in children ill with acute postinfectious glomerulonephritis

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Abstract

There are many studies about heart dysfunction and its significance in chronic renal diseases, but only few data regards cardiac involvement in acute glomerular diseases. The aim of this study was to assess echocardiographic changes in children with acute postinfectious glomerulonephritis (APGN), and the relationship of those changes to blood pressure (BP), edema and glomerular filtration rate (GFR). Echocardiography was performed on 127 patients on admission to the hospital, on a random sample consisting of 51 patients after 6–8 weeks, and 124 controls. In the acute phase, APGN patients had a greater left ventricular (LV) internal end-diastolic diameter (LVIDd) (P=0.022), interventricular septum thickness (IVSd) (P=0.038), LV mass (LVM) (P=0.0001), longer early diastolic flow deceleration time (DT) (P =0.0001), and higher numbers of cases with mitral regurgitation (MR) (P=0.0001) and pericardial effusion (P=0.0001) in comparison with the controls. Changes were more evident in the youngest patients. At follow-up after 6–8 weeks, echocardiographic parameters significantly improved, but LV posterior wall thickness, IVSd, LV end-diastolic volume, LVM and DT remained greater than in the controls. GFR and edema influenced echocardiographic parameters. In conclusion, in a group of children ill with APGN, increases in left ventricular dimensions, wall thickness, LVM and changes in the left ventricular diastolic function related to edema and GFR were found. Whether different treatment regimens effect these changes requires further study.

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Abbreviations

A :

mitral peak flow velocity of the late filling

APGN :

acute postinfectious glomerulonephritis

BP :

blood pressure

BSA :

body surface area

DT :

early diastolic flow deceleration time

E :

mitral peak flow velocity of the early filling

EF :

left ventricular ejection fraction

FS :

left ventricular fractional shortening

GFR :

glomerular filtration rate

IVSd :

interventricular septal thickness at end-diastole

LV :

left ventricular

LVDV :

left ventricular end-diastolic volume

LVSV :

left ventricular end-systolic volume

LVH :

left ventricular hypertrophy

LVIDd :

left ventricular internal end-diastolic diameter

LVISd :

left ventricular internal end-systolic diameter

LVM :

left ventricular mass

LVPWd :

left ventricular posterior wall thickness at end-diastole

MAP :

mean arterial pressure

MR :

mitral regurgitation

RWT :

relative wall thickness

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Correspondence to Augustina Jankauskiene.

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Jankauskiene, A., Jakutovic, M., Cerniauskiene, V. et al. Echocardiographic findings in children ill with acute postinfectious glomerulonephritis. Eur J Pediatr 162, 500–505 (2003). https://doi.org/10.1007/s00431-003-1241-8

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Keywords

  • Children
  • Echocardiography
  • Glomerulonephritis
  • Heart