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Long‐term right ventricular changes in mustard‐exposed patients: A historical cohort
Author(s) -
Khosravi Arezoo,
Motamedi Mohamad Ali,
KazemiSaleh Davoud,
Aslani Jafar,
Ghanei Mostafa
Publication year - 2018
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.22539
Subject(s) - medicine , cohort , cardiotoxicity , respiratory system , cardiology , surgery , toxicity
Abstract Introduction Mustard gas (MG) is a chemical warfare agent widely used in the Iran‐Iraq War. Its catastrophic effects on the lungs, eyes, and skin have been well studied. However, it also affects the cardiovascular system. We aimed to evaluate the long‐term effect of MG on right ventricular (RV) function. Methods All patients presenting to the university clinics between May 2014 and September 2015 were consecutively evaluated to enter the study based on the inclusion criteria (documented proof of chemical injury, no past or present cardiovascular disease, not a current smoker, and no history of sleep apnea). A comparable control group of veterans without MG exposure was randomly selected. All patients underwent echocardiographic measurement of RV size and function by a blinded cardiologist. Results We included 23 patients in the MG‐exposed group and 19 subjects in the control group, with a mean age of 48.6 years. Mean chemical injury severity score was 29.7% and mean time from the MG exposure was 29.2 years. The main complaint of MG‐exposed patients pertained to respiratory symptoms (91%). Pulmonary artery pressure was higher (32.83 vs. 28.95 mmHg) and RV strain was lower (−17.05% vs. −20.72%) in the MG‐exposed than in the control group ( P < .05). Conclusion Our results present baseline RV values for MG‐exposed patients and show mild but significant changes after 3 decades. Further cellular and molecular studies are needed to evaluate underlying mechanisms of MG cardiotoxicity.