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Cardiac functions in children with steroid‐sensitive nephrotic syndrome
Author(s) -
Nalcacioglu Hulya,
Ozkaya Ozan,
Kafali Hasan Candas,
Tekcan Demet,
Baysal Kemal
Publication year - 2020
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.14285
Subject(s) - medicine , diastole , doppler imaging , nephrotic syndrome , cardiology , gastroenterology , doppler echocardiography , endocrinology , blood pressure
Background The aim of the present study was to evaluate the presence of cardiac systolic and diastolic dysfunction in pediatric patients with steroid‐sensitive nephrotic syndrome (NS). Methods The study population consisted of 19 patients with debut‐relapse of NS aged 1–18 years and 30 sex and age‐matched healthy controls. Blood and urine samples, two M‐mode conventional echocardiograms and tissue Doppler velocity imaging were evaluated in both attack and remission periods. Results With regard to conventional pulse wave Doppler (cPWD), steroid‐sensitive NS patients (both in debut / relapse and in remission periods) had a higher peak of late diastolic flow velocities (A peak), and patients in debut / relapse had a lower E/A ratio than the control group, indicating diastolic dysfunction (overall P = 0.003 and P = 0.006, respectively). Based on tissue Doppler velocity imaging echocardiography results, patients in debut/relapse had a higher A′ and a lower E′/A′ ratio (overall P < 0.001 and P = 0.001, respectively). There was also a significant difference in the cPWD E/TDI E′ ratio between the patients showing an increased cPWD E/TDI E′ ratio in remission periods compared to in debut/relapse periods ( P = 0.09). The albumin levels were positively correlated with E′/A′ and E/ E′ ratio ( r = 0.609; P = 0.007, r = 0.472; P = 0.041 respectively). Conclusions Systolic cardiac functions are preserved but diastolic functions are affected in steroid‐sensitive NS patients both in debut/relapse and in remission periods in a relatively short time. The persistence of left ventricular (LV) dysfunction during the remission period requires special attention during the follow up for early detection of cardiac abnormalities.