Prematüre retinopatisinde kardiyak ejeksiyon fraksiyonu ve konjenital kalp hastalıkları

Öz

Amaç: Prematüre retinopatisi (PR)  gelişen ve gelişmeyen olgularda kardiyak ejeksiyon fraksiyonu (EF) ve konjenital kalp hastalıklarının (KKH) incelenmesi.

Materyal ve Metod:  Prospektif özellikteki çalışmaya 57 prematüre hasta dahil edildi. PR gelişen 27 olgu Grup 1, PR gelişmeyen 30 olgu Grup 2 olarak sınıflandırıldı. Kardiyak parametreler M-mode ekokardiyografi ile ölçüldü. Veriler SPSS programında analiz edildi.

Bulgular:  Grupların Ort. DH’ları arasında anlamlı bir fark gözlenmezken, 1. Gruptaki olguların ort. DA’sının anlamlı olarak düşük olduğu gözlendi ( sırasıyla p = 0.12, p = 0.03). 1 . Gruptaki olgularda EF % 69±9 iken, 2. Gruptaki olgularda % 70±6 idi. Ort. EF açısından iki grup arasında fark saptanmadı ( p > 0.05). Atrial septal defekt (ASD) görülme sıklığı 1. Grupta % 40.8 , 2. Grupta % 41, patent ductus arteriozus (PDA) sıklığı ise 1. Grupta % 26.,  2. Grupta % 12.5 idi. Birinci grupta gözlenen PDA sıklığının istatistiksel olarak daha yüksek olduğu gözlendi ( p < 0.05).  

Sonuç:  PR gelişen ve gelişmeyen olgularda EF açısından fark gözlenmezken, PR gelişen olgularda KKH’lardan PDA yaklaşık 2 kat daha sık gözlenmektedir. PR gelişen olgular PDA’nın kapanması için yakından takip edilmelidir.

 

Anahtar Kelimeler: Prematüre,retinopati,kardiyak hastalık

Anahtar Kelimeler

• Prematüre,retinopati,kardiyak hastalık

Cardiac ejection fraction and congenital hearth diseases in retinopathy of prematurity

Öz

Background: To investigate cardiac ejection fraction measurements and presence of any congenital hearth disease in premature babies with and without retinopathy of prematurity

Method: Totally 57 premature patients enrolled to the study. Twenty-seven patients with ROP defined as Group1 and 30 patients without ROP defined as Group 2. All cardiac parameters were measured by using M-mode echocardiography. Datas analyzed in SPSS programme.

Results:  No significant difference was found to be in terms of mean gestational age, whereas the mean GA was significantly lower in Group 1 ( respectively p = 0.12, p = 0.03). The mean ejection fractions were 69±9 % in Group 1 and 70±6 % in Group 2, there was no significant difference  in EF between two groups ( p > 0.05). The incidences of ASD were 40.8% in Group 1 and 41% in Group 2. The incidences of PDA were 26% in Group 1 and 12.5% in Group 2. The incidence of PDA was significantly higher in Group 1 ( p < 0.05)

Conclusion:  There is no significant differences in terms of EF and ASD in patients with and without ROP, while the incidence of PDA was two times higher in patients with ROP. Patients with ROP should be closely followed for closure in PDA.

 

Keywords: Premature, retinopathy, cardiac disease

Anahtar Kelimeler

• Premature,retinopathy,cardiac disease

Kaynakça

1. Özcan PY. Prematüre Retinopatisinde Etyopatogenez. Güncel Retina 2018;2:5-12.
2. Darlow BA, Hutchinson JL, Henderson‐Smart DJ. Prenatal risk factors for severe retinopathy of prematurity among very preterm infants of the Australian and New Zealand Neonatal Network. Pediatrics 2005; 115: 990‐6.
3. Chen Y, Xun D, Wang YC, Wang B et al. Incidence and risk factors of retinopathy of prematurity in two neonatal intensive care units in North and South China. Chin Med J (Engl). 2015; 128: 914-8.
4. Breatnach CR, Levy PT, James AT, Franklin O, El-Khuffash A. Novel echo- cardiography methods in the functional assessment of the newborn heart. Neonatology 2016; 110: 248-60.
5. Lewandowski AJ, Bradlow WM, Augustine D, Davis EF et al. Right ventricular systolic dysfunction in young adults born preterm. Circulation 2013; 128: 713-20.
6. Mitsiakos G, Papageorgiou A. Incidence and factors predisposing to retinopathy of prematurity in inborn infants less than 32 weeks of gestation. Hippokratia. 2016 ;20(2):121-126.
7. Ciccone MM, Cortese F, Gesualdo M,Di Mauro A et al. The role of very low birth weight and prematurity on cardiovascular disease risk and on kidney development in children: a pilot study. Minerva Pediatr. 2016. [Epub ahead of print]
8. Levy PT, El-Khuffash A, Patel MD, Breatnach CR et al. Maturational patterns of systolic ventricular deformation mechanics by Two-Dimensional speckle-Tracking echocardiography in preterm infants over the first year of age. J Am Soc Echocardiogr. 2017.pii: S0894-7317(17)30181-5.

9. Azhari N, Shihata MS, Al-Fatani A. Spontaneous closure of atrial septal defects within the oval fossa. Cardiol Young 2004; 14: 148-55.
10. Serafini O, Misuraca G, Greco F, Bisignani G, Manes MT, Venneri N. Prevalence of structural abnormalities of the atrial septum and their association with re- cent ischemic stroke or transient ischemic attack: echocardiographic evaluation in 18631 patients. Ital Heart J Suppl 2003; 4: 39-45
11. Lopez L, Colan SD, Frommelt PC, Ensing GJ et al. Recommendations for quantification methods during the performance of a pediatric echocardiogram: a report from the Pediatric Measurements Writing Group of the American Society of Echocardiography Pediatric and Congenital Heart Disease Council. J Am Soc Echocardiogr 2010;23:465–95; quiz 576–7.
12. Azhar AS, Habib HS. Accuracy of initial evaluation of heart murmurs in neonates: Do we need an echocardiogram ?. Pediatr Cardiol. 2006;27:234- 237.
13. Du ZD, Roguin N, Barak M. Clinical and echocardiyografik evaluation of neonates with heart murrnurs. Acta Pediatr 1997;86:752-737.
14. Güven H, Bakiler AR, Kozan M, Aydınoglu H, Helvacı M, Dorak C. Echocardiographic screening in newborn infants. Çocuk Sağlığı ve Hastalıkları Dergisi 2006;49:8-11.
15. Bhat R, Das UG. Management of patent ductus arteriosus in premature infants. Indian J Pediatr 2015; 82(1): 53-60.
16. Halil H, Buyuktiryaki M, Atay FY, Yekta Oncel M, Uras N. Reopen- ing of the ductus arteriosus in preterm infants; Clinical aspects and subsequent consequences. J Neonatal Perinatal Med. 2018.