Functional features of the myocardium in school-age children with chronic somatic pathology according to echocardiographic examination

Abstract

The peculiarity of the modern pathology of childhood is the increasing frequency of transition of acute forms of diseases into recurrent and chronic ones and increasing primary chronic pathology. Systematic loads on «endurance» during training determine the necessity to study the possibilities of heart remodelling in school-age children against the background of chronic somatic pathology. Objective: to reveal structural and functional changes of myocardium in schoolchildren with chronic somatic pathology according to echocardiogram examination data. Materials and methods. We analysed 32 echocardiogram results in children aged from 7 to 17 years. The main group (n=16) - children with chronic somatic pathology out of exacerbation, control group (n=16) - children of the 2nd health group. Distribution of chronic somatic pathology in the main group: CNS diseases (n=4), kidney and urinary tract (n=5), GI (n=2), glands of internal secretion (n=3), vascular malformations (n=2). All children underwent echocardiogram examination with analysis of left ventricular ejection fraction systolic and diastolic myocardial function, left ventricular end-diastolic dimension, myocardial wall thickness, valve apparatus, presence/absence of physiological transudate in the pericardial cavity, and presence of small anomalies of cardiac development. Clinical and anamnestic data of the subjects, echocardiogram method and conventional statistical processing of the obtained results using STATISTICA for Windows software system were used to achieve the set goal and solve the research tasks. Results of the study. In the main group left ventricular ejection fraction was 61,8±1,57%, in the control group - 68,25±1,86% (p≤0,05). Left ventricular end-diastolic dimension was normal in both groups (p≥0.05). Concentric myocardial remodelling and increased myocardial wall thickness were found only in the main group in 18.8% (n=3) and 37.5% (n=6) of cases, respectively (p≤0.05). Valve pathology in the main and control groups was 43.8% (n=7) and 18.8% (n=3) of cases. Physiological transudate in the pericardial cavity was noted equally in both groups in 12.5% of cases. Small anomalies of cardiac development were detected in the main and control groups in 31.3% (n=5) and 18.8% (n=2) cases, respectively. Conclusion. Low values of left ventricular ejection fraction and increased myocardial wall thickness indicate a decrease in left ventricular function of the heart and a negative impact of metabolic disorders in children with chronic somatic pathology.