SIGNIFICANCE OF THE FALSE CHORDS IN THE LEFT VENTRICLE FOR DIAGNOSTIC APPROACHES IN CHILD CONNECTIVE TISSUE DYSPLASIAS
https://doi.org/10.15829/1728-8800-2017-6-99-104
Abstract
Aim. The study was aimed on the importance evaluation of the false chords (FC) diagnostics in the left ventricle (LV) of the heart at early age to predict connective tissue dysplasia (CTD) development.
Material and methods. The study performed at cardiorheumatological department of MAI “CCCH №11” of Yekaterinburg city. Case histories of 200 patients analyzed, of those had undergone treatment in the department last 6 months. Group consisted of children aged 1 month to 17 year old, mean age 9,7±4,6 y. o. Phenotype of CTD was evaluated according to theGent score criteria (2010) and the Score by Kadurina T. I. et al. Heart structure and functioning were assessed with bi-dimensional transthoracic echocardiography. Statistics was done with SPSS Statistics 17.0 and Microsoft Office Excel 2013.
Results. All children had phenotype markers of CTD syndrome. Significance assessment of CTD by Kadurina score was 8,1±3,8 (2-33) points, that is grade 1 severity of CTD. In 17% (n=34) of children there was moderate CTD grade, and in 10% (n=20) there were dysplastic changes in ≥3 organ systems. Most of patients (95,5%) had FC (2,0±0,5 U) localized in various areas of the LV. Chords always correlated with phenotypic CTD markers in other physiological systems. And the number of concomitant markers significantly increased with the children’s age.
Conclusion. In most cases CTD syndrome is associated with the changes in the heart, and FC inLV can be regarded as easy approachable and most early and reliable phenotypical marker of this systemic disorder.
About the Authors
V. E. TimokhinaRussian Federation
Ekaterinburg
K. R. Mekhdieva
Russian Federation
Ekaterinburg
A. M. Cherednichenko
Ekaterinburg
F. A. Blyakhman
Russian Federation
Ekaterinburg
References
1. Martinov AI, Nechaeva GI, Akatova EV [et al.]. National recommendations of the Russian scientific society of internal medicine for diagnostics, treatment and rehabilitation of patients with connective tissue dysplasia. Medical news of North Caucasus 2016; 11(1):2–76. Russian (Мартынов А.И., Нечаева Г.И. Акатова Е.В. [и др.]. Национальные рекомендации РНМОТ по диагностике, лечению и реабилитации пациентов с дисплазиями соединительной ткани. Медицинский вестник Северного Кавказа 2016, 11(1):2–76).
2. Kadurina TI, Gnusaev SF, Arsentiev VG [et al.]. Multiorgan disorders in connective tissue dysplasia in children. Algorithm of diagnosis. Management tactics. Draft of Russian recommendations. Part 2. Medical news of North Caucasus 2016; 11(2):239–263. Russian (Кадурина Т.И., Гнусаев С.Ф., Арсентьев В.Г. [и др.]. Полиорганные нарушения при дисплазиях соединительной ткани у детей. Алгоритмы диагностики. Тактика ведения. Проект российских рекомендаций. Часть 2. Медицинский вестник Северного Кавказа 2016, 11(2)239–263).
3. Zemtsovsky EV. Non-differentiated connective tissue dysplasia. "Carthage should be destroyed"? Cardiovascular Therapy and Prevention 2008, 7(6):73–78. Russian (Земцовский Э.В. Недифференцированные дисплазии соединительной ткани. «Карфаген должен быть разрушен»? Кардиоваскулярная терапия и профилактика 2008, 7(6):73–78).
4. Kadurina TI, Gnusaev SF, Abbakumova LN. [et al.]. Hereditary and multivariate connective tissue disorders in children algorithm of diagnosis. Medical news of North Caucasus 2015; 10(1):5–35. Russian (Кадурина Т.И., Гнусаев С.Ф., Аббакумова Л.Н. [и др.]. Наследственные и многофакторные нарушения соединительной ткани у детей алгоритмы диагностики. Тактика ведения. Медицинский вестник Северного Кавказа 2015, 10(1):5–35).
5. Zemtsovsky EV, Malev EG, Minor anomalies of the heart and dysplastic phenotypes. SPb.: Izdatelstvo IVESEP; 2012: p. 160. Russian (Земцовский Э.В., Малев Э.Г. Малые аномалии сердца и диспластические фенотипы: Монография. СПб.: Издательство «ИВЭСЭП», 2012 p. 160).
6. Philip S, Cherian KM, Wu MH [et al.]. Left Ventricular False Tendons: Echocardiographic, Morphologic, and Histopathologic Studies and Review of the Literature. Pediatrics and Neonatology 2011; 52:279–286.
7. Kenchaiah S, Benjamin EJ, Evans JC [et al.]. Epidemiology of Left Ventricular False Tendons: Clinical Correlates in the Framingham Heart Study. Journal of American Society of Echocardiography 2009; 22(6):739–745.
8. Pisiak S, Dorniak K, Hellmann M [et al.]. Left ventricular false tendons: echocardiographic characteristics in the Polish population. Folia Morphologica 2015; 74(2)225–228.
9. Druk IV, Nechaeva GI, Oseeva OV [et al.]. Personalized Risk Assessment of Adverse Cardiovascular Events in Young Patients With Connective Tissue Dysplasia. Kardiologyia 2015; 55(3):75–84. Russian (Друк И.В., Нечаева Г.И., Осеева О.В. [и др.]. Персонифицированная оценка риска развития неблагоприятных сердечно-сосудистых проявлений у пациентов молодого возраста с дисплазией соединительной ткани. Кардиология 2015, 55(3):75–84).
10. Ferrer FS, Ferrer MLS, Murcia MDG [et al.]. Basic Study and Clinical Implications of Left Ventricular False Tendon. Is it associated with innocent murmur in children or heart disease? Revista Española de Cardiología 2015; 68(8):700–705.
11. Blyakhman FA, Zinovieva YA, Mekhdieva KR [et al.] False tendons in the left ventricle. Russian Journal of Cardiology 2017; 2:87–91. Russian (Бляхман Ф.А., Зиновьева Ю.А., Мехдиева К.Р. [и др.]. Ложные сухожилия в левом желудочке. Российский кардиологический журнал 2017, 2:87–91).
12. Cheitlin MD, Armstrong WF, Aurigemma GP [et al.] ACC/AHA/ASE 2003 Guideline Update for the Clinical Application of Echocardiography: Summary Article. Circulation 2003; 108(9):1146-62.
13. Mekhdieva K, Blyakhman F. Impact of left ventricular false tendons on young athletes’ cardiovascular adaptation to exercise loads. Journal of Mechanics in Medicine and Biology 2017; 17(3):17500661–9.
14. Blyakhman F. Left ventricular inhomogeneity and the heart’s functional reserve. In: ed. Prof. D. Ghista, Cardiac Pumping and Perfusion Engineering. World Scientific Press, 2007:17–56.
15. Pigolkin YuI, Shilova MA, Kil’dyushov EM [et al.]. Forensic medical characteristic of the causes behind sudden death in the young subjects. Sudebno-meditsinskaya ekspertiza 2016, 5:4–9. Russian (Пиголкин Ю.И., Шилова М.А., Кильдюшов Е.М. [и др.]. Судебно-медицинская характеристика причин внезапной смерти у лиц молодого возраста. Судебно-медицинская экспертиза 2016, 59(5):4–9).
Review
For citations:
Timokhina V.E., Mekhdieva K.R., Cherednichenko A.M., Blyakhman F.A. SIGNIFICANCE OF THE FALSE CHORDS IN THE LEFT VENTRICLE FOR DIAGNOSTIC APPROACHES IN CHILD CONNECTIVE TISSUE DYSPLASIAS. Cardiovascular Therapy and Prevention. 2017;16(6):99-104. (In Russ.) https://doi.org/10.15829/1728-8800-2017-6-99-104