Prevalence of elevated pulmonary artery systolic pressure in Down Syndrome young patients with and without congenital heart disease.

Autor:	Nicoletti A; Pediatric Unit, Department of Science of Health, University Magna Graecia of Catanzaro, Catanzaro, Italy., Vatrano M; UTIC and Cardiology, Hospital 'Pugliese-Ciaccio', Catanzaro, Italy., Sestito S; Pediatric Unit, Department of Science of Health, University Magna Graecia of Catanzaro, Catanzaro, Italy., Apa R; Pediatric Unit, Department of Science of Health, University Magna Graecia of Catanzaro, Catanzaro, Italy., Patroniti S; Department of Human Pathology in Adult and Developmental Age 'Gaetano Barresi', Unit of Emergency Pediatrics, University of Messina, , 'G. Martino' Policlinic, Italy., Ceravolo G; Department of Human Pathology in Adult and Developmental Age 'Gaetano Barresi', Unit of Emergency Pediatrics, University of Messina, 'G. Martino' Policlinic, Italy., Calabrò MP; Department of Human Pathology in Adult and Developmental Age 'Gaetano Barresi', Unit of Pediatric Cardiology, University of Messina, 'G. Martino' Policlinic, Italy., Parisi F; Pediatric Unit, Department of Science of Health, University Magna Graecia of Catanzaro, Catanzaro, Italy., Roppa K; Pediatric Unit, Department of Science of Health, University Magna Graecia of Catanzaro, Catanzaro, Italy., De Sarro R; Pediatric Unit, Department of Science of Health, University Magna Graecia of Catanzaro, Catanzaro, Italy., Gitto E; Department of Human Pathology in Adult and Developmental Age 'Gaetano Barresi', University of Messina, Messina, Italy, Neonatal and Pediatric Intensive Care Unit., Pensabene L; Pediatric Unit, Department of Science of Health, University Magna Graecia of Catanzaro, Catanzaro, Italy., Concolino D; Pediatric Unit, Department of Science of Health, University Magna Graecia of Catanzaro, Catanzaro, Italy.
Jazyk:	angličtina
Zdroj:	Journal of biological regulators and homeostatic agents [J Biol Regul Homeost Agents] 2020 Jul-Aug; Vol. 34 (4 Suppl. 2), pp. 99-106 SPECIAL ISSUE: FOCUS ON PEDIATRIC CARDIOLOGY.
Abstrakt:	This study examined the prevalence and distribution of elevated systolic pulmonary arterial pressure, measured by echocardiography, in young patients with down syndrome associated or not with congenital heart disease and surgical correction during childhood. Pulmonary artery systolic pressure, computed by regurgitant tricuspid flow velocity evaluation, is the most frequently used parameter for the screening of pulmonary hypertension. Down syndrome and congenital heart disease often coexist and the probability to detect elevated systolic pulmonary arterial pressure in this setting is high. However, little is known about the evaluation of pulmonary arterial pressure during growth of patients with down syndrome with or without congenital heart disease. We enrolled 47 young patients (55% of male sex; mean age: 18.4 ± 6.0 years), 40 with congenital heart disease and 7 without a cardiac defect. Systolic pulmonary arterial pressure was assessed by echocardiography. No difference was found in the population dichotomized by presence or absence of CHD. Only male sex (p=0.000), highly sensitive troponin-T (P=0.027), tricuspid annular plane systolic excursion (TAPSE, p=0.045) and sPAP (p=0.004) were elevated in surgical group. The ASD was found as, the most common structural abnormality in our patients (50%), followed by VSD (27.5%) and complex CHD (such as complete atrioventricular canal defect, CAVC = 25% and Fallot disease = 15%). Furthermore, about 45% of patients had the combined defect. Only 37.5% of patients underwent to corrective surgery during the first months of life. We observed a significantly increase of sPAP values in patients with complex CHD, such as CAVC (p=0.019) and Fallot disease (p=0.001) but, in the following multivariate analysis performed in the patients with CHD, only Fallot disease remains as independent predictors of elevated values of sPAP (p=0.022). An elevated systolic pulmonary arterial pressure may represent the key screening tool in the diagnostic assessment of suspect pulmonary arterial hypertension in high risk population with down syndrome regardless the presence of congenital heart disease. (Copyright 2020 Biolife Sas. www.biolifesas.org.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu