Derya ÇİMEN, Canan YILDIRIM, Bedri ALDUDAK

Subakut sklerozan panensefalitli hastaların ekokardiyografik değerlendirilmesi

Amaç: Subakut sklerozan panensefalit (SSPE), santral sinir sisteminin yavaş virüs enfeksiyonu sonucu ortaya çıkan kronik, progressif dejeneratif bir hastalığıdır. Bu hasta grubunun kalp fonksiyonları ile ilgili çalışmalar kısıtlı olduğu için bu konuya ışık tutmak amacıyla farklı evrelerdeki hastaların kalp fonksiyonları değerlendirilmiştir. Yöntemler: Çalışma prospektif bir çalışma şeklinde olup, Çocuk Nörolojisi polikliniğinde takip edilen 49 SSPE olgusu (17 kız, 32 erkek) çalışmaya alındı. Hastalar evre 2(n=29) ve evre 3(n=20) olarak iki gruba ayrıldı. Ekokardiyografik veriler yaş ortalaması aynı olan 26 kontrol grubu ile karşılaştırıldı. M- mode, pulse Doppler ve doku Doppler ekokardiyografik incelemeler ve gruplara uygulandı. Bulgular: Sinüs taşikardisi (100 atım/dak üzeri)19 hastada ( %37,8) mevcuttu. Kalbin sistolik ve diyastolik fonksiyon parametreleri arasında anlamlı farklılık yoktu. Evre 2 SSPE grubunda, EF: 69.9±6.4, FS: 39.2±5.58, MPI(mitral):0.38±0.03, MPI(triküspid): 0.39±0.10, Evre 3 grubunda, EF: 68.5±7.00, FS: 37.8±5.34, MPI(mitral):0.37±0.09, MPI(triküspid):0.38±0.12, Kontrol grubunda EF:70.96±5.54, FS:39.96±5.05, MPI(mitral):0.35±0.06, MPI (triküspid):0,36±0,04 olarak bulundu. Farklı evrelerde bakılan hastaların ekokardiyografik verileri kontrol grubu ile karşılaştırıldığında istatistiki olarak anlamlı farklılık bulunmamıştır (p > 0,05). Sonuç: Bu çalışma kalp fonksiyonlarının ileriki dönemlere kadar korunabileceğini, kronik ve yatağa bağımlı bir hastalık olan SSPE de bu durumun mortalite açısından önemli bir risk oluşturmayacağını göstermektedir.

Anahtar Kelimeler:

Subakut sklerozan panensefalit, ekokardiyografi, kardiyak fonksiyon

Echocardiographic evaluation of patients with subacute sclerosing panencephalitis

Objective: Subacute sclerosing panencephalitis is a slowly progressive, inflammatory and neurodegenerative disease caused by virus infection in the central nervous system. Since there are a limited number of studies in the literature evaluating the cardiovascular functions of patients with SSPE, the present study evaluates the patients with SSPE using tissue Doppler echocardiography and compares them between the control group in order to shed some light on the subject. Methods: The study is a prospective observational study. 49 patients (17 female, 32 male) with SSPE were included in the study. Patients were divided into two groups: Stage 2 (n=29) and Stage 3 (n=20). Echocardiographic data were compared with a control group of 26 which is the same average age. All children underwent a detailed echocardiography, which contained an M-mode, pulse Doppler and tissue Doppler imaging. Results: Sinus tachycardia ( >100 beats/min in children) was detected in nineteen (38.7%) patients. There were not significant differences between parameters of systolic and diastolic function of the heart. Stage 2 group, EF: 69.9±6.4; SF: 39.2±5.58; and MPI (mitral): 0.38±0.03 and MPI (tricuspid): 0.39±0.10. And in the Stage 3 group, EF: 68.5±7.0, SF: 37.8±5.34, MPI (mitral): 0.37±0.09 and MPI (tricuspid): 0.38±0.12. In the control group EF:70.96±5.54; SF:39.96±5.05 and MPI(mitral): 0.35±0.06 MPI (tricuspid):0.36±0.04 and statistically meaningful differences were not found between patients and control groups (p >0.05). Conclusion: Cardiac functions may be preserved and cardiac functions constitute no significant risks of mortality in the advanced stages of patients with Subacute sclerosing panencephalitis, which is a group of chronic and bedridden patients.

Keywords:

Subacute Sclerosing Panencephalitis, echocardiography, cardiac function,

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