MITRAL REGURGITATION IN CHILDREN WITH MITRAL VALVE PROLAPSE. FEATURES OF ECHOCARDIOGRAPHIC INDICATORS
Mitral valve prolapse plays an important role in cardiovascular pathology in children. The study reveals the condition of the central hemodynamic and echomorphometric parameters in children with mitral valve prolapse (MVP) taking into account mitral regurgitation.
Materials and methods. We examined 106 children with MVP. Among them there were 90 children with MVP of 1st degree and 16 children with the 2nd degree aged from 13 to 17 years. The presence and absence of mitral regurgitation were included also. Thus, 56 (52.8%) children with MVP of the 1st degree formed subgroup without mitral regurgitation, and 34 (32.1%) – with regurgitation. MVP of the 2nd degree formed subgroup which included children both without – 6 (5.6%) and with regurgitation – 10 (9.4%). The control group consisted of 23 almost healthy children of the same age. All patients were clinically examined and consulted by specialists. Common echocardiographic parameters were used for the study.
Results. An increase (p<0.05) of E/A parameter in children with MVP was noted, mainly with 1st degree. It showed the initial manifestations of diastolic dysfunction of the heart. This indicator increases with regurgitation appearance and depends from the MVP degree (r=0.45). Hemodynamics was generally within normal criteria.
Conclusions. In children with mitral valve prolapse, regardless to degree, normovolemic and eukinetic type of central hemodynamic was observed. Children with MVP with regurgitation appearance have increased risk of left ventricular diastolic dysfunction. With the progression of mitral valve prolapse, manifestations of diastolic myocardial dysfunction increases. This category of children must have preventive methods to restore echomorphometric parameters for reducing complications occurrence.
2. Kushnyr SM, Beliakova TB. Osobennosty vehetatyvnoi rehuliatsyy u detei s prolapsom mytralnoho klapana. Ulianovskyi medyko-byolohycheskyi zhurnal, 2012; 4:54-57.
3. Taschuk VK, Amelina TN, Turubarova-Leunova NA. Aktualnyie aspektyi prolapsa mitralnogo klapana u sportsmenov. Uchenyie zapiski universiteta P.F. Lesgafta, 2013; 7(101): 141-145
4. Barry P. Boden, Ilan Breit, Jason A. Beachler, [et al.] (2013). Fatalities in high school and college football players. The American Journal of Sports Medicine, 2013; 41 (3): 180-186.
5. ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease. Journal of the American College of Cardiology, 2008; 52 (13): P. 1–142.
6. Volosovets OP, Krivopustov OP, Kuz'menko AJa et al. Prolapse of mitral valve for children: rational going near the supervision. Art of Treatment, 2005: 2 (18): 20–28
7. Reeva SV, Malev EH, Pankova YA, Tymofeev EV, Zemtsovskyi EV. Vehetatyvnaia dysfukntsyia u lyts molodoho vozrasta s prolapsom mytralnoho klapana y marfanoydnoi vneshnostiu. Rossyiskyi kardyolohycheskyi zhurnal, 2013; 1(99): 23-27.
8. Duren DR, Becker AE, Dunning AJ. Long-term follow-up of idiopathic mitral valve prolapse in 300 patients: a prospective study. Journal of the American College of Cardiology, 1988; 11: 42–47
9. Halaktyonova MI, Myronova OY. Osobennosty tsentralnoi hemodynamyky u detei s syndromom dysplazyy soedynytelnoi tkany serdtsa. Mat y Dytia v Kusbasse, 2014; 1(56): 41-45
10. Kuleshov OV. Osoblyvosti klinichnoho obstezhennia ditei z malymy sertsevymy anomaliiamy. Biomedical and biosocial anthropology, 2017; 28:144-147
11. Kuznetsova MA. Osoblyvsoti prolapsa mitralnoho klapana u osib molodoho viku. Scientific Journal «ScienceRise», 2014; 3/1(3); 46-48
12. Vertinskiy EA, Kaminskaya TV, Abelskaya IS, Chizh SA, Zharihina MP. Integralnyiy podhod v otsenke tyazhesti pervichnoy mitralnoy regurgitatsii. Meditsinskie novosti, 2016; 8: 17-21
13. Abdrazmanova AI, Abdulyanov IV. Prolaps mitralnogo klapana v praktike pediatra. Prakticheskaya meditsina, 2015; 3(88): 17-24
14. Malev EG, Pshepyi AP, Vasina LV, Reeva SV, Timofeev EV, Korshunova AL, Zemtsovskyi EV. Left ventricular remodelling and diastolic dysfunction in mitral valve prolapse. Russian Journal of Cardiology. 2013;(2):12-17. (In Russ.)
15. Dziak HV, Nekhanevych OB. Diastolichna funktsiia livoho shlunochka u sportsmeniv z malymy anomaliiamy rozvytku sertsia. Medychni perspektyvy, 2015; 20(3): 10-15.