Estimation of abnormalities of the left ventricle diastolic function in children with juvenile idiopathic arthritis

  • Dr Krzysztof Truszkowski, Children's Cardiology Department, 2nd Chair of Pediatrics Medical University of Lodz, Poland
  • Dr Katarzyna Niewiadomska-Jarosik, Children's Cardiology Department, 2nd Chair of Pediatrics Medical University of Lodz, Poland
  • Dr Elzbieta Smolewska, Children's Cardiology Department, 2nd Chair of Pediatrics Medical University of Lodz, Poland
  • Dr Malgorzata Biernacka-Zielinska, Children's Cardiology Department, 2nd Chair of Pediatrics Medical University of Lodz, Poland
  • Prof Henryka Brozik, Children's Cardiology Department, 2nd Chair of Pediatrics Medical University of Lodz, Poland
  • Prof Jerzy Stanczyk, Children's Cardiology Department, 2nd Chair of Pediatrics Medical University of Lodz, Poland

    • One of the most prevalent systemic autoimmune connective tissue diseases in children is juvenile idiopathic arthritis (JIA). In children with JIA, the heart is involved in 30-80% of cases, with clinical manifestation in 3-9%.
    The aim of the study was to check if patients with JIA have the left ventricle (LV) diastolic dysfunction.
    The study involved 50 children with JIA. The control group consisted of 20 healthy children. Each patient had echocardiography examination; the systolic and diastolic function of left ventricle were analyzed.
    Statistically significant differences were noted between E/A ratio, (1.456 +/- 0.353, and 1.864 +/- 0.385 in the studied and in the control group, respectively). MPI was approximately 0.476 +/- 0.13 and 0.411 +/- 0.075 in the groups. Mean AEF value in the groups was 12.09 +/- 6.04 kdyn and 6.17 +/- 1.9 kdyn. Mean VpMV was 0.7 +/- 0.14 m/s, and 0.81 +/- 0.13 m/s in the groups, respectively. All values also differed in a statistically significant way. In the studied group, there was no LV systolic function impairment observed.
    Conclusions:
    1. In evaluation of LV diastolic dysfunction in patients with JIA, use of several parameters is recommended. Total myocardial performance index (MPI), and velocity of early mitral inflow wave propagation (VpMV) seem to be the most valuable, due to their independence from other factors.
    2. Atrial ejection force (AEF) is a useful parameter in evaluation of left ventricle diastolic function.
    3. The presence of LV diastolic dysfunction did not correlate with disease duration.