Comparison of ECG, laboratory and echocardiographic parameters in patients with acute myocarditis at acute attack and clinical remission
Open Access
- 3 April 2020
- journal article
- research article
- Published by Veritas Publications LTD in Ortadoğu Tıp Dergisi
- Vol. 12 (2) , 175-180
Abstract
Tr en Amaç: Çocukluk ve ergenlikte yüksek morbidite ve mortaliteye sahip miyokardit patogenezi tam olarak aydınlatılamamıştır. Akut miyokardit patogenezi, çoklu ajanların rol oynadığı karmaşık bir süreçtir. Miyokarditin akut alevlenmesi ve klinik remisyon sırasında EKG, laboratuvar ve ekokardiyografik parametreleri karşılaştırmayı amaçladık. Materyal ve Yöntem: Akut miyokardit atağı olan 144 hasta (124 erkek, 20 kadın) çalışmaya dahil edildi (28 ± 5). Bu hastalar 3-12 aylık klinik remisyon döneminde kontrol altına alındı. Akut alevlenme ve klinik remisyon sırasında hastaların EKG, laboratuvar ve ekokardiyografik parametreleri karşılaştırıldı. QT ve Tp-e gibi EKG parametreleri ölçüldü. Rutin biyokimya ve hemogram parametrelerine ek olarak troponin I, ürik asit, CRP, sedimantasyon, TSH ve kolesterol düzeyleri ölçüldü. Sol ventrikül ejeksiyon fraksiyonu ekokardiyografik parametre olarak ölçüldü. Bulgular: Klinik remisyon ile karşılaştırıldığında, akut atak miyokarditli hastalarda Tp-e aralığı (p: 0,032), QT-max (p = 0,014), QT-min (p = 0,001), TSH (p <0,001), Trop (p <0,00), Üre (p = 0,028), Alt (p = 0,010), Ast (p <0,001), Wbc (p <0,001), Hb (p <0,001), Htc (p <0,001), Rdw (p <0,001), Plt (p <0,001), Mpv (p <0,001), Neu (p = 0,003), Lym (p = 0,013), Mon (p <0,001), Eo (p = 0,003), Pdw (p <0,001), CRP (p=0,001), ESR (p<0,001), and HDL-C (p=0,002) önemli ölçüde değişmiştir. Sonuç: EKG parametreleri, inflamasyon belirteçleri ve HDL kolesterol düzeyleri, hastaların akut alevlenmesi sırasında sol ventrikül ejeksiyon fraksiyonuna ek olarak klinik remisyonda önemli ölçüde iyileşti. LVEF, EKG parametreleri, inflamasyon belirteçleri, TSH ve HDL kolesterol düzeylerinin hastalığın klinik seyri ve patogenezi açısından önemli olduğu düşünülmektedir. Aim: The pathogenesis of myocarditis, which has high morbidity and mortality in childhood and adolescence, has not been fully elucidated. The pathogenesis of acute myocarditis is a complex process in which multiple agents play a role. We aimed to compare ECG, laboratory and echocardiographic parameters of patients during acute exacerbation of myocarditis and clinical remission. Material and Method: 144 patients (124 males, 20 females) with an acute myocarditis episode were included in the study (28 ± 5). These patients were called for control during the clinical remission period of 3-12 months. The ECG, laboratory and echocardiographic parameters of the patients were compared during acute exacerbation and clinical remission. QT and Tp-e ECG parameters were measured. In addition to routine biochemistry and hemogram parameters, troponin I, uric acid, CRP, sedimentation, TSH and cholesterol levels were measured. Left ventricular ejection fraction was measured as an echocardiographic parameter. Results: When compared with the clinical remission Tp-e interval (p: 0.032), QT-max (p=0.014), QT-min (p=0.001), TSH (p<0.001), Trop (p<0.00), Urea (p=0.028), Alt (p=0.010), Ast (p<0.001), Wbc (p<0.001), Hb (p<0.001), Htc (p<0.001), Rdw (p<0.001), Plt (p<0.001), Mpv (p<0.001), Neu (p=0.003), Lym (p=0.013), Mon (p<0.001), Eo (p=0.003), Pdw (p<0.001), CRP (p=0.001), ESR (p<0.001), and HDL-C (p=0.002) were significantly changed in patients with acute attack myocarditis. Conclusion: ECG parameters, inflammation markers, and HDL cholesterol levels were significantly improved in the clinical remission in addition to the left ventricular ejection fraction during acute exacerbation of the patients. LVEF, ECG parameters, inflammation markers, TSH and HDL cholesterol levels were thought to be important in terms of clinical course and pathogenesis of the disease.Keywords
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