Cardiac Manifestations in Patients with HLA B27-Associated Juvenile Arthritis

Huppertz, HI; Voigt, Ingmar; Müller-Scholden, J.; Sandhage, K

doi:10.1007/s002469910023

Cited by 37 publications

(18 citation statements)

References 28 publications

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“…Our study is in agreement with the studies of Oguz et al [9] and Bharti et al [19]. Huppertz et al [22] reported that late diastolic Xow velocity was signiWcantly increased in patients with HLA B27-associated JIA at the termination of exercises. This is in contrast to our results where we noted diastolic dysfunction at rest.…”

Section: Discussionsupporting

confidence: 95%

“…This is consistent with results of Ozer et al [8] and Bernstein et al [21], who reported the occurrence of pericarditis in 30 and 36%, respectively, of their series of JIA patients without any clinical evidence of pericarditis. In contrast to previous results, Oguz et al [9], Bharti et al [19] and Huppertz et al [22] reported the absence of pericardial eVusion in their JIA series. Valvular involvement is a rare but serious complication of JIA.…”

Section: Discussioncontrasting

confidence: 59%

“…Chen et al [6] and Lee and Schueller [24] reported mitral and aortic aVection in JIA patients. Also, Huppertz et al [22] described four patients with aortic regurgitation out of 40 JIA patients. In contrast to our results, Oguz et al [9] and Bharti et al [19] did not mention valvular heart aVection in their groups of JIA patients.…”

Section: Discussionmentioning

confidence: 97%

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Assessment of cardiac and pulmonary function in children with juvenile idiopathic arthritis

2010

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Juvenile idiopathic arthritis (JIA) is the most common rheumatologic disorder of childhood. It is a group of diseases characterized by chronic synovitis and associated with many extra-articular manifestations including cardiac and pulmonary involvement. Cardiac involvement as pericarditis, myocarditis and valvular disease is common in JIA. There are, however, few descriptions concerning systolic and diastolic functions of the left ventricle (LV) and the development of lung disease in children with JIA. The study was carried out to detect the cardiac and pulmonary involvement and to study the systolic and diastolic function of the left ventricle in a group of children with juvenile idiopathic arthritis. Forty-five children with JIA without any cardiac or pulmonary symptoms and 30 age- and sex-matched controls were included in the study. M-mode, two-dimensional and pulsed Doppler echocardiography (ECHO) was performed on 36 patients. Tissue Doppler ECHO examination was performed on 24 patients to assess systolic and diastolic functions of left ventricle. Pulmonary function tests: Forced vital capacity (FVC%), the predicted forced expiratory volume in the first second (FEV(1)%) and FEV(1)/FVC ratio and peak expiratory flow (PEF), total lung capacity (TLC) and residual volume (RV), carbon monoxide diffusing capacity of the lung (DLCO) and DLCO/alveolar volume (VA) were evaluated in 32 patients. Informed consent was obtained from all children's parents. The study protocol was approved by ethical committee of Faculty of Medicine, Assiut University. In this study, children with JIA had higher systolic and diastolic blood pressures, resting heart rate, left ventricle systolic size and volume (4.35 ± 0.68 vs. 3.92 ± 0.28, P value = 0.02). On Doppler and tissue Doppler analysis, the JIA group had lower peak early filling velocity (E, m/s), higher peak atrial filling velocity (A, m/s) and prolonged diastolic E and A waves deceleration times and isovolumic relaxation time (IRT) compared to control. Regarding pulmonary function tests, children with JIA showed significant decrease in FVC, PEF, Pimax, Pemax and DLCO compared to normal controls. This decrease was not related to age, height or weight of these patients. There was significant inverse correlation between lung function parameters and the rheumatoid factor titer, erythrosedimentation rate, disease duration and the duration of methotrexate use (P < 0.01). Despite of an asymptomatic cardiopulmonary status, significant systolic and diastolic functional abnormalities exist in children with JIA. Also, both restrictive and obstructive lung impairments were found.

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Section: Discussionsupporting

confidence: 95%

Section: Discussioncontrasting

confidence: 59%

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Assessment of cardiac and pulmonary function in children with juvenile idiopathic arthritis

2010

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“…Echocardiographic detection of early cardiac involvement in juvenile rheumatoid arthritis (RA) was shown previously in one case series [17]. Systolic and diastolic functions of the left ventricle were studied echocardiographically in children with JIA in several studies [1,4,13,19], but no studies have evaluated right-ventricular (RV) functions with echocardiography in children with JIA. Pulsed tissue Doppler tissue (TDI) of the velocity of tricuspid annular motion is a new, rapid, and noninvasive method for evaluating RV functions [18].…”

Section: Introductionmentioning

confidence: 99%

The Forgotten Chamber: Right-Ventricular Functions in Juvenile Idiopathic Arthritis

et al. 2012

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Cardiac involvement, such as pericarditis, myocarditis, and endocarditis, is seen in juvenile idiopathic arthritis. Although there have been some reports about right-ventricular systolic and diastolic functions of adults with rheumatoid arthritis and left-ventricular systolic and diastolic functions of children with JIA, there have been no studies about RV functions of children with JIA. The aim of this study was to determine RV functions in children with JIA. We performed conventional echocardiography and tissue Doppler imaging measurements of the right ventricle of patients with JIA. All patients were in sinus rhythm at the time of examination without overt LV heart failure and with normal LV ejection fraction. Fifty-five children with the diagnosis of JIA and 33 healthy control subjects were included in the study. Peak systolic, early, and late diastolic tricuspid annular velocities were significantly decreased in JIA patients compared with healthy controls (p < 0.05). Isovolumic accelaration (IVA), as a measure of myocardial acceleration during isovolumic contraction of the right ventricle, was also significantly lower in JIA patients than in healthy controls (p < 0.05). RV systolic and diastolic functions, in addition to the previously shown LV functions, are affected in JIA patients. IVA decreases in JIA patients and may be used as an alternative, noninvasive parameter for the assessment of RV systolic function in children with JIA.

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“…Ainsi, les auteurs concluaient à la non-corrélation entre l'IA et l'HLA B27 en l'absence de spondylarthrite. Huppertz et al ont analysé les atteintes cardiaques de 40 arthrites juvéniles à l'aide d'une écho-graphie cardiaque systématique [41]. Quatre patients HLA B27 positif avaient une IA.…”

Section: Troubles De La Conductionunclassified

Aortite thoraco-abdominale au cours d’une spondylarthrite ankylosante : un nouveau cas et revue de la littérature

Lassalle

Lonchampt

Puéchal

et al. 2011

Journal des Maladies Vasculaires

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Cardiac Manifestations in Patients with HLA B27-Associated Juvenile Arthritis

Cited by 37 publications

References 28 publications

Assessment of cardiac and pulmonary function in children with juvenile idiopathic arthritis

Assessment of cardiac and pulmonary function in children with juvenile idiopathic arthritis

The Forgotten Chamber: Right-Ventricular Functions in Juvenile Idiopathic Arthritis

Aortite thoraco-abdominale au cours d’une spondylarthrite ankylosante : un nouveau cas et revue de la littérature

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