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Cardiac involvement in multisystem inflammatory syndrome in children: single-centre experience

Published online by Cambridge University Press:  15 July 2022

Vildan Atasayan Open the ORCID record for Vildan Atasayan [Opens in a new window] ,
Özge P. Akbay Open the ORCID record for Özge P. Akbay [Opens in a new window] ,
Şengül Çağlayan ,
Betül Sözeri ,
Canan Hasbal Akkuş ,
Alican Vuran ,
Taliha Öner Open the ORCID record for Taliha Öner [Opens in a new window]  and
Mehmet Karacan Open the ORCID record for Mehmet Karacan [Opens in a new window]
Vildan Atasayan*
Affiliation:
Department of Pediatric Cardiology, University of Health Sciences, Umraniye Training and Research Hospital, İstanbul, Turkey
Özge P. Akbay
Affiliation:
Department of Pediatrics, University of Health Sciences, Umraniye Training and Research Hospital, İstanbul, Turkey
Şengül Çağlayan
Affiliation:
Department of Pediatric Rheumatology, University of Health Sciences, Umraniye Training and Research Hospital, İstanbul, Turkey
Betül Sözeri
Affiliation:
Department of Pediatric Rheumatology, University of Health Sciences, Umraniye Training and Research Hospital, İstanbul, Turkey
Canan Hasbal Akkuş
Affiliation:
Department of Pediatrics, University of Health Sciences, Umraniye Training and Research Hospital, İstanbul, Turkey
Alican Vuran
Affiliation:
Department of Pediatric Cardiovascular Surgery, University of Health Sciences, Umraniye Training and Research Hospital, İstanbul, Turkey
Taliha Öner
Affiliation:
Department of Pediatric Cardiology, University of Health Sciences, Umraniye Training and Research Hospital, İstanbul, Turkey
Mehmet Karacan
Affiliation:
Department of Pediatric Cardiology, University of Health Sciences, Umraniye Training and Research Hospital, İstanbul, Turkey
*
Author for correspondence: Vildan Atasayan, MD, Department of Pediatric Cardiology, University of Health Sciences, Umraniye Training and Research Hospital, Elmalıkent District, Adem Yavuz Street, 34764 Ümraniye, İstanbul, Turkey. Tel: +902166321818 int:4782. E-mail: vatasayan@gmail.com
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Abstract

Background:

This study aimed to evaluate electrocardiographic and echocardiographic findings, Holter recordings of the multisystem inflammatory syndrome in children, and to identify prognostic factors for cardiac involvement.

Methods:

We retrospectively reviewed demographic characteristics, medical data, laboratory findings, electrocardiogram and echocardiographic findings, 24-hour Holter recordings, need for an ICU, and extracorporeal membrane oxygenation in multisystem inflammatory syndrome in children. Acute left ventricular systolic dysfunction was defined as left ventricular ejection fraction (EF) ≤%55 on echocardiography.

Results:

Sixty-seven children were included in the study. 24-hour Holters were recorded in 61.2% of the patients and 49.2% were normal. On echocardiographic examination, 14.9% of the patients had systolic dysfunction (EF ≤ 55%). While 32.8% of patients had mild mitral regurgitation, 3% had moderate mitral regurgitation, and 6% had mild aortic regurgitation. There was no statistically significant difference in EF values between the group with arrhythmia in Holter and the group with normal Holter results (p ≥ 0.05). B-type natriuretic peptide was positively correlated with C-reactive protein, ferritin, and fibrinogen. Significant effectivity of the B-type natriuretic peptide value was observed in the differentiation of those with EF ≤ and > 55%. Extracorporeal membrane oxygenation support was needed for three (4.5%) patients. One patient who died had systemic juvenile idiopathic arthritis.

Conclusions:

Neutrophil/lymphocyte ratio, C-reactive protein, D-dimer, ferritin, troponin, and B-type natriuretic peptide were found to be significantly higher in patients with systolic dysfunction. Also, the cut-off value of 1700 pg/ml for B-type natriuretic peptide was significantly effective. These parameters may indicate the severity of the disease but should be supported by prospective studies.

Keywords

MIS-CCOVID-19Holter ECGpaediatric
Type
Original Article
Information
Cardiology in the Young , Volume 33 , Issue 7 , July 2023 , pp. 1117 - 1123
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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