Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-27T08:35:50.315Z Has data issue: false hasContentIssue false
  • English
  • Français

Evaluation of cardiac functions with Doppler echocardiography in children with Down syndrome and anatomically normal heart

Published online by Cambridge University Press:  26 April 2012

Mohammed Al-Biltagi ,
Amany R. Serag ,
Mohammed M. Hefidah  and
Maaly M. Mabrouk
Mohammed Al-Biltagi*
Affiliation:
Cardiology Unit, Department of Paediatric, Faculty of Medicine, Tanta University, Tanta, Egypt
Amany R. Serag
Affiliation:
Department of Cardiology, Faculty of Medicine, Menoufyia University, Egypt
Mohammed M. Hefidah
Affiliation:
Department of Diagnostic Radiology, Faculty of Medicine, Tanta University, Tanta, Egypt
Maaly M. Mabrouk
Affiliation:
Department of Clinical Pathology, Faculty of Medicine, Tanta University, Tanta, Egypt
*
Correspondence to: Dr M. Al-Biltagi, MD, PhD, Associate Professor of Pediatrics and Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta, Egypt. Tel: +20102209797; Fax: +20402213543; E-mail: mbelrem@hotmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

To study the cardiac functions in Down syndrome children who did not have structural cardiac lesion by conventional and tissue Doppler echocardiography.

Materials and methods

A total of 85 children with Down syndrome without anatomic heart disease and 50 normal control children were subjected to the assessment of right and left ventricular functions by both two-dimensional and tissue Doppler echocardiography.

Results

Children with Down syndrome had significantly higher left ventricular ejection fraction detected by two-dimensional echocardiography and left ventricular diastolic dysfunction detected by tissue Doppler than observed in the controls. In addition, children with Down syndrome also had right ventricular systolic and diastolic dysfunctions. Children with Down syndrome had significantly higher pulmonary artery systolic pressure than the control children. There was no significant difference in the cardiac functions between children with non-disjunction Down syndrome and those with the translocation type.

Conclusion

Despite an apparently normal heart, children with Down syndrome may have silent disturbed cardiac functions, which may be detected by two-dimensional or tissue Doppler echocardiography. This may have an important clinical implication, especially before involving Down syndrome children in surgery or strenuous exercise.

Keywords

Tissue Dopplerechocardiographycardiac functionDown syndrome
Type
Original Article
Information
Cardiology in the Young , Volume 23 , Issue 2 , April 2013 , pp. 174 - 180
Copyright
Copyright © Cambridge University Press 2012 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Banjar, HH. Down's syndrome and pulmonary arterial hypertension. PVRI Review 2009; 1: 213–216.Google Scholar
2. Barlow, GM, Chen, XN, Shi, ZY, et al. Down syndrome congenital heart disease: a narrowed region and a candidate gene. Genet Med 2001; 3: 91–101.Google Scholar
3. Frid, C, Drott, P, Lundell, B, Rasmussen, F, Anneren, G. Mortality in Down's syndrome in relation to congenital malformations. J Intellect Disabil Res 1999; 43: 234–241.Google Scholar
4. Marino, B. Patterns of congenital heart disease and associated cardiac anomalies in children with Down syndrome. In: Marino B, Pueschel SM (eds). Heart Disease in Persons with Down Syndrome. Paul H Brookes Publishing, Baltimore, 1996: 133–140.Google Scholar
5. Picard, MH, Adams, D, Bierig, SM, et al. American society of echocardiography recommendations for quality echocardiography laboratory operations. J Am Soc Echocardiogr 2011; 24: 1–10.Google Scholar
6. Cevik, Y, Değertekin, M, Başaran, Y, Turan, F, Pektaş, O. A new echocardiographic formula to calculate ejection fraction by using systolic excursion of mitral annulus. Angiology 1995; 46: 157–163.Google Scholar
7. Giardini, A. Limitations inherent to the simplified Bernoulli equation explain the inaccuracy of Doppler echocardiographic estimates of pulmonary artery pressures in patients with pulmonary hypertension. Chest 2011; 140: 270–271.Google Scholar
8. Ng, AC, Thomas, L, Leung, DY. Tissue Doppler echocardiography. Minerva Cardioangiol 2010; 58: 357–378.Google Scholar
9. Pastore, E, Marino, B, Calzolari, A, Digilio, M, Giannotti, A, Turchetta, A. Clinical and cardiorespiratory assessment in children with Down syndrome without congenital heart disease. Arch Pediatr Adolesc Med 2000; 154: 408–410.Google Scholar
10. Morrison, R, McGrath, A, Davidson, G, Brown, JJ, Murray, GD, Lever, AF. Low blood pressure in Down's syndrome. A link with Alzheimer's disease? Hypertension 1996; 28: 569–575.Google Scholar
11. Sethupathy, P, Borel, C, Gagnebin, M, et al. Human microRNA-155 on chromosome 21 differentially interacts with its polymorphic target in the AGTR1 3′ untranslated region: a mechanism for functional single-nucleotide polymorphisms related to phenotypes. Am J Hum Genet 2007; 81: 405–413.Google Scholar
12. Wiseman, FK, Alford, KA, Tybulewicz, VL, Fisher, EM. Down syndrome – recent progress and future prospects. Hum Mol Genet 2009; 18: R75–R83.Google Scholar
13. Iellamo, F, Galante, A, Legramante, J, et al. Altered autonomic cardiac regulation in individuals with Down syndrome. Am J Physiol Heart Circ Physiol 2005; 289: H2387–H2391.CrossRefGoogle ScholarPubMed
14. Russo, MG, Pacileo, G, Marino, B, et al. Echocardiographic evaluation of left ventricular systolic function in the Down syndrome. Am J Cardiol 1998; 81: 1215–1217.Google Scholar
15. Goulopoulou, S, Baynard, T, Collier, S, et al. Cardiac autonomic control in individuals with Down syndrome. Am J Ment Retard 2006; 111: 27–34.Google Scholar
16. Fernhall, B, Otterstetter, M. Attenuated responses to sympathoexcitation in individuals with Down syndrome. J Appl Physiol 2003; 94: 2158–2165.Google Scholar
17. Recalde, AL, Landing, BH, Lipsey, AI. Increased cardiac muscle fiber size and reduced cell number in Down syndrome. Pediatr Pathol 1986; 6: 47–53.Google Scholar
18. Molkentin, JD, Lu, JR, Antos, CL, et al. A calcineurin-dependent transcriptional pathway for cardiac hypertrophy. Cell 1998; 93: 215–228.Google Scholar
19. Rothermel, BA, Vega, RB, Yang, J, Wu, H, Bassel-Duby, R, Williams, RS. A protein encoded within the Down syndrome critical region is enriched in striated muscles and inhibits calcineurin signaling. J Biol Chem 2000; 275: 8719–8725.Google Scholar
20. Tandan, S, Wang, Y, Wang, TT, et al. Physical and functional interaction between calcineurin and the cardiac L-type Ca2+ channel. Circ Res 2009; 105: 51–60.Google Scholar
21. Arron, JR, Winslow, MM, Polleri, A, et al. NFAT dysregulation by increased dosage of DSCR1 and DYRK1A on chromosome 21. Nature 2006; 441: 595–600.Google Scholar
22. Schloo, BL, Vawter, GF, Reid, LM. Down syndrome: patterns of disturbed lung growth. Hum Pathol 1991; 22: 919–923.Google Scholar
23. Cappelli-Bigazzi, M, Santoro, G, Battaglia, C, et al. Endothelial cell function in patients with Down's syndrome. Am J Cardiol 2004; 94: 392–395.Google Scholar