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Evaluation of subclinical cardiovascular risk and cardiac function in children with vesicoureteral reflux: a prospective study

Part of: Echocardiography

Published online by Cambridge University Press:  29 September 2021

Ahmet Midhat Elmacı Open the ORCID record for Ahmet Midhat Elmacı [Opens in a new window] ,
Hayrullah Alp Open the ORCID record for Hayrullah Alp [Opens in a new window]  and
Muhammet İrfan Dönmez Open the ORCID record for Muhammet İrfan Dönmez [Opens in a new window]
Ahmet Midhat Elmacı
Affiliation:
Department of Pediatric Nephrology, Dr. Ali Kemal Belviranlı Women’s Maternity and Children’s Hospital, Konya, Turkey Guest Faculty Member of KTO, Department of Pediatrics, Karatay University, Konya42285, Turkey
Hayrullah Alp*
Affiliation:
Department of Pediatric Cardiology, Dr. Ali Kemal Belviranlı Women’s Maternity and Children’s Hospital, Konya42285, Turkey
Muhammet İrfan Dönmez
Affiliation:
İstanbul University İstanbul Faculty of Medicine, Department of Urology, Division of Pediatric Urology, İstanbul34093, Turkey
*
Author for correspondence: H. Alp, MD, Assoc. Prof. Department of Pediatric Cardiology, Dr. Ali Kemal Belviranlı Women’s Maternity and Children’s Hospital, Fatih Mah. Yeni İstanbul Cd. No:32, 42285 Selçuklu, Konya, Turkey. Tel: 0090 506 648 76 53; Fax: 0090 332 237 60 25. E-mail: drhayrullahalp@hotmail.com
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Abstract

Background:

Vesicoureteral reflux is a prominent congenital anomaly of the kidney and the urinary tract. Further, renal scarring is known to be related to chronic inflammation. However, there have been limited studies to date regarding the cardiovascular consequences of vesicoureteral reflux.

Objective:

The aim of this study is to evaluate the possible subclinical atherosclerosis and cardiovascular complications in children with vesicoureteral reflux.

Methods:

Patients with vesicoureteral reflux and age matched healthy controls were prospectively included in this case-control study. Patients were divided into two groups concerning renal scarring status. To assess cardiac functions, carotid artery intima media, epicardial adipose tissue, and periaortic adipose tissue thicknesses were evaluated.

Results:

There were 50 patients with vesicoureteral reflux; 26 patients without renal scarring and 24 patients with renal scarring, as well as 40 healthy controls. Myocardial performance indexes (Tei indexes) measured by tissue Doppler echocardiography from septum and left ventricle were significantly increased in study group (for all, p < 0.001). Also, intima media, epicardial adipose tissue, and periaortic adipose tissue thicknesses of the study groups were significantly higher than the control group (for all, p < 0.001). However, no statistical difference was observed between renal scarring (−) and renal scarring (+) groups.

Conclusions:

Results of our study showed early deterioration of cardiac systolic and diastolic functions in children with vesicoureteral reflux regardless of renal scarring. Also, diagnosis of vesicoureteral reflux is an important risk factor for subclinical atherosclerosis, independent of renal scarring, which should be considered in the follow-up of these patients.

Keywords

Vesicoureteral refluxcardiac functionsDoppler echocardiographysubclinical atherosclerosischildrenrenal scar
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 8 , August 2022 , pp. 1222 - 1228
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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