MYOCARDIAL DYSFUNCTION IN CHILDREN WITH NEPHROTIC SYNDROME, A TISSUE DOPPLER STUDY

Background: The prevalence of chronic kidney disease (CKD) has increased steadily. Mortality and morbidity are seen more frequently in CKD compared to in healthy subjects. Cardiovascular events are the most frequent cause of mortality and morbidity in this patient group.
Objectives: To assess the presence of fQRS in children with NS and to evaluate the relationship between fQRS and myocardial functions.
 Patients & Methods: 30 children with nephrotic syndrome and 30 apparently healthy children were enrolled in the study. All patients in this study were subjected to:
Full history taking, full clinical examination and laboratory investigations; (BUN), creatinine, albumin, calcium, phosphorus, LDL, HDL, triglycerides and 24h urine collection for protein in urine. ECG and Echocardiography was performed to detect early pathological problems. Tissue doppler imaging was used to detect changes occurring in the heart with nephrotic syndrome.
Patient group was subdivided in to 2 groups according to presence of FQRS in ECG.
Results: fQRS was present in 56.7% of patient group. There was significant increase in systolic and diastolic blood pressure in patient with FQRS in ECG. There was no statistically significantdifferences between tissue doppler parameter and Tie index with FQRS except for Em wave. By univariate analysis for patient with FQRS and all parameter, FQRS was presented with increase in systolic and diastolic blood pressure, and in patient with systolic dysfunction (decrease FS%), and in patient with diastolic dysfunction (E`).
Conclusions:  NS children generally have a high risk of cardiovascular complications. The present study revealed that fQRS determined using ECG, an economic and easily accessible technique, can be used as an early marker of myocardial function impairment in this patient group.