scholarly journals Auscultatory manifestations of mitral valve prolapse in children with connective tissue dysplasia

2012 ◽  
Vol 93 (4) ◽  
pp. 570-575
Author(s):  
Sh M Magomedova ◽  
Yu M Belozerov ◽  
K A Masuev ◽  
I M Osmanov
Keyword(s):  
Mitral Valve ◽  
Connective Tissue ◽  
Children And Adolescents ◽  
Mitral Valve Prolapse ◽  
Control Group ◽  
Ehlers Danlos Syndrome ◽  
Psychoemotional Stress ◽  
Connective Tissue Dysplasia ◽  
Cardiac Pain ◽  
Leaflet Prolapse

Aim. To study the features of auscultatory symptoms in children with mitral valve prolapse secondary to connective tissue dysplasia. Methods. Auscultation and phonocardiography was performed in 545 children and adolescents with mitral valve prolapse, including a prolapse, which is a variant of the asthenic constitution - 140, with a prolapse with undifferentiated connective tissue dysplasia - 340, with mitral valve prolapse with differentiated connective tissue dysplasia - 65 children (patients with Marfan syndrome and Ehlers-Danlos syndrome). The control group consisted of 200 children and adolescents of similar age. Results. In children with an asthenic constitution and mitral valve prolapse in most cases (90.7%) established were isolated clicks, and only iin a small percentage of cases the clicks combined with the late systolic murmur. Complaints of these children did not differ significantly in the frequency from the control values. Compared with the control group up to 6 times more frequently found was the symptom of chronic psychoemotional stress. Chronic psychoemotional stress was also observed more frequently in adolescents with mitral valve prolapse in the background of undifferentiated and differentiated connective tissue dysplasia. Children with asthenic constitution the frequency of cardiac pain did not differ from the control values. A significant increase in the frequency of cardialgia was reported in children and adolescents with undifferentiated and differentiated connective tissue dysplasia. Cardiac pain was described as stabbing, pressing, aching, and was felt in the left side of the chest without irradiation. In most children the pain continued for 5-20 min, were usually enduced by physical exertion and emotional stress, often accompanied by autonomic disturbances, which resolved spontaneously or after administration of the tincture of valerian or valokordin. The absence of ischemic changes in the myocardium according to the comprehensive investigation can be regarded as a manifestation of cardialgia as a sympathalgia related to psychoemotional features of children with mitral valve prolapse («cardiac pain is inseparable from the personality»). The auscultatory pattern suring mitral valve prolapse in the background of undifferentiated and differentiated connective tissue dysplasia was very similar. Conclusion. According to the phonocardiography and auscultatory data we can conclude that there is a certain parallelism of the severity of valve leaflet prolapse and of the sound phenomena: in isolated clicks the leaflet prolapse degree is usually minor, however in cases of isolated late systolic and holosystolic murmurs - the prolapse degree is significant.

scholarly journals CARDIAL MANIFESTATIONS OF NON-DIFFERENTIATED CONNECTIVE TISSUE DYSPLASIA AND THEIR INFLUENCE ON PREGNANCY

2021 ◽  
pp. 14-22
Author(s):  
V. Yu. DOBRIANSKA ◽  
S. M. HERYAK ◽  
L. M. MALANCHUK ◽  
M. I. SHVED ◽  
I. V. KORDA
Keyword(s):  
Mitral Valve ◽  
Connective Tissue ◽  
Ventricular Arrhythmia ◽  
Pregnant Women ◽  
Mitral Valve Prolapse ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Adequate Treatment ◽  
Pregnancy And Childbirth ◽  
Connective Tissue Dysplasia

Among the visceral manifestations of NDST in pregnant women most often diagnosed mitral valve prolapse (20-25%) that accompanied by more cardiovascular and obstetric complications during pregnancy. It demonstrates the high clinical significance of the problem of connective tissue dysplasia with mitral valve prolaps for pregnancy and requires adequate treatment programs for prevention of complications and management of pregnant women with connective tissue dysplasia. Aim. Determination of the frequency of pregnancy pathology in women with clinical signs of NDST and MVP complicated by extrasystolic arrhythmia. Materials and methods. 138 pregnant women with MVP and concomitant signs of NDST and 54 healthy pregnant women were selected for analysis. Clinical manifestations of NDST, different variants of arrhythmias and the total number of complications of pregnancy and childbirth were evaluated. Results. In pregnant women with clinical signs of NDST and MVP complicated by extrasystolic arrhythmia, cases of frequent sinus extrasystole were significantly more often compared to frequent ventricular arrhythmia (47.8% vs. 18.1%, p<0.001) and cases of combination of frequent sinus extrasystole and ventricular arrhythmia (13.3 % vs. 1.5%, p <0.05). They significantly more often identified both symptoms of arrhythmological nature and symptoms that indicated a violation of autonomic status. The presence of NDST syndrome is more often accompanied by the development of complications of pregnancy and childbirth. These pregnant women have genetic and phenotypic risk factors for the development of pathological pregnancy and childbirth, birth trauma, disability of mother and newborn, which justifies such patients in a separate risk group for individualized programs of the prevention and treatment of visceral (cardiac) manifestations of NDST and possible complications of pregnancy and childbirth. Conclusions. 3.1% of pregnant women are diagnosed with phenotypic signs (stigma) of undifferentiated connective tissue dysplasia, and the most common visceral cardiac manifestation is mitral valve prolapse. The presence of mitral valve prolapse and extrasystolic arrhythmia in pregnant women with NDST is accompanied by significantly more frequent development of pregnancy and childbirth complications in these patients.

scholarly journals Features of rheoencephalography in children with primary mitral valve prolapse

2019 ◽  
Vol 23 (4) ◽  
pp. 632-637
Author(s):  
A.V. Kuleshov ◽  
L.M. Bulat ◽  
Y.A. Medrazhevskaya ◽  
S.L. Malyk ◽  
I.V. Chigir
Keyword(s):  
Blood Flow ◽  
Mitral Valve ◽  
Carotid Artery ◽  
Connective Tissue ◽  
Vertebral Artery ◽  
Mitral Valve Prolapse ◽  
Pulse Wave ◽  
Cerebral Hemodynamics ◽  
Control Group ◽  
Quantitative Indicators

Annotation. Mitral valve prolapse (MVP), as a manifestation of connective tissue dysplasia, is of great interest in the field of medicine. It occupies an important place in the structure of diseases of the cardiovascular system, which is mainly due to its high incidence and possible complications. MVP is detected in almost 2–3% of the population. In addition, this pathology with a genetic predisposition is a manifestation of a connective tissue defect and is rare in newborns and at an early age, which characterizes it as a progressive disease. At the moment, the features of cerebral hemodynamics in children with MVP are not well understood. The aim of our study was to study cerebral hemodynamics in children with primary mitral valve prolapse using quantitative indicators of rheoencephalography (REG). The study included patients with primary MVP. Under our supervision, there were 106 children aged 13 to 17 years. The control group included 23 healthy children at the same age. All children underwent a REG with quantitative indicators. In children with MVP, there is a variability in the results of REG in the cerebral hemispheres. Vascular elasticity is significantly reduced due to anacrot time increase (p<0.001), which, in fact, is characteristic of the hypertonic type of blood flow (57.5%). It can be argued that in children there is a hypovolemic type of blood flow in the form of a decrease in the rheographic index relative to the control group (p<0.05). There is a tendency to vascular tone tension of all calibers according to the absence of statistically significant deviations of the corresponding indicators (dictrotic index and the ratio of the duration of the ascending phase to the duration of the entire pulse wave). The same picture is observed with venous blood flow, according to the values of the dystolic index in the carotid artery basin. In the basin of the vertebral artery there is a tendency to increase the tone of small vessels and venous vessels. Thus, in children with mitral valve prolapse, cerebral blood flow changes in the form of hypovolemia in the carotid artery basin and normovolemia in the vertebral artery basin according to REG parameters; in this group of children with MVP, there is a tendency to tension in the tone of blood vessels of all calibers according to the absence of statistically significant deviations of the corresponding indicators (dictrotic index and the ratio of the duration of the ascending phase to the duration of the entire pulse wave). Also, patients with MVP should be constantly monitored by narrow specialists (cardiologists, neurologists) for timely and adequate recovery.

scholarly journals Assessment of heart rate variability and tone of the autonomic nervous system in puberty-aged children with undifferentiated connective tissue dysplasia

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
O V Sidorovich ◽  
S Y U Elizarova ◽  
A V Khizhnyak ◽  
N A Kuznetsova ◽  
E E Prosova
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Connective Tissue ◽  
Control Group ◽  
Healthy Children ◽  
Autonomic Nervous ◽  
Connective Tissue Dysplasia ◽  
End Of Puberty

Abstract   Within the framework of the research into pathological conditions and syndromes associated with undifferentiated connective tissue dysplasia (UCTD), an emphasis needs to be placed on the changes in heart rhythm. In puberty, the severity of neurovegetative disorders caused by the presence of UCTD might increase manifold. The features of heart rate variability (HRV) in pubertal children against the background of UCTD have been studied insufficiently and require more detailed analysis. This study aims to assess heart rate variability and tone of the autonomic nervous system (ANS) in puberty-aged children with UCTD. Two groups of children were examined, with methods including electrocardiography and cardiointervalography. The main group consisted of 36 puberty-aged children with UCTD, the control group consisted of 30 healthy children. ANS tone was assessed based on the HRV. In the control group of children aged 11, the value of variation range (VR) was 0.18±0.4, mode amplitude (MA) 35.2±2.4, stress index (IN) 72.8±4.3, which corresponds to the state of vegetative balance. As the puberty progresses, the state of eutonia is replaced by the activation of the sympathetic division of the ANS, which becomes most pronounced at the age of 13 years. In the control group of children aged 13, the value of VR was 0.08±0.02, MA 61.7±2.1, SI 210.6±8.6, which corresponds to moderate sympathicotonia. By the end of puberty, in healthy children, the severity of sympathetic activation begins to decrease, and at the age of 15 years, vegetative balance is again observed. However, this pattern is violated in children with UCTD. Upon entering puberty, moderate activation of the sympathetic division of the ANS is already observed in children with UCTD. At the age of 11 years in this group, the value of VR is 0.06±0.02, MA 72.4±3.1, SI 211.2±8.6. At the age of 13, pronounced sympathicotonia is observed, which is confirmed by the values of VR - 0.04±0.01, MA 80.2±4.3 and SI 34.3±14.7. By the end of puberty in children with UCTD, in contrast to the control group, the analyzed parameters indicate not an equilibrium of the ANS, but the predominance of parasympathetic activation. The research provides an insight into heart rate variability in puberty-aged children with UCTD. It was established that healthy children enter puberty in a state of equilibrium of the autonomic nervous system, which in the middle of puberty is replaced by moderate sympathicotonia, and then returns to its original values. Children with the presence of UCTD enter puberty with moderately pronounced sympathicotonia, which gradually increases to pronounced values and is replaced by moderate vagotonia. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Relevance of the Problem of Myopia in School-age Children with Signs of Undifferentiated Connective Tissue Dysplasia

2018 ◽  
Vol 15 (2S) ◽  
pp. 58-64
Author(s):  
V. V. Li ◽  
G. P. Smoliakova ◽  
V. V. Egorov ◽  
O. I. Kashura
Keyword(s):  
Connective Tissue ◽  
Choroidal Thickness ◽  
School Age Children ◽  
Comparative Characteristic ◽  
Control Group ◽  
Moderate Degree ◽  
Ophthalmological Examination ◽  
School Age ◽  
School Myopia ◽  
Connective Tissue Dysplasia

Purpose:to study the frequency and structure of undifferentiated connective tissue dysplasia (UCTD) in school-age children with myopia, their relationship to choroidal thickness and course of myopia.Patients and methods. The object of study was 120 children (240 eyes) aged 11–13 years with school axial myopia (axial length (AL) from 24.5 to 26.0 mm). Special ophthalmological examination included optical coherent tomography of macular zone (“RTVue 100” Optovue, USA) and “Cross Line” scan for measuring choroidal thickness in foveal area and 1000 μm from it in nasal and temporal regions.Results.According to studies, the phenotypic signs of UCTD were diagnosed in 56 children (46.7%) with school myopia, the largest group included phenotypic signs of locomotor syndrome; 14 children (25%) had a weak degree of UCTD, 34 children (60.7%) — moderate degree and 8 children (14.3%) — pronounced degree. Comparative characteristic of changes in choroidal thickness detected a high degree of interrelation between the severity of clinical manifestations of UCTD and the level of decrease in blood-flow in the choroid. In children of the main group with signs of UCTD, the annual growth of AL exceeded the same parameters in children of the control group by more than 2.5 times (p < 0.05); due of accumulation of phenotypic signs of UCTD, a more noticeable tendency to decrease of choroidal thickness and the increase of AL was observed (p < 0.05). The statistical analysis confirmed the presence of significant negative correlation between the decrease in average thickness index in segment of the macular map and the degree of increase of AL (p < 0.05).Conclusions. According to results of diagnostic screening, in 46.7% children with school myopia, we detected phenotypic signs of UCTD. The method of optical coherence tomography showed that with increasing severity of UCTD, indexes of choroidal thickness in the macular zone are significant decreased. In the catamnesis (duration 1 year), it was found that in children with myopia with moderate and pronounced degrees of UCTD, increase of AL is associated with degree of thinning choroidal thickness, which indicates violations of biomechanical status of sclera. 

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