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Persistent Valvular Regurgitation After Acute Rheumatic Fever: Early Predictors of Long Term Outcomes in a Pediatric Retrospective Cohort.
Licciardi, Francesco; Baldini, Letizia; Del Monte, Francesco; Geranzani, Alice; Mulatero, Roberta; Covizzi, Carlotta; Scaioli, Giacomo; Mazza, Giuseppe Antonio; Montin, Davide.
Afiliación
  • Licciardi F; Department of Public Health and Pediatrics, Università degli Studi di Torino, Piazza Polonia 94, 10126, Turin, Italy. francesco.licciardi@gmail.com.
  • Baldini L; Immunorheumatology Unit, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza di Torino, Turin, Italy. francesco.licciardi@gmail.com.
  • Del Monte F; Università degli Studi di Torino, Turin, Italy.
  • Geranzani A; Università degli Studi di Torino, Turin, Italy.
  • Mulatero R; Department of Public Health and Pediatrics, Università degli Studi di Torino, Piazza Polonia 94, 10126, Turin, Italy.
  • Covizzi C; Università degli Studi di Torino, Turin, Italy.
  • Scaioli G; Department of Public Health and Pediatrics, Università degli Studi di Torino, Piazza Polonia 94, 10126, Turin, Italy.
  • Mazza GA; Immunorheumatology Unit, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza di Torino, Turin, Italy.
  • Montin D; Department of Public Health and Pediatrics, Università degli Studi di Torino, Piazza Polonia 94, 10126, Turin, Italy.
Pediatr Cardiol ; 2024 Jun 19.
Article en En | MEDLINE | ID: mdl-38896284
ABSTRACT
Describe the echocardiographic evolution of valvular regurgitation in patients with rheumatic carditis (RC) and to establish which features may predict long-term outcome, in the absence of acute rheumatic fever (ARF) relapse. Retrospective cohort study. 123 patients with confirmed RC, diagnosed at Turin Children's Hospital between 2010 and 2019. We reviewed the echocardiographic images recorded at diagnosis, after 6-8 weeks, after 6 months, then yearly, to assess which predictors at diagnosis are associated with the degree of improvement at 6 months. Secondly, we tested which variables predict the regression of pathological regurgitation of mitral (MV) or aortic valve (AV) during follow-up. At onset, 90.2% patients had MV regurgitation while 42.3% had AV involvement. 115 (93.5%) patients were treated with steroids and 70.8% experienced a downgrading of RC after 6 months. Steroids were associated with better outcomes at six months (p = 0.01). During follow-up (median 56.1 months), MV improved in 58.6% patients, AV in 46.2%. At multivariate analysis, erythrocyte sedimentation rate (ESR) was positively associated with regression of MV regurgitation (OR 1.02, p = 0.02), while higher degree of carditis at onset was negatively associated (OR 0.04, p < 0.01). Conversely, regression of AV regurgitation was more frequent in patients with bi-valvular involvement (OR 20.5, p = 0.03) and in absence of murmur at onset (OR 0.04, p = 0.01). This study indicates that valvular regurgitation improves overtime if there are no ARF recurrences during follow-up, especially when the MV is involved and in patients treated with steroids.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Pediatr Cardiol Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Pediatr Cardiol Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos