การศึกษาการทำงานซีสโตลิกของหัวใจห้องล่างซ้ายในผู้ป่วยโรคไข้เลือดออก / มณนิภา สื่อเสาวลักษณ์ = Study on left ventricular systolic function in patients with dengue hemorrhagic fever / Monnipa Suesaowalak
To compare cardiac systolic function, as represented by ejection fraction (EF), velocity of circumferential fiber shortening / end systolic wall stress relationship (VCFC/ESS) Z-score measured by echocardiography, between the toxic stage and after recovery in patients with dengue hemorrhagic (DHF). Design: Cross-sectional analytic study. Setting: Department of Pediatrics, King Chulalongkorn Memorial Hospital. Patients: Children (age 0-15 years) with serologically proven DHF who were admitted to King Chulalongkorn Memorial Hospital between April 1st, 2000 and March 31st, 2001. Methods: Clinical evaluation, blood investigation, infor consent and echocardiograms were done in all recruited children, during toxic stage, convalescent stage and after recovery (2-3 weeks after discharge). Ejection fraction (EF) velocity of circumferential fiber shortening / end systolic wall stress relationship (VCFC/ESS) Z-score were compared between toxic stage and after recovery using paired t-test for statistical significance (p<0.05). Results: Eighteen children (10 males, 8 females; mean age 11.3 years) with clinical diagnosis and serologically proven DHF underwent echocardiograms. The ejection fraction was significantly decreased in the toxic stage compare to after recovery (56.1+-8.3% VS 63.2+-4.5%, p<0.001). The VCFC/ESS Z-score was significantly decreased in the toxic stage compare to after recovery (-1.1+-2.6 VS 0.2+-1.3, p = 0.026). The cardiac systolic function between shock (EF = 56.0+-5.4%, VCFC = -1.0+-0.1, n = 7) and non shock groups (EF = 56.4+-0.1%, VCFC = -1.2+-3.9, n = 11) is not significantly different. Conclusions: DHF is associated with impaired left ventricular systolic function. No association between the degree of cardiac dysfunction and the severity of DHF was found in this study. The importance of these findings deserves further investigation.