Document Detail

Cardiac function in Vietnamese patients with different dengue severity grades.
MedLine Citation:
PMID:  21946658     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Dengue continues to cause significant global morbidity and mortality. Severe disease is characterized by cardiovascular compromise from capillary leakage. Cardiac involvement in dengue has also been reported but has not been adequately studied.
SETTING: Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
SUBJECTS AND DESIGN: Seventy-nine patients aged 8-6 yrs with different dengue severity grades were studied using echocardiography including tissue Doppler imaging. The patients were split into severity grades: dengue, dengue with warning signs, and severe dengue. Changes in cardiac functional parameters and hemodynamic indices were monitored over the hospital stay.
MEASUREMENTS AND MAIN RESULTS: Patients with severe dengue had worse cardiac function compared with dengue in the form of left ventricular systolic dysfunction with increased left myocardial performance index (0.58 [0.26-0.80] vs. 0.38 [0.22-0.70], p = .006). Septal myocardial systolic velocities were reduced (6.4 [4.8-10] vs. 8.1 [6-13] cm/s, p = .01) as well as right ventricular systolic (11.4 [7.5-17] vs. 13.5 [10-17] cm/s, p = .016) and diastolic velocities (13 [8-23] vs. 17 [12-25] cm/s, p = .0026). In the severe group, these parameters improved from hospital admission to discharge; septal myocardial systolic velocities to 8.8 (7-11) cm/s (p = .002), right ventricular myocardial systolic velocities to 15.0 (11.8-23) cm/s, (p = .003), and diastolic velocity to 21 (11-25) cm/s (p = .002). Patients with cardiac impairment were more likely to have significant pleural effusions.
CONCLUSIONS: Patients with severe dengue have evidence of systolic and diastolic cardiac impairment with septal and right ventricular wall being predominantly affected.
Sophie Yacoub; Anna Griffiths; Tran Thi Hong Chau; Cameron P Simmons; Bridget Wills; Tran Tinh Hien; Michael Henein; Jeremy Farrar
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Critical care medicine     Volume:  40     ISSN:  1530-0293     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-18     Completed Date:  2012-03-12     Revised Date:  2014-08-25    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  477-83     Citation Subset:  AIM; IM    
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MeSH Terms
Age Distribution
Cardiovascular Diseases / epidemiology*,  physiopathology,  ultrasonography*
Cohort Studies
Dengue / epidemiology*,  physiopathology,  ultrasonography
Echocardiography, Doppler / methods
Echocardiography, Doppler, Pulsed
Electrocardiography / methods
Endemic Diseases / statistics & numerical data*
Heart Function Tests
Middle Aged
Risk Assessment
Severe Dengue / epidemiology,  physiopathology,  ultrasonography
Severity of Illness Index
Sex Distribution
Stroke Volume
Survival Rate
Ventricular Dysfunction, Left / epidemiology,  physiopathology,  ultrasonography
Vietnam / epidemiology
Young Adult
Grant Support
100562//Wellcome Trust; //Wellcome Trust
Comment In:
Crit Care Med. 2012 Feb;40(2):675-6   [PMID:  22249046 ]

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