الفهرس | Only 14 pages are availabe for public view |
Abstract This study was conducted to to evaluate the carotid intima media thickness as an early indicator of atherosclerosis and to assess Left ventricular mass (LVM) in children with nephrotic syndrome from from April 2019 till August 2020. Nephrotic patients are prone to atherosclerosis in consequence of frequent exposures to hyperlipidemia, hypertension, and immunosuppressive drugs. CIMT (carotid intima media thickness)is a surrogate marker for evaluation of diffuse thickening and stiffening of large and medium sized vessels, Cardiovascular disease are preceded by endothelial dysfunction and CIMT changes, Some manifestations of NS, like proteinuria and hyperlipidemia, are associated with an increased risk of cardiac morbidity and mortality The Study included 81 patients with idiopathic NS with an age range between 2 and 15 years (54 males and 27 females) who were diagnosed clinically and proven by laboratory results. All children underwent a complete lipid profile including total cholesterol, high-density lipoprotein (HDL), low-density lipoproteins (LDL) and triglycerides All patients had undergone echocardiographic examination and Measurement of cIMT. Height was significantly lower in patients than controls (p=0.041). BMI and weight were significantly higher in patients than controls p= (.013 and 0.04) respectivly Frequency of elevated TG was significantly higher in the case group than controls (21.0% versus 5%) p= .023 According to our results the mean carotid intima-media thickness (mm) was higher in nephrotic children (.5123± .12081) compared to controls (.4200± .09115) (P-value =.000). Subsequently, CIMT was significantly correlated to disease duration (p= .000). IVSd , LVIDd ,LVIDs , LVPWd , EF and Carotid doppler IMT were significantly higher in the case group than controls ( p= .000 , .000 , 0.003 , .002, .010 , .000 respectivily ) LV Mass and LVM Index were significantly higher in the cases group than controls (p= .000, .000 respectivily) As regard LVM, was positively correlated to BP (blood pressure), age of onset, TG levels and BMI (body mass index). There were no significant differences between three groups regard as echo findings Significant negative correlation between both LVM and LVMI with HDL indicating the protective role of HDL on left ventricle function. So; NS patients should be examined carefully and undergo regular lipid profile measurement Also, assessment of CIMT and echocardiographic assessment should be done for nephrotic patients with risk factors. |