Detection of cardiac changes in juvenile rheumatoid arthritis by non-invasive methods of circulatory system investigation
Małgorzata Szumera, Maria Korzon
Med Sci Monit 1999; 5(3): CR479-487
The aim of the study was a complex evaluation of circulatory system in children with juvenile rheumatoid arthritis (j.r.a.) on the basis of available non-invasive methods of circulatory system investigation. 89 children with j.r.a. were examined. Obtained results were compared with the results recorded in 50 healthy children of corresponding age group and gender. Anamnesis, physical and radiological examinations revealed low percentage of changes. Patients with generalised j.r.a. more often displayed tachycardia and low heart sounds, in single cases pericardial friction murmur was detected. Changes in ECG were observed in approx. 40% patients, and they frequently concerned ST segment and T wave and were diagnosed in children with generalised form of the disease. Deviations in echocardiography were observed in over 60% cases. Statistically significant decrease of left ventricular ejection fraction (%EF) and percentage shortening fraction of left ventricle (%SF) were recorded in generalised j.r.a. when compared with other forms of the disease and control group. There was a statistically significant difference in the decrease of intraventricular septum - systole (IVSs%) in generalised and polyarticular j.r.a. when related to oligoarticular form of the disease. Reduced left ventricular posterior wall - systole (%LVPWs) was only observed in patients with generalised and oligoarticular j.r.a. Pericardial pathology was detected in 1/3 investigations, most often in generalised j.r.a. It was manifested by pericardial exudate or excessive pericardial saturation. We analysed the presence of changes in echo and ECG with respect to disease duration. It was found that changes in ECG and echo were significantly more frequent during the first 5 years of j.r.a. when compared with later phase of the disease.
Keywords: Echocardiography, Heart, juvenile chronic arthritis