eISSN: 1896-9151
ISSN: 1734-1922
Archives of Medical Science
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4/2019
vol. 15
 
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abstract:
Clinical research

Cardiac assessment in Wilson’s disease patients based on electrocardiography and echocardiography examination

Małgorzata Buksińska-Lisik, Tomasz Litwin, Tomasz Pasierski, Anna Członkowska

Arch Med Sci 2019; 15 (4): 857–864
Online publish date: 2017/09/07
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Introduction
Wilson’s disease (WD) is a rare genetic disorder that leads to impairments in copper metabolism. Patients principally exhibit liver and neuropsychiatric symptoms, but because copper also accumulates in all body organs, other (typically milder) clinical symptoms can occur. To date, cardiac involvement has not been thoroughly investigated in patients with WD. This study aimed to evaluate heart structure and function in patients with WD with commonly available diagnostic methods.

Material and methods
We compared 125 WD patients with an age- and sex-matched control group. Patients with WD were grouped according to their dominant symptoms – neurologic or hepatic. All subjects underwent clinical, electrocardiographic (ECG), and echocardiographic examinations.

Results
All subjects had sinus rhythm on electrocardiography. The only ECG parameter that differed between patients with WD and the control group was the QRS prolongation (92.0 vs. 86.4 ms; p < 0.05). On echocardiography patients with WD exhibited more hypertrophy in the left ventricle than controls (posterior wall in diastole: 1.0 vs. 0.93; p < 0.01) and the left ventricle hypertrophy was more pronounced in the neurologic than in the hepatic subgroup (1.05 vs. 0.96 cm; p < 0.01). Left ventricular systolic function was similar in the WD and the control group (ejection fraction: 67.5% vs. 67.7%). On tissue Doppler echocardiography patients with WD demonstrated slowing of myocardial relaxation, which was more evident in the neurologic group.

Conclusions
Heart involvement in WD was manifested mainly by mild left ventricular hypertrophy and subclinical changes in diastolic function, particularly in the patients with the neurologic form of disease.

keywords:

left ventricular diastolic dysfunction; left ventricular hypertrophy; hepatolenticular degeneration

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