Tipo
Artigos em Conferência
Tipo de Documento
Resumo Extendido
Título
Should children with exercise induced intra-ventricular gradients, be treated with beta-blockers
Participantes na publicação
Cotrim C. (Author)
Martins Rui (Author)
Dep. Estatística e Investigação Operacional
CEAUL
Resumo
Background: In our experience, treadmill exercise echocardiography (SE) is feasible and safe in children (C). Regional wall motion abnormalities (RWMA) are of limited usefulness, but Doppler often - (in 39% from 258 previously studied C) - documents significant intraventricular gradients (IVG), occult at rest, and allowing to document a possible explanation for exercise related symptoms, or abnormal resting or stress-ECG findings.\\\\\\\\\\\\\\\\n\\\\\\\\\\\\\\\\nPurpose - To assess the effect of ß blockers on the occurrence of IVG, in C, with symptoms or abnormal resting or stress-ECG findings.\\\\\\\\\\\\\\\\n\\\\\\\\\\\\\\\\nMethods – We repeated SE in 66 of the 101 C – (with normal echocardiogram at rest) - that developed IVG on exertion, under treatment with ß blockers. These 66 C who repeated the SE under treatment with ß blockers are the study group. 15 (23%) of them were female and the mean age of the group was 14,6 ± 1,7 years old (11 to 17).\\\\\\\\\\\\\\\\n\\\\\\\\\\\\\\\\nThey all underwent SE with 2D and Doppler echocardiographic evaluation of, and during treatment with ß blockers.\\\\\\\\\\\\\\\\n\\\\\\\\\\\\\\\\nResults: Mean IVG in those 66 C submitted to SE was 105 ± 38 mmHg in the first SE evaluation. In SE evaluation performed under ß blockers, 37 of them didn’t develop IVG and in 29 of them IVG was significantly reduced to a mean IVG of 58 ± 32 mmHg (p< 0,0001). The mean heart rate attained at peak exercise was 178 ± 15 bpm in the first SE evaluation and 157 ± 9 bpm in the evaluation performed under treatment with ß blockers (p<0, 0001). 47 of these C reproduced clinical symptoms (that were indication to SE) of beta-blockers, and only 7 reproduced the symptoms under treatment with beta blockers (p< 0,0001).\\\\\\\\\\\\\\\\n\\\\\\\\\\\\\\\\nConclusions: In C with symptoms, abnormal rest or exercise ECG on medical evaluation and IVG on exertion, treatment with oral ß blockers prevented the occurrence of IVG or significantly reduced its magnitude. These changes were associated to significant clinical improvement in 85 % of the symptomatic population.
Instituição
FACULDADE DE CIÊNCIAS DA UNIVERSIDADE DE LISBOA
Evento
European Heart Journal - Cardiovascular Imaging
Identificadores da Publicação
ISSN - 2047-2412
Local
Austria
Organizadores
EuroEcho-2019
Identificadores do Documento
DOI -
https://doi.org/10.1093/ehjci/jez319.578
Identificadores de Qualidade
SCIMAGO Q1 (2020) - 2.576 - Radiology, Nuclear Medicine and Imaging
SCIMAGO Q1 (2020) - 2.576 - Medicine (miscellaneous)
SCIMAGO Q1 (2020) - 2.576 - Cardiology and Cardiovascular Medicine