Title Akutni miokarditis u djece i adolescenata Title (english) Acute myocarditis in children and adolescents Author Nina Sapunar Mentor Daniel Dilber (mentor)Committee member Ruža Grizelj (predsjednik povjerenstva)Committee member Marija Jelušić (član povjerenstva)Committee member Daniel Dilber (član povjerenstva)Granter University of Zagreb Defense date and country 2024-07-12, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Uvod: Miokarditis je upalno stanje središnjeg sloja srca, miokarda, koji se sastoji od srčanih mišićnih stanica odgovornih za srčane kontrakcije, a nalazi se među vodećim uzrocima iznenadnih srčanih smrti mladih. Istraživanje je analiziralo slučajeve akutnog miokarditisa među djecom i adolescentima na Klinici za pedijatriju Kliničkog bolničkog centra Zagreb s ciljem da se prepoznaju trendovi u dijagnostičkim postupcima i laboratorijskim nalazima te da se postigne općenito bolje razumijevanje ovoga stanja.
Ispitanici i metode: Ispitanici istraživanja bili su djeca i pacijenti u dobi 0-18 godina zaprimljeni s dijagnozom akutnog miokarditisa u Kliničkom bolničkom centru Zagreb od siječnja 2012. godine do ožujka 2024. godine. Od početno identificiranih 38 ispitanika njih 13 isključeno je zbog isključenja dijagnoze tijekom obrade. Podatci su prikupljeni retrospektivno iz BIS-a i medicinskih arhiva, a uključivali su laboratorijske nalaze, patohistološke nalaze biopsije srca, nalaze direktnih i indirektnih metoda dokazivanja prisutnosti virusa te radiološke i EKG nalaze. Istraživanje je odobrilo Etičko povjerenstvo Kliničkog bolničkog centra Zagreb.
Rezultati: U istraživanju je sudjelovalo ukupno 25 pacijenata od kojih je 84% bilo muškog spola, a 68% su bili adolescenti u dobi 16-17 godina. Laboratorijski nalazi pokazali su povišene razine troponina u 96% slučajeva, CK-a u 87%, CK-MB-a u 100%, NT-proBNP-a u 85% i CRP-a u 88% pacijenata. Kardiotropni virusi otkriveni su u 38% pacijenata, a uključuju
influencu tip A i B, Epstein-Barr virus, enteroviruse i parvovirus B19. Od 25 pacijenata, samo ih je 11 bilo podvrgnuto biopsiji endomiokarda ili MR-u. Statistički testovi povezanosti nisu pokazali značajnu povezanost između povišenih razina NT-proBNP-a i troponina s patološkim nalazima TTE-a i EKG-a, vjerojatno zbog malog uzorka.
Zaključak: Rezultati istraživanja pokazali su povišene vrijednosti markera oštećenja miokarda i upale u većini slučajeva potvrđujući povezanost ovih markera s akutnim miokarditisom. Istraživanje nije potvrdilo povećanje broja slučajeva povezanih s pojavom SARS-CoV-2 virusa i uvođenjem cjepiva za tu bolest. Uočena je nedosljednost u provedbi dijagnostičkih pretraga što ukazuje na potrebu za standardizacijom postupaka i proširenjem uzorka istraživanja.
Abstract (english) Introduction: Myocarditis is an inflammatory condition of the central layer of the heart, the myocardium, composed of cardiac muscle cells responsible for heart contractions and is among the leading causes of sudden cardiac death in young individuals. The study analyzed cases of
acute myocarditis among children and adolescents at the Department of Pediatric Cardiology of the University Hospital Centre Zagreb with the aim of identifying trends in diagnostic procedures and laboratory findings to achieve a better understanding of this condition overall.
Patients and methods: Participants in the study were children and patients aged 0-18 years admitted with a diagnosis of acute myocarditis at the University Hospital Centre Zagreb from January 2012 to March 2024. Of the initially 38 identified patients, 13 were excluded due to
exclusion of diagnosis during the evaluation. Data were collected retrospectively from BIS and medical archives, including laboratory findings, histopathological findings from heart biopsies, results from direct and indirect methods for virus detection and radiological and ECG findings. The study was approved by the Ethics Committee of the University Hospital Centre Zagreb.
Results: A total of 25 patients participated in the study of which 84% were male and 68% were adolescents aged 16-17 years. Laboratory findings showed elevated levels of troponin in 96% of cases, CK in 87%, CK-MB in 100%, NT-proBNP in 85% and CRP in 88% of patients.
Cardiotropic viruses were detected in 38% of patients and included influenza type A and B, Epstein-Barr virus, enteroviruses and parvovirus B19. Of the 25 patients, only 11 underwent endomyocardial biopsy or MRI. Statistical tests did not show a significant correlation between
elevated troponin and NT-proBNP levels with pathological findings on TTE and ECG, likely to the small sample size.
Conclusion: The study results showed elevated troponin, CK, CK-MB, NT-proBNP and CRP in most cases, confirming the association of these markers with acute myocarditis. The research did not confirm an increase in the number of cases related to the emergence of the SARS-CoV- 2 virus and the introduction of vaccines for this disease. Inconsistencies in the use of diagnostic tests were observed, indicating the need for standardization of procedures and expansion of
research sample.
Keywords
pedijatrijska kardiologija
akutni miokarditis
dijagnostički postupci
Keywords (english)
pediatric cardiology
acute myocarditis
diagnostic procedures
Language croatian URN:NBN urn:nbn:hr:105:026253 Study programme Title: Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2024-07-02 22:23:03
