This study was designed to investigate the differences in pulsatile hemodynamics, echocardiographic findings, 24-h Holter monitoring and heart rate variability parameters of dipper patterns in children with newly diagnosed essential hypertension. This study included 30 children with newly diagnosed essential hypertension and 30 healthy controls. The essential hypertension cohort was divided into dippers and non-dippers. Physical examinations, 24-hour ambulatory blood pressure monitoring, 24-h Holter monitoring, 24-h heart rate variability, conventional 2-dimensional and Doppler echocardiography, and tissue Doppler imaging were performed. Pulse wave analysis using an oscillometric monitor was conducted to measure augmentation index (AIx) and pulse wave velocity (PWV). In patients with essential hypertension, left ventricular (LV) wall thickness and LV mass index were increased. There were no significant differences in LV mass index and LV wall thickness based on the dipping patterns. Time domain values and the standard deviation of all RR intervals (SDNN) were substantially lower in the essential hypertension group. SDNN values were considerably lower in the non-dipper group compared with the dipper group. In terms of frequency domain measures, low frequency measured in daytime values was much lower in the essential hypertension group compared with the control. The dipper patterns revealed that low frequency measured in nighttime values was also substantially lower in the non-dipper group. Pulse wave analysis and AIx values were notably higher in the essential hypertension patient group and those with non-dipper status. SDNN values, which reflect parasympathetic activity, were markedly lower in children with hypertension and the non-dipper group than healthy controls and the dipper group, respectively. Also, parameters related to arterial stiffness, such as PWV and AIx values were significantly higher in children with hypertension and the non-dipper group.
Background: The rate of congenital heart disease is 0.8% in all live births. The majority of this, however, is acyanotic congenital heart disease. The survival rate of children with cardiac disease has increased with the developments provided in recent years and their lifetime is extended. Objectives: This study aims to evaluate neurodevelopment of children with uncomplicated acyanotic congenital heart disease in preschool period and determine the factors affecting their neurodevelopmental process. Patients and Methods: 132 children with acyanotic congenital heart disease aged 6 - 72 months were involved in the study. Mental development and intelligence levels of patients under 2 years old were assessed by using Bayley Development Scale-III, and Stanford Binet Intelligence test was employed for patients over 2 years old. Denver Developmental Screening Test II was applied to all patients for their personal-social, fine motor, gross motor and language development. Results: The average age of patients (67 girls, 65 boys) included in the study was 35.2 ± 19.6 months. It was determined that there were subnormal mental level in 13 (10%) patients and at least one specific developmental disorder in 33 (25%) patients. Bayley Mental Development Scale score of patients who had received incubator care in perinatal period was found significantly low (88 ± 4.2) compared to those with no incubator care (93.17 ± 8.5) (P = 0.028). Low educational level of father was established to be linked with low mental development scores at the age of 2 and following that age (P < 0.05). Iron deficiency anemia was discovered to be related to low psychometric test scores at every age (P < 0.05). Conclusions: Neurodevelopmental problems in children with acyanotic congenital heart disease were found higher compared to those in society. Mental development and intelligence levels of patients were determined to be closely associated with receiving incubator care, father’s educational level and iron deficiency anemia. Keywords: Acyanotic Congenital Heart Disease; Psychometric Assessment; Mental Development
3 October 2018 in Clinical and Experimental Hypertension
Background: To the best our knowledge there is no data in the literature related to changes in renal resistive index (RRI) values in children who have hypertension (HT). In this study, we aimed to investigate the changes of RRI values and it is usability in children with HT. Methods: A total of 75 children; 48 with newly diagnosed HT and 27 healthy controls were included in the study. Routine history, physical examination, and laboratory examinations were performed. Left ventricular (LV) dimensions and systolic-diastolic functions, septum and posterior wall thickness (IVSd and PWd) and LV mass index (LVMI) were calculated by echocardiography. In addition to routine renal ultrasonography (US), renal pulsatility indexes (RPI), accelerated time and RRI were measured. Increased RRI was accepted as >0.70. Results: Increased RRI was detected in 25 (52%) of HT patients. Systolic and diastolic blood pressure (SBP and DBP), and pulse pressure (PP), low-density lipoprotein cholesterol and triglyceride levels, RRI, RPI, kidney length, IVSd, PWd, and LVMI were significantly higher in patients with HT (both p < 0.05). SBP and PP, PWd, LV ejection fraction, LV fractional shortening, and LVMI were positively correlated with the RRI. High-density lipoprotein cholesterol was negatively correlated with the RRI. Of these measurements, RRI values were found to be independently associated with PP and LVMI (p < 0.05). Conclusions: In hypertensive children, RRI was significantly higher than healthy controls and it is also related with LVMI and PP.