Myocardial Performance Index in Nephrotic Syndrome

Abstract

Background: Primary or idiopathic nephrotic syndrome (PNS) is the most frequent form of Nephrotic Syndrome in children. There is an increased incidence of heart disease in patients with (PNS). Protein wasting and systemic inflammatory activation during PNS may contribute to cardiac remodeling and dysfunction. Methods: This study was carried out in nephrology unit jointly with cardiology unit in El-Minia University Hospital at the period between March 2015 till December 2016 and included 30 PNS patients as group I and twenty age and sex matched healthy control as group II. Both groups are subjected to full history taking, thorough clinical examination, anthropometric measurements, and lab studies, including serum albumin; renal function tests, 24 h urine protein, and serum cholesterol level. Doppler Echocardiography was used for evaluation of both ventricular hemodynamics, MPI (myocardial performance index) and LV function by LV end systolic diameter, LV end diastolic diameter, LV ejection fraction. Results: The difference between both groups in conventional echo is non-significant, while it is significant in tissue echocardiography in both ventricles including IVRT, IVCT, MPI, E/A, and DT. Ventricular diastolic dysfunction was detected in 30% of patients in whom; diastolic blood pressure (DBP) was significantly higher than those with normal RV diastolic function. Also, DBP not affected by duration of illness and other biochemical parameters.