Morphometric Determinants of Myocardial Dysfunction in Children with Congenital Heart Defects in the Postoperative Period

Abstract

The objective of the study. To define morphometric markers of myocardial dysfunction in children with CHD in the postoperative period. Materials and research methods. Prospective cohort study was conducted. The basic study group included 108 children with CHD aged from 1 to 13 years old (mean age 7.84±0.8 years old). The control group of the study consisted of 40 practically healthy children. In the main group of children, subgroups were formed depending on the severity of CHF and functional class (FC): 1st group including 55 children with CHF-0, 2nd group with 28 children with FC I CHF I , and 3rd group with 25 children with FC II CHF II A. Research results. It was found that in children with FC I CHF I and with II FC CHF II A degree at the age of 1-3 years old, 4-6 and 7-13 years old there was a significant increase in the values of the right ventricle (RV), the diameter of the pulmonary trunk with a decrease in ejection fraction and the size of the left atrium (LA) relative to the control, which are potential signs of diastolic dysfunction in the postoperative period. The most vulnerable in this regard were children aged 1-3 and 4-6 years old, perhaps due to the short postoperative period and the worst myocardial compensatory response. Diagnostically significant correlations between morphometric parameters of echocardiography and the clinical course of the postoperative period in children with congenital heart disease were determined . Conclusion. On the basis of clinical (index of adaptive potential of the cardiovascular system) and echocardiographic parameters, diagnostic criteria for myocardial adaptation in children with CHD in the postoperative period have been developed.