Abstract
Background : ACE inhibitors through reverse remodeling mechanisms may encounter secondary LV changes due to rheumatic MR. Studies regarding RHD in Indonesia, however, remain limited. Objectives : This study purposed to define the characteristic profile of pediatric rheumatic heart disease patients with mitral regurgitation who received ACE inhibitors. Methods : This descriptive observational study involved 47 pediatric RHD patients in the Pediatric Cardiology Outpatient Department of dr. Saiful Anwar General Hospital from November 2018 to June 2019. Patients were divided into the captopril group and the no captopril group. The Captopril group was defined as patients who had been receiving captopril for more than or equal to 12 months prior to the study. Data about demographic and echocardiographic parameters were analyzed. Results: Female patients were predominant (68%), with a mean age of 12.1 years and body mass index (BMI) of 17.2 kg/m2. The Captopril group revealed younger age, higher BMI, and longer initial time of RHD diagnosis compared to the no captopril group. Evaluation of LV remodeling parameters demonstrated that the captopril group had smaller LVIDd, lower LVMI, higher FS, and higher LVEF. LVPWd dan RWT were found to be relatively similar among both groups. Evaluation of MR grade revealed that the captopril group showed the lower value of MR VC, MR EROA, and MR regurgitant volume, as well. Conclusion: Pediatric rheumatic MR receiving ACE inhibitors revealed smaller LVIDd, lower LVMI, lower MR grade, higher FS, and higher LVEF compared to patients receiving no ACE inhibitors.
Highlights
Rheumatic heart disease (RHD) is one of the most leading causes of morbidity and mortality of cardiovascular disease worldwide, especially in the pediatric population.[1]
This study purposed to define the characteristic profile of pediatric rheumatic heart disease patients with mitral regurgitation who received Angiotensin-converting enzyme (ACE) inhibitors
RHD occurs as a complication of acute rheumatic fever (ARF), in which 35% of patients diagnosed with ARF developed RHD after one year, and the rate increased to 51% after 10 years.[2]
Summary
Rheumatic heart disease (RHD) is one of the most leading causes of morbidity and mortality of cardiovascular disease worldwide, especially in the pediatric population.[1] RHD occurs as a complication of acute rheumatic fever (ARF), in which 35% of patients diagnosed with ARF developed RHD after one year, and the rate increased to 51% after 10 years.[2] The incidence of ARF in children aged 5-14 years ranges from 300,000 – 350,000 per year, subsequently raises the incidence risk of RHD.[3]. Its study on rheumatic MR is still limited, in Indonesia.[5] This study purposed to define the characteristic profile of pediatric rheumatic heart disease patients with mitral regurgitation who received ACE inhibitors
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