Evaluation of serum nitrate levels in infants and children with congenital heart diseases

This study was carried out on 100 patients having congenital heart disease [CHO], 63 males and 37 females, their age ranged from 4 months to 12.5 years. In addition, 20 apparently healthy children were taken as a control group. This study was done at AI-Azhar University Hospital on patients attending the cardiology and pediatric cardiology outpatient clinic as well as children admitted to the inpatient department. The CHO patients were divided into groups according to: pulmonary artery systolic pressure [PASP] [normal PASP, mild, moderate or severe pulmonary hypertension], presence or absence of heart failure [HF]: [patients with or without heart failure], correction of the cardiac defect: [patients with or without surgical correction] and cyanosis [cyanotic or non-cyanotic CHO]. All patients were subjected to the following: full history taking, complete physical examination [general and cardiac], plain x-ray chest and heart, electrocardiography, echo cardiography and measurement of serum nitrate levels. Our results showed statistically significant differences in serum nitrate levels particulary between patients with severe pulmonary hypertension and those without and between patients with heart failure and those without. The levels were higher in the HF group compared to non-HF group and the control group. No statistically significant differences in serum nitrate levels were found between patients who previously underwent operations for correction of the cardiac defects and those who did not nor between cyanotic and non-cyanotic groups

Subclinical cardiac involvement in systemic lupus erythematosus

Cardiovascular lesions are commonly found in children and adolescents with systemic lupus erythematosus [SLE] with relevant implication in mortality and morbidity. The purpose of the study was to verify whether there is any sign of cardiovascular involvement in childhood SLE without clinical manifestations using electrocardiography [ECG] and echocardiography [ECHO]. The study was carried out on 40 children with SLE who attended the outpatient clinics of Rheumatology, Pediatrics, Cardiology and Internal Medicine departments of Assiut and AI-Azhar universities. They were free of any clinically evident cardiac manifestations such as dyspnea, orthopnea and edema of the lower limbs. In addition, twenty apparently healthy children were taken as a control group. All subjects underwent complete history and physical examinations, x ray chest, ECG and two dimensional,M mode, continuous wave [CW], pulse wave [PW] and color flow Doppler examinations .The following investigations were done: complete blood count [CBc], erythrocyte sedimentation rate[ESR], antistreptolysin O titre [A SOT], C reactive protein[CRP], C[3] complement, rheumatoid factor[RF],anfinuclear antibodies[ANA] and anti double strand DNA[anti ds DNA]. Minor ECG changes were detected in 15% of patients. ECHO showed pericarditis with effusion, aortic insufficiency, mitral regurgitation, mild tricuspid regurgitation and mild pulmonary hypertension in 15%, 20%, 25%, 15% and 20% of patients with SLE respectively. A significant reduction of ejection fraction [EF] and fraction shortening [FS] was found in our patients .Significant diastolic dys functions were manifested by decreased early diastolic flow velocity [E], early diastolic flow velocity/late diastolic flow velocity [E/A] ratio and increased E deceleration time [Edt], left ventricular posterior wall diameter in diastole [LVPWd], interventricular septum in diastole[.lVSd] and pulmonary artery systolic pressure [PASP]. Cardiovascular involvement in childhood SLE is Regular cardiac evaluation using [ECG] and [ECHO] is recommended to detect subclinical cardiac involvement