RESUMO
[This corrects the article DOI: 10.3389/fncel.2022.953620.].
RESUMO
Background: Patients with spinal muscular atrophy (SMA) may suffer from multisystem injury, including an impaired cardiovascular system. However, M-mode echocardiography, the current dominant echocardiographic modality, is limited in the detection of myocardial injury. We considered the use of left ventricular strain imaging in detecting myocardial injury and explored the serum lipid profile related to cardiovascular disease in later-onset SMA children. Methods: A case-control study involving 80 patients with later-onset SMA and 80 age-, gender-, and body surface area-matched control children was conducted in a single tertiary pediatric hospital in China. Data on the left ventricular strain measured using two-dimensional speckle tracking echocardiography, left ventricular function parameters assessed by M-mode echocardiography, and serum lipid profile of these two groups were retrospectively collected for differential analysis. Results: The mean age of the 80 SMA patients were (6.87 ± 2.87) years, of which 46 were type 2 and 34 were type 3 patients. The global longitudinal strain (GLS) of the SMA group (-18.7 ± 2.9%, p < 0.001) was lower than that of the control group; the time to peak longitudinal strain (TTPLS) of the SMA group (22.9 ± 13.6 ms, p < 0.001) was higher than that of the control group, while left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS), measured by the Teichholz method of M-mode echocardiography, showed no significant differences between the two groups. In addition, independent indicators for cardiovascular risk, including total cholesterol (TC)/HDL, low-density lipoprotein (LDL)/HDL, and Apo B/Apo A1 levels, were higher in SMA children than in the control group. Conclusion: Compared with healthy controls, later-onset SMA children presented with reduced GLS and prolonged TTPLS while the LVEF and LVFS values were within normal range. In particular, whether a reduced GLS or prolonged TTPLS in later-onset SMA compared to the control group can predict the risk of future cardiomyopathy remains to be investigated.
RESUMO
OBJECTIVES: To build a fluid-structure interaction model of pulmonary veins with total anomalous pulmonary venous connection, which can be used to predict the result of surgical treatment and at the same time to estimate the elastic properties of pulmonary veins based on patient-specific data and clinic postoperative results. METHODS: The fluid-structure interaction (FSI) model was used to simulate the anastomosis on pulmonary veins based on computed tomography angiography data collected from three children with total anomalous pulmonary venous connection (TAPVC), supra-cardiac type. The deformation and the stress of anastomosis, and also the velocity of blood flow were calculated in fluid-structure coupling algorithm. During the simulation the variable boundary conditions were applied, including the thickness of vessel wall and the vessel elasticity for which was selected a range of values. The calculation results were finally compared to postoperative results of same patients and discussed. The corresponding outcomes are given in the conclusions section. RESULTS: The blood flow velocity through the outlet will vary depending on the properties of vessels, including physical properties and thickness of vessel wall. The stress on vessel is lower for smaller values of Young's modulus. The calculated blood flow velocity correlates well with the postoperative results for the Young's modulus of vessels ranging from 0.5 to 1.0 MPa. CONCLUSIONS: The FSI model has high potential to predict the result of surgery for TAPVC and to estimate the physical properties of pulmonary vein. This model also has potential to guide the strategy for surgical treatment.
