title: Cardiac function in Vietnamese patients with different dengue severity grades.
abstract: OBJECTIVE
  Dengue continues to cause significant global morbidity and mortality. Severe disease is characterized by cardiovascular compromise from capillary leakage. Cardiac involvement in dengue has also been reported but has not been adequately studied.
  
  
  METHODS
  Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
  
  
  METHODS
  Seventy-nine patients aged 8-6 yrs with different dengue severity grades were studied using echocardiography including tissue Doppler imaging. The patients were split into severity grades: dengue, dengue with warning signs, and severe dengue. Changes in cardiac functional parameters and hemodynamic indices were monitored over the hospital stay.
  
  
  METHODS
  None.
  
  
  RESULTS
  Patients with severe dengue had worse cardiac function compared with dengue in the form of left ventricular systolic dysfunction with increased left myocardial performance index (0.58 [0.26-0.80] vs. 0.38 [0.22-0.70], p = .006). Septal myocardial systolic velocities were reduced (6.4 [4.8-10] vs. 8.1 [6-13] cm/s, p = .01) as well as right ventricular systolic (11.4 [7.5-17] vs. 13.5 [10-17] cm/s, p = .016) and diastolic velocities (13 [8-23] vs. 17 [12-25] cm/s, p = .0026). In the severe group, these parameters improved from hospital admission to discharge; septal myocardial systolic velocities to 8.8 (7-11) cm/s (p = .002), right ventricular myocardial systolic velocities to 15.0 (11.8-23) cm/s, (p = .003), and diastolic velocity to 21 (11-25) cm/s (p = .002). Patients with cardiac impairment were more likely to have significant pleural effusions.
  
  
  CONCLUSIONS
  Patients with severe dengue have evidence of systolic and diastolic cardiac impairment with septal and right ventricular wall being predominantly affected.
authors.affiliation: Department of Infection and Immunity, Imperial College, London, UK. s.yacoub@imperial.ac.uk
authors.forename: Sophie
authors.initials: S
authors.lastname: Yacoub
authors.forename: Anna
authors.initials: A
authors.lastname: Griffiths
authors.forename: Tran Thi Hong
authors.initials: TT
authors.lastname: Chau
authors.forename: Cameron P
authors.initials: CP
authors.lastname: Simmons
authors.forename: Bridget
authors.initials: B
authors.lastname: Wills
authors.forename: Tran Tinh
authors.initials: TT
authors.lastname: Hien
authors.forename: Michael
authors.initials: M
authors.lastname: Henein
authors.forename: Jeremy
authors.initials: J
authors.lastname: Farrar
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000503:physiopathology; D002648:Child; D015331:Cohort Studies; D015897:Comorbidity; D003715:Dengue / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D015150:Echocardiography, Doppler / Q000379:methods; D018619:Echocardiography, Doppler, Pulsed; D004562:Electrocardiography / Q000379:methods; D019353:Endemic Diseases / Q000706:statistics & numerical data*; D005260:Female; D006334:Heart Function Tests; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018570:Risk Assessment; D019595:Severe Dengue / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology; D012720:Severity of Illness Index; D017678:Sex Distribution; D013318:Stroke Volume; D015996:Survival Rate; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology; D014744:Vietnam / Q000453:epidemiology; D055815:Young Adult