title: Assessment of cardiac function in absence of congenital and acquired heart disease in patients with Down syndrome.
abstract: BACKGROUND
  Extra genetic material in patients with Down syndrome (DS) may affect the function of any organ system. We evaluated cardiac functions using conventional tissue Doppler and two-dimensional speckle tracking echocardiography in patients with DS in the absence of congenital and acquired heart disease in patients.
  
  
  METHODS
  A total of 115 patients with DS between 6 and 13 years of age with clinically and anatomically normal heart and 55 healthy children were included in this cross-sectional study. DS was diagnosed by a karyotype test. Patients with mosaic type were not included in this study. Systolic and diastolic functions were evaluated by echocardiography.
  
  
  RESULTS
  Pulsed waved Doppler transmitral early/late inflow velocity (E/A), tissue Doppler mitral annular early/late diastolic peak velocity (Ea/Aa), transtricuspid E/A and tricuspid valve annulus Ea/Aa, pulmonary venous Doppler systolic/diastolic (S/D) wave ratio were lower in patients with Down syndrome than in the control group (P=0.04, P=0.001, P<0.05, P<0.001, P<0.001, respectively). Mitral and tricuspid annular Ea were lower in patients with DS (P<0.001). The right and left ventricular myocardial performance indexes were higher in patients with DS than in the controls (P<0.01). They had significantly higher left ventricular mass, ejection fraction, the mitral annular plane systolic excursion values. However, the Down syndrome group compared with the controls had a lower strain values examined by two-dimensional longitudinal speckle-tracking strain echocardiography.
  
  
  CONCLUSIONS
  These findings suggest conventional tissue Doppler and two-dimensional longitudinal speckletracking strain echocardiography were useful methods of investigating ventricular function and identifying a higher incidence of biventricular dysfunction in patients with Down syndrome compared with the healthy controls.
authors.affiliation: Department of Pediatric Cardiology, Balikesir Ataturk Hospital, Balikesir, Turkey. drsevketballi@hotmail.com.
authors.forename: Sevket
authors.initials: S
authors.lastname: Balli
authors.affiliation: Department of Pediatric Cardilogy, Siyami Ersek Education and Research Hospital, Istanbul, Turkey.
authors.forename: Ilker Kemal
authors.initials: IK
authors.lastname: Yucel
authors.affiliation: Department of Pediatric Cardiology, Children's Hospital, Mersin, Turkey.
authors.forename: Ayse Esin
authors.initials: AE
authors.lastname: Kibar
authors.affiliation: Department of Pediatric Cardiology, Yuzuncu Yil University of Medicine, Van, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Ece
authors.affiliation: Department of Pediatrics, Balikesir Ataturk Hospital, Balikesir, Turkey.
authors.forename: Eylem Sen
authors.initials: ES
authors.lastname: Dalkiran
authors.affiliation: Department of Medical Genetics, Balikesir Ataturk Hospital, Balikesir, Turkey.
authors.forename: Sukru
authors.initials: S
authors.lastname: Candan
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D016009:Chi-Square Distribution; D002648:Child; D003430:Cross-Sectional Studies; D004314:Down Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000453:epidemiology; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology; D006334:Heart Function Tests; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000453:epidemiology; D015994:Incidence; D008297:Male; D011379:Prognosis; D018570:Risk Assessment; D017678:Sex Distribution; D014421:Turkey; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology
keywords: Down syndrome; diastolic function; strain imaging analysis; systolic function; tissue Doppler