An incidence study of adolescent idiopathic scoliosis with cardiac abnormality

English Keywords:Adolescent idiopathic scoliosis  Doppler ultrasonography  Cardiac

English Abstract:

  【Abstract】 Objectives: To investigate the incidence of adolescent idiopathic scoliosis(AIS) patients with cardiac abnormalities and find risk factors of scoliosis related to cardiac abnormalities. Methods: From June 2008 to June 2011, the clinical data of 719 AIS patients receiving spinal correction in our center were reviewed in this study. There were 113 males and 606 females with a mean age of 15.1±2.2 years old(ranging from 10 to 18 years). Before surgery, each of them underwent cardiac doppler ultrasonography test. Congenital and the other cardiac abnormalities were calculated. After that, the patients were classified according to the gender(man/woman) and scoliosis type(thorax curvature and lumbar/thoracolumbar curvature) to compare the incidence of congenital cardiac abnormalities. The patients were classified according to the scoliosis type(thorax curvature and lumbar/thoracolumbar curvature), Cobb angle(≤70° and >70°) and thoracic kyphosis(<10°, 10°-40° and >40°) to compare the incidence of the other cardiac abnormalities. The binary classification Logistic regression analysis was performed to identify the correlation of the other cardiac abnormalities with the scoliosis type(thorax curvature and lumbar/thoracolumbar curvature), Cobb angle(continuous variable) and thoracic kyphosis(continuous variable) in patients with adolescent idiopathic scoliosis. Through the binary classification Logistic regression analysis, the correlation of the non-congenital cardiac abnormalities with the scoliosis type(thorax curvature and lumbar/thoracolumbar curvature), Cobb angle(continuous variable) and thoracic kyphosis(continuous variable) was reviewed. Results: The incidence of cardiac abnormalities was 6.68%(48/719) in 719 AIS patients. The incidence of congenital cardiac abnormalities was 4.59%(33/719). The most common congenital cardiac abnormalities in AIS patients were atrial septal defect(2.50%, 21/719), ventricular septal defect(0.56%, 4/719) and patent ductus ateriosus（0.28%, 2/719). The incidence of the other cardiac abnormalities was 2.09%(15/719). The other cardiac abnormalities were mitral valve prolapsed(1.11%, 8/719) and pulmonary hypertension(0.97%, 7/719). In 48 AIS patients with cardiac abnormalities, 36 patients denied such history, 3 of whom were noticed to be associated with sever cardiac abnormalities and underwent heart surgical intervention before the spine surgery. 12 patients had learned with heart abnormalities before admission, 10 of whom were noticed to be associated with sever congenital cardiac abnormalities and underwent heart surgical intervention before the spine surgery. There was no significant difference between the gender and scoliosis type on the incidence of congenital cardiac abnormalities. There was no significant difference among scoliosis type, Cobb angle and thoracic kyphosis on the incidence of the other cardiac abnormalities. There was no significant relationship of the incidence of mitral valve prolapsed and pulmonary hypertension with the scoliosis type, Cobb angle or thoracic kyphosis. Conclusions: Cardiac abnormalities are usually complicated with AIS, some of which have serious effects on the spine surgery. Cardiac intervention is necessary before the spine surgery. Cardiac doppler ultrasonography is an essential preoperative examination for AIS patients.