Asia Pac Allergy.  2018 Oct;8(4):e40. 10.5415/apallergy.2018.8.e40.

Evaluation of the left venticular systolic function with the measurement of global longitudinal strain by Speckle tracking echocardiography in anaphylaxis

• Demir S
• Atici A
• Coskun R
• Olgac M
• Unal D
• Sarikaya R
• Gelincik A
• Colakoglu
• Oflaz H
• Sonsoz MR
• Buyukozturk S

• KMID: 2423991
• DOI: http://doi.org/10.5415/apallergy.2018.8.e40

Abstract

BACKGROUND
It is not known how cardiac functions are affected during anaphylaxis.
OBJECTIVE
Our aim was to measure the cardiac functions shortly after an anaphylaxis attack using a new technique that detects subclinical left ventricular dysfunction.
METHODS
Patients in our hospital who experienced anaphylaxis and urticaria (control group) due to any cause were included in the study. Tryptase levels were measured on the third hour of the reaction and 6 weeks later. Left ventricular systolic functions were evaluated with global strain measurement using echocardiography, approximately 4 hours and 6-week post reaction.
RESULTS
Twelve patients were included in the anaphylaxis group (83.3% female; mean age, 43.25 ± 9.9 years). The causes of anaphylaxis were drug ingestion (n = 11) and venom immunotherapy. Eight of the anaphylactic reactions (66.7%) were severe and in 9 reactions (75%) tryptase levels increased. In the anaphylaxis group, strain values measured shortly after anaphylaxis were significantly lower than those calculated 6 weeks later (p < 0.001) and tryptase levels significantly increased (p = 0.002). The strain values measured both shortly after anaphylaxis and 6 weeks later did not differ according to severity of anaphylaxis. In severe anaphylaxis, tryptase levels during anaphylaxis and 6 weeks later were significantly higher (p = 0.019, p = 0.035). The control group evidenced no differences regarding strain and tryptase levels measured at reaction and 6 weeks later. At reaction, in the anaphylaxis group, the tryptase levels were higher and the strain values were lower than those in the urticaria group (p = 0.007, p = 0.003).
CONCLUSION
Cardiac dysfunction may develop during an anaphylaxis independent of severity of reaction.

Keyword

Anaphylaxis; Cardiac function; Speckle tracking echocardiography; Global longitudinal strain; Tryptase

MeSH Terms

Anaphylaxis*
Eating
Echocardiography*
Female
Humans
Immunotherapy
Tryptases
Urticaria
Venoms
Ventricular Dysfunction, Left
Tryptases
Venoms