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Radionuclide evaluation of cardiac function during sleep in children with bronchopulmonary dysplasia
J P Praud1, F Cavailloles, K Boulhadour
1Laboratory of Physiology, Hôpital Antoine Beclere, Clamart, France.
Insights
Sleep significantly impacts cardiac function in children with severe bronchopulmonary dysplasia. Radionuclide ventriculography during sleep reveals decreased left and right ventricular ejection fractions, especially with nocturnal desaturation.
Area of Science:
- Pediatric Cardiology
- Sleep Medicine
- Respiratory Medicine
Background:
- Severe bronchopulmonary dysplasia (BPD) affects cardiac function.
- Sleep disturbances are common in infants and children with BPD.
- The impact of sleep on cardiac function in pediatric BPD is not well understood.
Purpose of the Study:
- To assess the influence of sleep on cardiac function in children with severe BPD.
- To evaluate left and right ventricular ejection fractions (LVEF and RVEF) during different sleep states.
Main Methods:
- Equilibrium radionuclide ventriculography (RNV) was used in five children (1.5-5 years) with severe BPD.
- Cardiac function was measured during wakefulness, non-rapid eye movement (NREM) sleep, and rapid eye movement (REM) sleep.
- Polygraphic monitoring was performed concurrently with RNV.
Main Results:
- Left ventricular ejection fraction (LVEF) was normal during wakefulness, but right ventricular ejection fraction (RVEF) was low.
- Both LVEF and RVEF decreased significantly during sleep compared to wakefulness.
- The decrease in ejection fractions was more pronounced in children with greater nocturnal desaturation and paradoxical rib cage motion.
Conclusions:
- RNV is a feasible method for assessing cardiac function in sleeping children with BPD.
- Sleep significantly impairs cardiac function, particularly RVEF, in children with severe BPD.
- Findings highlight the importance of monitoring cardiac status during sleep in pediatric BPD.
Abstract:
The influence of sleep on cardiac function in severe bronchopulmonary dysplasia was assessed in five children 1.5 to 5 years of age. Left and right ventricular ejection fractions (LVEF and RVEF) were investigated by equilibrium radionuclide ventriculography in five children undergoing polygraphic monitoring during the different states of alertness: wakefulness, nonrapid eye movement sleep, and rapid eye movement sleep. Intraobserver and interobserver LVEF and RVEF measurement reproducibility was high. During quiet, supine wakefulness, LVEF was normal, but RVEF was low. During sleep, a decrease in both LVEF and RVEF, expressed as a percentage of the awake value, was marked in the two children with the most nocturnal desaturation and longest duration of paradoxic rib cage motion during inspiration. It is concluded that radionuclide ventriculography can be easily performed during sleep in children and can provide useful information regarding right ventricular function during sleep in children with severe bronchopulmonary dysplasia.