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Effect of adenotonsillar hypertrophy on right ventricle function in children

Jin Hwan Lee1, Jung Min Yoon1, Jae Woo Lim1

  • 1Department of Pediatrics, Konyang University College of Medicine, Daejeon, Korea.

Korean Journal of Pediatrics
|January 1, 2015
PubMed

Insights

Children with adenotonsillar hypertrophy (ATH) show elevated N-terminal of probrain natriuretic peptide (NT-proBNP) levels, indicating potential cardiac dysfunction. Echocardiography did not reveal significant right ventricle (RV) dysfunction, but NT-proBNP suggests underlying risks.

Area of Science:

  • Pediatric Cardiology
  • Pulmonology
  • Biomarkers

Background:

  • Chronic upper airway obstruction, common in children with adenotonsillar hypertrophy (ATH), can lead to hypoxemic pulmonary vasoconstriction and right ventricle (RV) dysfunction.
  • ATH is a prevalent cause of upper airway obstruction in pediatric populations.

Purpose of the Study:

  • To evaluate right ventricle (RV) function in children diagnosed with adenotonsillar hypertrophy (ATH).
  • To investigate the correlation between ATH and potential cardiac dysfunction markers.

Main Methods:

  • Inclusion of 21 children with ATH and 21 age- and gender-matched healthy controls.
  • Assessment of RV function using tricuspid annular plane systolic excursion and RV myocardial performance index via transthoracic echocardiography.
  • Measurement of plasma N-terminal of probrain natriuretic peptide (NT-proBNP) levels as an indicator of RV function.

Main Results:

  • Loud snoring was a common symptom reported in the ATH group via the STOP questionnaire.
  • Plasma NT-proBNP levels were significantly higher in children with ATH compared to controls (66.44±37.63 pg/mL vs. 27.85±8.89 pg/mL, P=0.001).
  • No significant differences in echocardiographic parameters for RV function were observed between the groups.

Conclusions:

  • While echocardiographic evidence of RV dysfunction was not confirmed, elevated NT-proBNP suggests a potential risk for cardiac dysfunction in children with chronic airway obstruction due to ATH.
  • Further research with larger patient cohorts and transthoracic echocardiography is warranted.
  • Pediatricians and otolaryngologists should consider cardiac implications in the management of children with severe ATH.
Abstract

Keywords:
Airway obstructionEchocardiographyHypertrophyObstructive sleep apneaProbrain natriuretic peptide

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