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Quantitative tissue velocity imaging evaluation of ventricular function in obstructive sleep apnoea-hypopnoea
Hong Mu1, Junjie Liu2, Kebo Gong1
1Department of Otorhinolaryngology, Qilu Children's Hospital of Shandong University, Jinan, China.
Insights
Children with obstructive sleep apnoea-hypopnoea syndrome (OSAHS) show early left and right ventricular dysfunction. Surgical treatment, such as adenoidectomy and tonsillectomy, effectively reverses this myocardial dysfunction in pediatric OSAHS patients.
Area of Science:
- Pediatric Cardiology
- Sleep Medicine
- Cardiovascular Physiology
Background:
- Obstructive sleep apnoea-hypopnoea syndrome (OSAHS) in children is associated with cardiovascular complications.
- Early detection of cardiac dysfunction is crucial for timely intervention.
Purpose of the Study:
- To evaluate left and right ventricular function changes in children with OSAHS.
- To assess the efficacy of surgical treatment for pediatric OSAHS.
Main Methods:
- Utilized polysomnography (PSG) for OSAHS diagnosis and grading.
- Employed quantitative tissue velocity imaging (QTVI) to assess mitral and tricuspid annular velocities.
- Compared cardiac function parameters between OSAHS patients and normal controls before and after surgery.
Main Results:
- Moderate to severe OSAHS in children demonstrated impaired left ventricular diastolic and right ventricular systolic function.
- QTVI revealed decreased mitral Va and tricuspid Vs values in moderate to severe OSAHS.
- Adenoidectomy and/or tonsillectomy significantly improved cardiac function and OSAHS severity (AHI, LSaO₂).
Conclusions:
- Pediatric OSAHS causes early-stage myocardial dysfunction, affecting both left and right ventricles.
- QTVI is a sensitive tool for detecting early cardiac changes in pediatric OSAHS.
- Surgical intervention for OSAHS in children effectively reverses ventricular dysfunction.
Abstract:
This study aimed to evaluate the changes in left and right ventricular functions of children with obstructive sleep apnoea-hypopnoea syndrome (OSAHS) and to determine the efficacy of surgical treatment for OSAHS in children. The subjects included 20 normal controls and 55 children of OSAHS with adenoid and/or tonsil hypertrophy diagnosed by polysomnography (PSG). We divided the children with OSAHS into the mild group, moderate group and severe group of OSAHS according to the condition of apnoea-hypopnoea index (AHI) and the lowest of oxygen saturation (LSaO₂). In mitral annulus,the Va values were increased in moderate and severe OSAHS (P > 0.05), and the Ve/Va values were decreased in the severe group (P > 0.05), while the Vs values were not changed (P > 0.05). In tricuspid annulus, the Vs values were decreased in moderate and severe OSAHS (P < 0.05), while the Ve, Va and Ve/Va values were not changed (P > 0.05). Six months after adenoidectomy and/or tonsillectomy, mitral Va values were decreased and tricuspid Vs values were increased significantly (P < 0.05), and AHI was decreased and LSaO₂ was significantly increased (P < 0.05). Compared with the control group, no difference was found in the above parameters (P > 0.05). The left ventricular diastolic function and the right ventricular systolic function of children with moderate to severe OSAHS are decreased to varying degrees at an early stage. Mitral annular and tricuspid annular velocity detected by quantitative tissue velocity imaging (QTVI) could sensitively reflect the early changes of left and right ventricular function. Adenoidectomy and/or tonsillectomy were effective methods to treat childhood OSAHS, which could reverse myocardial dysfunction.
