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Published on: December 13, 2019
Evaluation of the left and right ventricular systolic and diastolic function in asthmatic children
Esra Akyüz Özkan1, Hashem E Khosroshahi2
1Department of Pediatrics, Bozok University Medical Faculty, Yozgat, Turkey. esra.akyuz@mynet.com.
Insights
Pediatric asthma impairs cardiac systolic function, affecting both left and right ventricles. However, diastolic dysfunction was not observed in asthmatic children, possibly due to inhaled corticosteroid treatment.
Area of Science:
- Pediatric Cardiology
- Respiratory Medicine
- Echocardiography
Background:
- Asthma is a prevalent respiratory disorder in children.
- Cardiac function in pediatric asthma patients requires further investigation.
Purpose of the Study:
- To assess left (LV) and right (RV) ventricular function in children with asthma.
- To utilize conventional and tissue Doppler echocardiography for evaluation.
Main Methods:
- Studied 50 pediatric asthma patients and 40 healthy controls.
- Performed pulmonary function tests, electrocardiography, and echocardiography.
Main Results:
- Asthmatic children showed impaired LV and RV systolic function, with lower VCFc, LV/RV SV, TAPSE, S', and E' velocities.
- LV end-systolic wall stress was reduced in asthmatic children.
- Mitral ET was higher in asthmatics; FEV1 correlated with IVRT and mitral ET; PEF correlated negatively with RV/LV work indices.
Conclusions:
- Cardiac systolic function is impaired in pediatric asthma patients.
- Diastolic dysfunction was not detected, potentially due to inhaled corticosteroid use.
Background:
Asthma is the most common cause of respiratory disorders among children. We aimed to investigate left (LV) and right (RV) ventricular function in asthmatic children as detected by conventional and tissue Doppler echocardiography.
Methods:
Fifty pediatric patients with asthma and forty healthy children were studied. Pulmonary function tests, electrocardiography and echocardiographic examinations were performed on all children.
Results:
Rate-corrected velocity of circumferential fiber shortening (VCFc) (p = 0.044), the ratio between heights of early and late diastolic flow velocity peaks (E/A) (p = 0.019) and LV end-systolic wall stress (ESWSm) was lower (p = 0.003), RV stroke volume (SV) (p = 0.002), LV SV (p = 0.001), tricuspid annular plane systolic excursion (TAPSE) (p = 0.034), tricuspid annular peak velocity during systole (S') (p = 0.022), tricuspid and mitral early diastolic velocities (E') (p = 0.012, p = 0.003 respectively) were lower in asthmatic children than controls. The mitral valve ejection time (ET) was high in asthmatic group (p = 0.027). FEV1 was positively correlated with isovolumetric relaxation time (IVRT) (p = 0.018) (r = 0.382) and mitral ET (p = 0.018) (r = 0.381). PEF was negatively correlated with the RV work index (p = 0.032) (r = -0.348) and LV work index (p = 0.005) (r = -0.457).
Conclusion:
Although cardiac systolic function was found to be impaired in asthmatic patients, contrary to the literature, diastolic dysfunction was not observed in these patients, even by tissue Doppler imaging, and this finding may be attributed to using inhaled corticosteroid.
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