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Longitudinal Cardiovascular Outcomes of Sleep Disordered Breathing in Children: A Meta-Analysis and Systematic Review

Zarmina Ehsan1, Stacey L Ishman2,3, Thomas R Kimball4

  • 1Division of Pulmonary and Sleep Medicine, Children's Mercy Hospital, Kansas City, MO.

Sleep
|March 23, 2017
PubMed

Insights

Sleep disordered breathing (SDB) in children can affect cardiovascular health long-term. Treatment improved pulmonary artery pressure and right heart function, but more research is needed for a full understanding.

Area of Science:

  • Pediatric Cardiology
  • Sleep Medicine
  • Cardiovascular Health

Background:

  • Sleep disordered breathing (SDB) is linked to adult cardiovascular issues, but its long-term impact on children is not well-defined.
  • Understanding pediatric SDB's long-term cardiovascular effects is crucial for early intervention and management.

Purpose of the Study:

  • To systematically review and synthesize existing research on the long-term cardiovascular effects of SDB in children.
  • To assess the impact of SDB treatment on various cardiovascular parameters in pediatric populations.

Main Methods:

  • A systematic review and meta-analysis of prospective studies (≥7 participants, age ≤18) was conducted.
  • Searches were performed across PubMed, CINAHL, Embase, and Scopus databases.
  • Data on study design, demographics, clinical characteristics, and cardiovascular outcomes were extracted and analyzed.

Main Results:

  • Twenty-five articles (n=1418) were included, primarily focusing on outcomes after adenotonsillectomy for SDB.
  • Treatment of SDB led to significant reductions in mean pulmonary artery pressure, right ventricular end diastolic diameter, heart rate, and C-reactive protein.
  • No significant changes were observed in most left ventricular parameters, interventricular septum thickness, left atrial diameter, or aortic/pulmonary valve velocities.

Conclusions:

  • Long-term cardiovascular effects of pediatric SDB are evident, impacting autonomic function and cardiac function.
  • While treatment shows promise in improving certain cardiovascular markers, further large-scale, prospective studies with standardized outcomes are necessary.
  • More research is needed to fully elucidate the relationship between pediatric SDB and long-term cardiovascular morbidity.
Abstract

Keywords:
cardiovascularchildren.obstructive sleep apneaoutcomessleep disordered breathing

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