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The improvement of right ventricular function after adenotonsillectomy in children with obstructive sleep apnea

Dong Yeop Kim1, Kyung Ok Ko1, Jae Woo Lim1

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

Korean Journal of Pediatrics
|October 26, 2018
PubMed

Insights

Adenotonsillar hypertrophy (ATH) surgery improved right ventricular (RV) function in children with obstructive sleep apnea (OSA). The right ventricular myocardial performance index (RVMPI) showed early improvement, indicating better RV health post-surgery.

Area of Science:

  • Pediatric Cardiology
  • Sleep Medicine
  • Cardiopulmonary Physiology

Background:

  • Adenotonsillar hypertrophy (ATH) can cause upper airway obstruction, leading to obstructive sleep apnea (OSA).
  • OSA-related chronic hypoxemia may result in pulmonary vasoconstriction and right ventricular (RV) dysfunction.
  • Evaluating the impact of surgical intervention on RV function in children with OSA due to ATH is crucial.

Purpose of the Study:

  • To assess the effect of adenotonsillectomy (T&A) on right ventricular (RV) function in children with obstructive sleep apnea (OSA) caused by severe adenotonsillar hypertrophy (ATH).

Main Methods:

  • Thirty-seven children with OSA due to ATH underwent T&A.
  • Transthoracic echocardiography with tissue Doppler imaging (TDE) was used to evaluate mean pulmonary artery pressure (mPAP), tricuspid regurgitation (TR), tricuspid annular plane systolic excursion (TAPSE), and RV myocardial performance index (RVMPI) pre- and post-surgery.
  • Follow-up was conducted over 1.78±0.27 years.

Main Results:

  • The RVMPI significantly improved post-T&A (P=0.001), suggesting enhanced RV function.
  • TAPSE increased in absolute value (P=0.001), but its z-score showed no significant change (P=0.194).
  • Mean pulmonary artery pressure (mPAP) and tricuspid regurgitation (TR) parameters did not show significant differences post-T&A.

Conclusions:

  • The right ventricular myocardial performance index (RVMPI) measured by TDE may serve as an early indicator of RV function improvement in children with OSA secondary to ATH.
  • T&A can positively impact RV function in pediatric OSA patients.
Abstract

Keywords:
AdenotonsillectomyMyocardial performance index of the right ventricleObstructive sleep apnea

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