Pulmonary Hypertension in Children with Ventricular Septal Defects

Ventricular septal defect (VSD) is a common congenital heart disease which could be complicated with pulmonary hypertension (PH).

This study sought to establish the relationship between severity of PH and size of VSD and age.

This is a descriptive study where one hundred and fiftyone children aged 3 months to 18 years with echocardiographically confirmed VSD were studied. Pulmonary hypertension (PH) was determined using the tricuspid regurgitation jet velocity with a cutoff of systolic pulmonary arterial pressure (sPAP) at >25mmHg. Severity of pulmonary hypertension was classified into mild (25-50mg Hg); moderate, (51-60mm Hg) and severe ≥ 60mm Hg. Data were analysed using the SPSS version 25.

Majority 52.9% had mild PH while 17.6% had severe PH. Mild PH (χ2=15.513, p=0.004) was found among 66.7% of those with small-sized VSD, 42% of those with moderate-sized VSD and 57.1% of those with large-sized VSD. There was a weak positive correlation between PH and size of VSD (n=132, r=0.320, p<0.001). For one-unit increase in age (in months), PH was noted to decrease by 0.030 (B= -0.030, 95%CI: -0.090- 0.030) and for a unit increase in size (mm) of VSD, PH increased by 1.681 units (B=1.681, 95%CI: 0.798- 2.563).

There was a linear increase in pulmonary hypertension with increase in the size of ventricular-septal defect and decrease in the age of children with VSD. Age and VSD size were significant predictors of PH severity in children with VSD. All sizes of VSD are associated with pulmonary hypertension. A unit increase in age (in months), caused a decrease of PH by 0.030units and a unit increase in size (mm) of VSD resulted in an increased PH by 1.681 units.