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Cardiac function in bronchiolitis: Not only a right ventricle matter.

Maria L Rossi1,2, Stephanie M Hadley3, Paula C Randanne1

  • 1Department of Pediatric Cardiology, Hospital Sant Joan de Déu, Barcelona, Spain.

Pediatric Pulmonology
|October 13, 2022
PubMed
Summary

Severe bronchiolitis in infants can cause cardiac dysfunction, impacting right ventricle function and increasing NT-proBNP levels. Higher NT-proBNP predicts worse outcomes and need for respiratory support.

Keywords:
NT-proBNPdiastolic cardiac dysfunctionsystolic cardiac dysfunction

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Area of Science:

  • Pediatric Cardiology
  • Respiratory Medicine
  • Critical Care Medicine

Background:

  • Bronchiolitis, a common respiratory infection in infants, can present with extrapulmonary manifestations.
  • Previous studies suggest potential right ventricle (RV) dysfunction in severe cases.

Purpose of the Study:

  • To investigate cardiac dysfunction in infants hospitalized with bronchiolitis.
  • To determine the association between cardiac dysfunction, N-terminal pro-hormone B-type natriuretic peptide (NT-proBNP) levels, and severe bronchiolitis outcomes.

Main Methods:

  • Prospective cohort study of 181 infants (<1 year) hospitalized for bronchiolitis.
  • Echocardiography and NT-proBNP measurements were performed at admission.
  • Comparison of outcomes between infants requiring positive pressure respiratory support (PPRS) and controls.

Main Results:

  • Infants needing PPRS exhibited worse RV systolic and diastolic function compared to controls.
  • Elevated NT-proBNP levels (>3582 pg/dl) predicted the need for prolonged PPRS in infants under 2 months.
  • Significant differences in echocardiographic parameters (TAPSE, E/A, e', a') were observed.

Conclusions:

  • Severe bronchiolitis is associated with global cardiac dysfunction, including RV systolic and diastolic impairment.
  • NT-proBNP levels at admission are potent predictors of severe disease and adverse outcomes in infants with bronchiolitis.