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Tissue Doppler Echocardiography As A Predictor Of Early Subclinical Right Ventricular Diastolic Dysfunction In
Ahmed Mohammad Abbas1, Hany Hussein Mousa2, Reda Biomy3
1Department of Paediatrics, Kafrelsheikh University,Egypt.
Insights
Pediatric asthma may cause subtle right ventricular diastolic dysfunction, detectable by Tissue Doppler echocardiography even when conventional methods show normal results. This highlights early cardiac changes in asthmatic children.
Area of Science:
- Pediatric Cardiology
- Respiratory Medicine
- Cardiovascular Physiology
Background:
- Asthma is a common chronic respiratory condition in children.
- Cardiac function can be affected by chronic respiratory diseases.
- Early detection of cardiac dysfunction is crucial for managing pediatric asthma.
Purpose of the Study:
- To evaluate the impact of asthma on the systolic and diastolic heart functions in children.
- To investigate the relationship between cardiac systolic and diastolic functions in pediatric asthma patients.
Main Methods:
- A case-control study involving 120 children (5-15 years) with asthma and matched healthy controls.
- Utilized spirometry, conventional echocardiography, and tissue Doppler echocardiography.
- Calculated myocardial performance index and compared parameters between groups.
Main Results:
- No significant differences in left/right ventricular dimensions or pulmonary artery pressure between groups.
- Right ventricular end-diastolic diameter was significantly higher in asthmatic children (p=0.046).
- Tissue Doppler revealed significant differences in lateral annular peak velocities, isovolumetric relaxation time, and myocardial performance index (p<0.05).
Conclusions:
- Tissue Doppler echocardiography can identify subclinical right ventricular diastolic dysfunction in children with asthma.
- This dysfunction may be present even with normal clinical findings and conventional echocardiography.
- Highlights the utility of advanced echocardiography in detecting early cardiac changes in pediatric asthma.
Objectives:
To assess the effect of asthma in children on systolic and diastolic functions of the heart, and to explore the relationship between the two.
Method:
The case-controlstudy was conducted at Kafrelsheikh University Hospital, Egypt, from September 2019 to May 2022, and comprised asthmatic children of either gender aged 5-15 years and healthy controls matched for age and gender. The participants were subjected to detailed history, complete examination, spirometry evaluation and conventional and tissue Doppler echocardiography. Myocardial performance index was calculated and compared. Data was analysed using SPSS 22.
Results:
Of the 120 subjects, 60(50%) were cases; 33(55%) boys and 27(45%) girls with mean age 9.4±2.9 years(range: 5-15 years). The remaining 60(50%)subjects were controls; 34(56.6%) boys and 26(43.3%) girls with mean age 9.7±2.9 years (range: 5-15 years). Left ventricular dimensions, estimated pulmonary artery pressure, and right ventricular dimensions showed no significant inter-group differences (p>0.05), but right ventricular end diastolic diameter was significantly higher in the cases than the controls (p=0.046). Tissue Doppler showed that lateral annular peak Ê, Â, isovolumetric relaxation time and myocardial performance index values were significantly different between the groups (p<0.05).
Conclusions:
Tissue Doppler echocardiography could detectsubtle right ventricular diastolic dysfunction in asthmatic children even with no clinical symptoms and normal findings on conventional echocardiography.
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