International Journal of Medical Arts (Jul 2021)

Ventricular Function and Pulmonary Artery Pressure in Children with Mild and Moderate Bronchial Asthma

  • Tarek Kotb Alsayad,
  • Saad Ahmed Mohamed

DOI
https://doi.org/10.21608/ijma.2021.187835
Journal volume & issue
Vol. 3, no. 3
pp. 1754 – 1760

Abstract

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Background:Bronchial asthma is a chronic airway disease. Cardiac affection in children with bronchial asthma was reported mainly in cases with severe asthma and during acute exacerbations. Aim of the Work:To study cardiac affection in children with mild and moderate bronchial asthma using conventional and tissue Doppler imaging [TDI] echocardiography. Patients and Methods:This was a prospective case control study. Study involved 160 children aged 6-14 years’ old who were following in outpatient pediatric clinic, Al-Hussein hospital, Al-Azhar University, Cairo, Egypt, during the period from January 4, 2016, till February 15, 2017. All children underwent peak expiratory flow rate [PEFR] assessment. Echocardiography was done for all to assess systolic and diastolic functions of right ventricle [RV] and left ventricle [LV] using conventional and tissue Doppler imaging [TDI] echocardiography Results:TDI parameters showed evidence of RV diastolic dysfunction in patients with moderate asthma in the form of significantly lower tricuspid valve [TV] e’ [12.1 ± 2.7 cm/s], lower TV e’/a’ ratio [1.28 ± 0.18], prolonged RV isovolumetric relaxation time [IVRT] [71.8 ± 2.4 ms], and higher RV myocardial performance index [0.49 ± 0.04] compared to control group. Also, patients with mild asthma had impaired RV diastolic function in the form of significantly lower TV e’/a’ [1.51 ± 0.13] and longer RV IVRT [65 ± 2.9 ms] compared to control group. Pulmonary artery pressure was significantly elevated in moderate asthma group [18.4 ± 9.2 mmHg]. RV IVRT was the only parameter showing a significant negative correlation to PEFR Conclusion: Pediatric patients with mild and moderate bronchial asthma may have RV diastolic dysfunction. TDI is a good screening tool to detect early changes in cardiac function in such patients. RV IVRT measured by TDI is a sensitive tool to detect early diastolic impairment.

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