198 Echocardiographic evaluation of right ventricular function in asthmatic children: witness case study, contribution of new echo cardiographic techniques

Background Right ventricular dysfunction in asthmatic children can occur even in the absence of any ischemic, valvular or hypertensive cause. The advent of strain allowed detection of cardiac damage at an early stage. The objectives of our study were to evaluate systolic right ventricular function in cardiac asymptomatic asthmatic children and to evaluate the interest of two-dimensional strain in the detection of myocardial damage at a subclinical stage. Methods This was a prospective observational study conducted in the cardiology and pediatric departments of the main military training hospital of Tunis over a period of eight months from August 1, 2022 to March 31, 2023. Our population was made up of two groups. The first group comprising 30 asthmatic children and the second group comprising 25 controls. Standard echocardiography, tissue Doppler imaging and right ventricular deformation analysis were performed to study morphological and functional parameters. Results We collected 30 children followed for asthma. The sex ratio was 1.14 in asthmatics and 0.92 in the control population. The average age at the time of the study was 9 and 10 years respectively in the two groups. After a statistical analysis of the echocardiography data, we found a DTDVD significantly higher in asthmatics (1.8 cm versus 1.7 cm) without associated parietal hypertrophy. The TAPSE was significantly lower in asthmatics (20 mm versus 22 mm) as well as the fractional Shortening of the Surface with a lower value in asthmatics (52% versus 57%). The study of myocardial deformation found higher values of right ventricular global longitudinal strain (RVGLS) and lateral strain in controls (-25% versus -23%) and (-29% versus -27%) respectively. We reported a positive correlation between echocardiography data and the duration of asthma. In fact, the longer the duration of the disease, the greater the measurement of RVGLS ; this same result was found for the measurement of the S' wave. The multivariate study of altered global longitudinal strain was independently associated with a shorter duration of the illness. Conclusion Asthma is the most common respiratory pathology in children. This disease may be linked to subclinical right ventricular myocardial damage. Periodic monitoring and early detection of right ventricular systolic dysfunction in young asthmatic patients can help prevent progression to heart failure. Conflict of Interest no