Key result
Mild to moderate bronchial asthma in children was associated with impaired right ventricular diastolic function, indicated by lower tricuspid E' velocity (P=0.044) and higher RV-MPI (P=0.001).
Why the study?
Bronchial asthma may be associated with pulmonary hypertension and cardiac dysfunction, prompting evaluation of whether 2D-STE and TDI can detect subtle cardiac dysfunction in pediatric patients with mild to moderate asthma.
Does mild to moderate bronchial asthma cause detectable cardiac dysfunction using 2D-STE and TDI in pediatric patients compared to healthy controls?
Case-Control (n=57)
Does mild to moderate bronchial asthma cause detectable cardiac dysfunction using 2D-STE and TDI in pediatric patients compared to healthy controls?
Absolute Event Rate: 16% vs 16%
p-value: p=.044
Pediatric patients with mild to moderate bronchial asthma exhibit early signs of right ventricular diastolic dysfunction detectable by tissue Doppler imaging, despite preserved systolic and left ventricular functions.
Hypothesis-generating for RV monitoring in pediatric asthma; prospective studies needed before clinical adoption.
OBJECTIVE: Bronchial asthma is a common chronic inflammatory airway disease, which may be associated with pulmonary hypertension and cardiac dysfunction. The aim of this study was to evaluate the ability of 2D-speckle tracking echocardiography (2D-STE) and tissue doppler imaging (TDI) to detect subtle cardiac dysfunction in pediatric patients with mild to moderate bronchial asthma. METHODOLOGY: The study included 30 children with mild to moderate bronchial asthma and 27 age-matched healthy controls. Both groups underwent pulmonary function tests, TDI and 2D-STE. Myocardial performance index (MPI), S', E', A' velocities, global strain of left ventricle (LV), right ventricle (RV), and right atrium (RA) were measured. RESULTS: RV diastolic function was impaired in the patient group, as the tricuspid E' velocity was significantly lower in the patients when compared with the controls (16 [14-17] vs 16 [17-19] cm/s, P = .044), while the RV-MPI was significantly higher in patients when compared to controls (0.30 [0.27-0.36] vs 0.30 [0.30-0.30], P = .001). The global RV longitudinal strain, RA strain, and LV strain did not show significant differences between the test and the control groups. RV systolic parameters and LV systolic and diastolic parameters did not differ significantly between the two groups. CONCLUSION: Pediatric patients with mild to moderate bronchial asthma may have early RV diastolic dysfunction with preserved other cardiac functions.
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Abdelmohsen et al. (2019) conducted a case-control in mild to moderate bronchial asthma (n=57). Mild to moderate bronchial asthma vs. Age-matched healthy controls was evaluated on Tricuspid E' velocity (cm/s) (p=.044). Mild to moderate bronchial asthma in children was associated with impaired right ventricular diastolic function, indicated by lower tricuspid E' velocity (P=0.044) and higher RV-MPI (P=0.001).
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