Effect of adenotonsillar hypertrophy on right ventricle function in children

• Published in: Clinical and experimental pediatrics 2014, 57(11), , pp.484-488
• Main Authors: Lee, Jin Hwan, Yoon, Jung Min, Lim, Jae Woo, Ko, Kyung Og, Choi, Seong Jun, Kim, Jong-Yeup, Cheon, Eun Jung
• Format: Article
• Language: English
• Subjects: Age; Airway management; Airway obstruction; Blood pressure; Body mass index; Echocardiography; Hypertrophy; Laboratories; Obstructive sleep apnea; Original; Patients; Pediatrics; Plasma; Probrain natriuretic peptide; Pulmonary arteries; Pulmonary hypertension; Questionnaires; Sleep apnea; 소아과학
• ISSN: 1738-1061; 2092-7258; 2713-4148
• DOI: 10.3345/kjp.2014.57.11.484

Chronic upper airway obstruction causes hypoxemic pulmonary vasoconstriction, which may lead to right ventricle (RV) dysfunction. Adenotonsillar hypertrophy (ATH) is the most common cause of upper airway obstruction in children. Therefore, we aimed to evaluate RV function in children with ATH. Twenty-one children (male/female, 15/6; mean age, 92.3¡¾39.0 months; age range, 4-15 years) with ATH and 21 healthy age- and gender-matched controls were included in this study. Tricuspid annular plane systolic excursion and RV myocardial performance index were measured by transthoracic echocardiography. Further, the plasma level of N-terminal of probrain natriuretic peptide (NT-proBNP), an indicator of RV function, was determined. The snoring-tiredness during daytime-observed apnea-high blood pressure (STOP) questionnaire was completed by the patients' parents, and loud snoring was noted in the ATH group. The plasma NT-proBNP level was significantly higher in the ATH group than that in the controls (66.44±37.63 pg/mL vs. 27.85±8.89 pg/mL, P=0.001). The echocardiographic parameters were not significantly different between the groups. We were unable to confirm the significance of echocardiographic evidence of RV dysfunction in the management of children with ATH. However, the plasma NT-proBNP level was significantly higher in the ATH group than that in the control, suggesting that chronic airway obstruction in children may carry a risk for cardiac dysfunction. Therefore, more patients should be examined using transthoracic echocardiography. In addition, pediatricians and otolaryngologists should consider cardiologic aspects during the management of children with severe ATH.