The improvement of right ventricular function after adenotonsillectomy in children with obstructive sleep apnea.

Korean Journal of Pediatrics Pub Date : 2018-12-01 Epub Date: 2018-10-26 DOI:10.3345/kjp.2018.06436

Dong Yeop Kim, Kyung Ok Ko, Jae Woo Lim, Jung Min Yoon, Young Hwa Song, Eun Jeong Cheon

{"title":"The improvement of right ventricular function after adenotonsillectomy in children with obstructive sleep apnea.","authors":"Dong Yeop Kim, Kyung Ok Ko, Jae Woo Lim, Jung Min Yoon, Young Hwa Song, Eun Jeong Cheon","doi":"10.3345/kjp.2018.06436","DOIUrl":null,"url":null,"abstract":"Purpose: Adenotonsillar hypertrophy (ATH) that causes upper airway obstruction might lead to chronic hypoxemic pulmonary vasoconstriction and right ventricular (RV) dysfunction. We aimed to evaluate whether adenotonsillectomy (T&A) in children suffering from obstructive sleep apnea (OSA) due to severe ATH could improve RV function.Methods: Thirty-seven children (boy:girl=21:16; mean age, 9.52±2.20 years), who underwent T&A forsleep apnea due to ATH, were included. We analyzedthe mean pulmonary artery pressure (mPAP), the presence and the maximal velocity of tricuspid regurgitation (TR), the tricuspid annular plane systolic excursion (TAPSE), and the right ventricular myocardial performance index (RVMPI) with tissue Doppler echocardiography (TDE) by transthoracic echocardiography pre- and post-T&A. The follow-up period was 1.78±0.27 years.Results: Only the RVMPI using TDE improved after T&A (42.18±2.03 vs. 40±1.86, P=0.001). The absolute value of TAPSE increased (21.45±0.90 mm vs. 22.30±1.10 mm, P=0.001) but there was no change in the z score of TAPSE pre- and post-T&A (1.19±0.34 vs. 1.24±0.30, P=0.194). The mPAP was within normal range in children with ATH, and there was no significant difference between pre- and post-T&A (19.6±3.40 vs. 18.7±2.68, P=0.052). There was no difference in the presence and the maximal velocity of TR (P=0.058).Conclusion: RVMPI using TDE could be an early parameter of RV function in children with OSA due to ATH.","PeriodicalId":17863,"journal":{"name":"Korean Journal of Pediatrics","volume":"61 12","pages":"392-396"},"PeriodicalIF":0.0000,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d0/b3/kjp-2018-06436.PMC6313087.pdf","citationCount":"6","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Korean Journal of Pediatrics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3345/kjp.2018.06436","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2018/10/26 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}

引用次数: 6

Abstract

Purpose: Adenotonsillar hypertrophy (ATH) that causes upper airway obstruction might lead to chronic hypoxemic pulmonary vasoconstriction and right ventricular (RV) dysfunction. We aimed to evaluate whether adenotonsillectomy (T&A) in children suffering from obstructive sleep apnea (OSA) due to severe ATH could improve RV function.

Methods: Thirty-seven children (boy:girl=21:16; mean age, 9.52±2.20 years), who underwent T&A forsleep apnea due to ATH, were included. We analyzedthe mean pulmonary artery pressure (mPAP), the presence and the maximal velocity of tricuspid regurgitation (TR), the tricuspid annular plane systolic excursion (TAPSE), and the right ventricular myocardial performance index (RVMPI) with tissue Doppler echocardiography (TDE) by transthoracic echocardiography pre- and post-T&A. The follow-up period was 1.78±0.27 years.

Results: Only the RVMPI using TDE improved after T&A (42.18±2.03 vs. 40±1.86, P=0.001). The absolute value of TAPSE increased (21.45±0.90 mm vs. 22.30±1.10 mm, P=0.001) but there was no change in the z score of TAPSE pre- and post-T&A (1.19±0.34 vs. 1.24±0.30, P=0.194). The mPAP was within normal range in children with ATH, and there was no significant difference between pre- and post-T&A (19.6±3.40 vs. 18.7±2.68, P=0.052). There was no difference in the presence and the maximal velocity of TR (P=0.058).

Conclusion: RVMPI using TDE could be an early parameter of RV function in children with OSA due to ATH.

Abstract Image

查看原文本刊更多论文

阻塞性睡眠呼吸暂停患儿腺扁桃体切除术后右心室功能的改善。

目的:腺扁桃体肥大(ATH)引起的上气道阻塞可导致慢性低氧性肺血管收缩和右心室功能障碍。我们的目的是评估严重ATH导致的阻塞性睡眠呼吸暂停(OSA)患儿的腺扁桃体切除术(T&A)是否可以改善右心室功能。方法:37例儿童(男:女=21:16;平均年龄(9.52±2.20岁)，因ATH导致的睡眠呼吸暂停接受T&A。应用组织多普勒超声心动图(TDE)对t&a前后患者的平均肺动脉压(mPAP)、三尖瓣返流(TR)的存在及最大速度、三尖瓣环面收缩偏移(TAPSE)和右心室心肌功能指数(RVMPI)进行分析。随访时间为1.78±0.27年。结果:T&A后只有TDE组RVMPI改善(42.18±2.03 vs 40±1.86,P=0.001)。TAPSE的绝对值增加(21.45±0.90 mm vs. 22.30±1.10 mm, P=0.001)，但TAPSE的z评分在t&a前后没有变化(1.19±0.34 vs. 1.24±0.30,P=0.194)。ATH患儿的mPAP在正常范围内，t&a前后比较差异无统计学意义(19.6±3.40 vs. 18.7±2.68,P=0.052)。两组间TR的存在和最大速度无显著性差异(P=0.058)。结论:应用TDE检测RVMPI可作为ATH所致OSA患儿RV功能的早期指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Korean Journal of Pediatrics

自引率

0.00%

发文量

审稿时长

12 weeks

期刊介绍： Korean J Pediatr covers clinical and research works relevant to all aspects of child healthcare. The journal aims to serve pediatricians through the prompt publication of significant advances in any field of pediatrics and to rapidly disseminate recently updated knowledge to the public. Additionally, it will initiate dynamic, international, academic discussions concerning the major topics related to pediatrics. Manuscripts are categorized as review articles, original articles, and case reports. Areas of specific interest include: Growth and development, Neonatology, Pediatric neurology, Pediatric nephrology, Pediatric endocrinology, Pediatric cardiology, Pediatric allergy, Pediatric pulmonology, Pediatric infectious diseases, Pediatric immunology, Pediatric hemato-oncology, Pediatric gastroenterology, Nutrition, Human genetics, Metabolic diseases, Adolescence medicine, General pediatrics.