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ORIGINAL ARTICLE
Korean J Pediatr 2014 November;57(11) :484-488.
Published online 2014 July 07.       
Effect of adenotonsillar hypertrophy on right ventricle function in children
Jin Hwan Lee1, Jung Min Yoon1, Jae Woo Lim1, Kyung Og Ko1, Seong Jun Choi2, Jong-Yeup Kim2, Eun Jung Cheon1
1Departments of Pediatrics, Konyang University College of Medicine, Daejeon, Korea
2Departments of Otolaryngology, Konyang University College of Medicine, Daejeon, Korea
Corresponding Author: Eun Jung Cheon ,Tel: +82-42-600-9230, Fax: +82-42-600-9090, Email: ejcheon000@kyuh.ac.kr
Copyright © 2014 by The Korean Pediatric Society
ABSTRACT
Purpose: 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.
Methods: Twenty-one children (male/female, 15/6; mean age, 92.339.0 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.
Results: 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 (66.4437.63 pg/mL vs. 27.858.89 pg/mL, P =0.001). The echocardiographic parameters were not significantly different between the groups.
Conclusion: 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.
Keywords: Hypertrophy | Obstructive sleep apnea | Airway obstruction | Echocardiography | Probrain natriuretic peptide
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