The influence of Asthma on Right Ventricular Systolic and Diastolic Function in Children according to Tissue Doppler Echocardiography

Introduction:Asthma is the most common chronic inflammatory condition affecting the lower airways among children. Asthma may influence right ventricular (RV) function and patients may develop right ventricular hypertrophy, pulmonary hypertension and cor pulmonale. The main objective of this study is to determine RV dysfunction in asymptomatic asthmatic children as detected by tissue Doppler echocardiography (TDE). Methods:In this cross-sectional study, 31 cases suffering from mild intermittent asthma, and 31 age/gender-matched healthy controls were evaluated according to standard echocardiography, pulsed-wave Doppler (PWD), TDE, and pulmonary function tests on spirometry. Results: We did not observe a statistically significant difference between cases and controls as far as RV wall, RV diameter, and ejection fraction (EF) were concerned. PWD indices of both ventricles were not significantly different between the two groups. TDE evaluation of  RV diastolic function revealed that  annular peak velocity early diastole (E’), annular peak velocity late diastole (A’), and E’/A’ ratio had significant differences between the two groups (P = 0.001, respectively). Isovolumic relaxation time (IVRT) and myocardial performance index (MPI) of the lateral tricuspid annulus differed significantly in asthmatic children compared to healthy children (p = 0.002 and p = 0.001, respectively). There were no significant differences in regard to PEF, FVC, and FEV1/FVC between the two groups. Conclusion:Despite normal clinical and standard echocardiographic findings, subclinical diastolic impairment of right ventricular function was determined. The findings of this study suggest that assessment, detection, and monitoring of RV diastolic function play an important role among well-controlled, mild intermittent asthmatic patients.