Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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The improvement of right ventricular function after adenotonsillectomy in children with obstructive sleep apnea

  • Kim, Dong Yeop (Department of Pediatrics, Konyang University College of Medicine) ;
  • Ko, Kyung Ok (Department of Pediatrics, Konyang University College of Medicine) ;
  • Lim, Jae Woo (Department of Pediatrics, Konyang University College of Medicine) ;
  • Yoon, Jung Min (Department of Pediatrics, Konyang University College of Medicine) ;
  • Song, Young Hwa (Department of Pediatrics, Konyang University College of Medicine) ;
  • Cheon, Eun Jung (Department of Pediatrics, Konyang University College of Medicine)
  • Received : 2018.03.14
  • Accepted : 2018.07.06
  • Published : 2018.12.15
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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, $9.52{\pm}2.20years$), 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 $1.78{\pm}0.27years$. Results: Only the RVMPI using TDE improved after T&A ($42.18{\pm}2.03$ vs. $40{\pm}1.86$, P=0.001). The absolute value of TAPSE increased ($21.45{\pm}0.90mm$ vs. $22.30{\pm}1.10mm$, P=0.001) but there was no change in the z score of TAPSE pre- and post-T&A ($1.19{\pm}0.34$ vs. $1.24{\pm}0.30$, 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 ($19.6{\pm}3.40$ vs. $18.7{\pm}2.68$, 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.

Keywords

References

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