Echocardiographic evaluations of right ventricular functions and dimensions in children with bronchial asthma in Ile-Ife, Nigeria

Abstract

Asthma is a chronic inflammatory airway disorder with cardiovascular effects. This study aimed to determine the relationship between right ventricular function and dimensions, and the severity of bronchial asthma. Children aged 6–14 years with asthma were recruited for this comparative cross-sectional study. The severity of asthma and the level of symptom control were documented using GINA criteria. The lung function tests by spirometry, conventional echocardiography, and tissue Doppler echocardiography were performed. The majority (71.2%) had mild intermittent asthma. The symptoms of asthma were well-controlled in 75.0% of participants. The mean right ventricle (RV) anterior wall thickness of children with asthma was significantly thicker than non-asthmatics [10.1 (1.3) vs 9.0 (1.3) mm; t = 5.709; p < 0.001]. The difference in the mean tricuspid ratio of the early to late diastolic velocities (tricuspid E’/A’) between the subjects [1.8 (0.4) mm] and control [2.0 (0.4) mm] was statistically significant [t = 1.980; p = 0.047] but the mean trans annular plane systolic excursion (TAPSE) in subjects, 23.4 (3.9) and the control, 23.4 (2.8) were similar and not statistically significant (t = 0.009, p = 0.990). The mean RV wall thickness in persistent asthma [10.5 (1.4)] was thicker than in intermittent asthma [9.8 (0.9)] and was statistically significant (t = 2.750; p = 0.006). The TAPSE (F = 4.010; p = 0.022), RV isovolumetric relaxation time (F = 10.380; p = 0.005), and tricuspid E’/A’ (F = 9.500; p = 0.008) significantly increased as the level of asthma symptom control worsened. Children with worsening asthma symptoms present with right ventricular dysfunction, hence a need for echocardiographic monitoring in children with asthma.