Çetin Mecnun, Bozan Nazım
Department of Pediatric Cardiology, Yuzuncu Yil University, Van, Turkey.
Department of Otolaryngology, Yuzuncu Yil University, Van, Turkey.
Int J Pediatr Otorhinolaryngol. 2017 Oct;101:41-46. doi: 10.1016/j.ijporl.2017.07.027. Epub 2017 Jul 22.
Comparison of left ventricular functions in preoperative and postoperative periods of children with adenotonsillar hypertrophy (ATH) who have findings of upper airway obstruction (UAO), using echocardiographic parameters.
Thirty children who were diagnosed with UAO due to ATH, and who have undergone adenoidectomy/adenotonsillectomy and 30 healthy children, between 2 and 11 years of age, were included in the study. Patient group was evaluated by the pulsed wave tissue Doppler echocardiography, as well as with conventional echocardiography, before and 6 months after the operation.
Of 30 children in study group, 18 (60%) had adenotonsillectomy and 12 (40%) had adenoidectomy. The differences between groups regarding myocardial performance index (MPI) was not statistically significant (p = 0.847). There was not any statistically significant difference between groups in terms of mitral isovolemic acceleration (MIVA) (2.28 ± 0.67, 2.24 ± 0.55, 2.23 ± 0.49; p = 0.943, respectively). Interventricular septum diameter (IVSD) was significantly higher in preoperative group than postoperative and control groups (3.68 ± 0.52, 3.50 ± 0.40, 3.38 ± 0.60; p = 0.028, respectively). Pulmonary acceleration time (PAcT) was found to be significantly lower in preoperative group compared to postoperative and control groups (107.64 ± 16.60, 119.52 ± 15.95, 120.47 ± 16.19; p = 0.004, respectively). Mean pulmonary arterial pressure (mPAP) was significantly higher in preoperative group than postoperative and control groups (30.58 ± 8.11, 25.23 ± 9.07, 25.00 ± 6.52; p = 0.002, respectively). In postoperative group mPAP was found to be similar to the control group.
Clinical or subclinical left ventricle (LV) dysfunction in children with ATH who have findings of UAO was not determined while mean pulmonary arterial pressure was significantly higher compared with the control cases. Besides early adenotonsillectomy is a beneficial treatment option for these patients.
运用超声心动图参数比较患有腺样体扁桃体肥大（ATH）且有上气道阻塞（UAO）表现的儿童术前和术后的左心室功能。
本研究纳入了30名因ATH被诊断为UAO且接受了腺样体切除术/腺样体扁桃体切除术的2至11岁儿童，以及30名健康儿童。患者组在手术前和术后6个月通过脉冲波组织多普勒超声心动图以及传统超声心动图进行评估。
研究组的30名儿童中，18名（60%）接受了腺样体扁桃体切除术，12名（40%）接受了腺样体切除术。两组之间在心肌性能指数（MPI）方面的差异无统计学意义（p = 0.847）。两组在二尖瓣等容加速（MIVA）方面无统计学显著差异（分别为2.28±0.67、2.24±0.55、2.23±0.49；p = 0.943）。术前组的室间隔直径（IVSD）显著高于术后组和对照组（分别为3.68±0.52、3.50±0.40、3.38±0.60；p = 0.028）。与术后组和对照组相比，术前组的肺动脉加速时间（PAcT）显著更低（分别为107.64±16.60、119.52±15.95、120.47±16.19；p = 0.004）。术前组的平均肺动脉压（mPAP）显著高于术后组和对照组（分别为30.58±8.11、25.23±9.07、25.00±6.52；p = 0.002）。术后组的mPAP与对照组相似。
未发现患有ATH且有UAO表现的儿童存在临床或亚临床左心室（LV）功能障碍，但其平均肺动脉压显著高于对照组。此外，早期腺样体扁桃体切除术对这些患者是一种有益的治疗选择。
