Elmeazawy Rehab, Razaky Osama El, El Amrousy Doaa, Badreldeen Al Shimaa
Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta, Egypt.
BMC Pediatr. 2025 Sep 9;25(1):677. doi: 10.1186/s12887-025-06028-2.
This study aimed to evaluate the impact of asthma severity on biventricular cardiac functions using tissue Doppler imaging (TDI), two-dimensional speckle tracking echocardiography (2D-STE), and three-dimensional speckle tracking echocardiography (3D-STE).
Sixty-three children with asthma, aged between 5 and 16 years, were enrolled in the study along with 63 matched controls. All participants underwent cardiac assessments, including TDI, 2D-STE, 3D-STE, conventional echocardiography, and pulmonary function testing with spirometry.
Sixty-three asthmatic children with a mean age of 9.96 ± 3 years were enrolled in the patient group. Based on the severity of asthma, they s were categorized into three subgroups: mild, moderate, and severe persistent. The TDI examination revealed a significant decline in right ventricular (RV) diastolic and systolic functions, indicated by lower tricuspid E'/A' ratio and RV S respectively. Additionally, there was a notable increase in both the RV and LV myocardial performance index (MPI) in the severe asthma group compared to other severity subgroups. Children with severe asthma also demonstrated significantly lower values in three-dimensional global longitudinal strain (3D GLS), three-dimensional global circumferential strain (3D GCS), three-dimensional global area strain (3D GAS), and three-dimensional global radial strain (3D GRS) during (3D-STE examination compared to other severity subgroups. However, there was no discernible difference between the severity subgroups when 2D-STE was used.
TDI and 3D-STE exhibited the ability to identify early biventricular dysfunction in pediatric patients diagnosed with severe bronchial asthma.
本研究旨在利用组织多普勒成像(TDI)、二维斑点追踪超声心动图(2D-STE)和三维斑点追踪超声心动图(3D-STE)评估哮喘严重程度对双心室心功能的影响。
63名年龄在5至16岁之间的哮喘儿童以及63名匹配的对照者参与了本研究。所有参与者均接受了心脏评估,包括TDI、2D-STE、3D-STE、传统超声心动图检查以及采用肺量计进行的肺功能测试。
患者组纳入了63名平均年龄为9.96±3岁的哮喘儿童。根据哮喘严重程度,他们被分为三个亚组:轻度、中度和重度持续性。TDI检查显示右心室(RV)舒张和收缩功能显著下降,分别表现为三尖瓣E'/A'比值和RV S降低。此外,与其他严重程度亚组相比,重度哮喘组的RV和左心室(LV)心肌性能指数(MPI)均显著升高。在3D-STE检查中,重度哮喘儿童的三维整体纵向应变(3D GLS)、三维整体圆周应变(3D GCS)、三维整体面积应变(3D GAS)和三维整体径向应变(3D GRS)值也显著低于其他严重程度亚组。然而,使用2D-STE时,各严重程度亚组之间没有明显差异。
TDI和3D-STE能够识别诊断为重度支气管哮喘的儿科患者早期双心室功能障碍。