ORIGINAL PAPER
Left heart ventricle function in children snoring due to adeno-tonsillar hypertrophy
Submission date: 2019-01-20
Final revision date: 2019-02-11
Acceptance date: 2019-02-12
Publication date: 2019-02-27
Pediatr Pol 2019;94(1):13-17
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Nasopharyngeal lymphatic tissue hypertrophy is the most common cause of sleep breathing disorders in children. Obstructive sleep apnoea has a proven adverse effect on the control of hypertension and the condition of left ventricle in adults. It is not clear whether snoring can have a negative effect on the selected echocardiographic parameters of the left ventricle.
Aim of the study:
The aim of the study was to evaluate the selected parameters of the left ventricular structure and function in snoring children who had undergone adenoidectomy, adenotonsillectomy, or tonsillectomy in order to restore patency of the upper respiratory tract.
Material and methods:
The study group consisted of 50 snoring children with nasopharyngeal lymphatic tissue hypertrophy. The control group contained 20 children without sleep breathing disorders. The age of children was between five and 14 years. Functional and structural echocardiographic parameters were assessed before and at three and six months after ENT surgery.
Results:
The echocardiographic evaluation showed that the values of selected parameters describing the left ventricular anatomy and systolic-diastolic function were normal and did not differ significantly between the study group and the control group at any stage of the study.
Conclusions:
Snoring reported by parents does not affect adversely left ventricle structure or function in children. Unlike in adults, myocardial overload is not common in snoring children.
Nasopharyngeal lymphatic tissue hypertrophy is the most common cause of sleep breathing disorders in children. Obstructive sleep apnoea has a proven adverse effect on the control of hypertension and the condition of left ventricle in adults. It is not clear whether snoring can have a negative effect on the selected echocardiographic parameters of the left ventricle.
Aim of the study:
The aim of the study was to evaluate the selected parameters of the left ventricular structure and function in snoring children who had undergone adenoidectomy, adenotonsillectomy, or tonsillectomy in order to restore patency of the upper respiratory tract.
Material and methods:
The study group consisted of 50 snoring children with nasopharyngeal lymphatic tissue hypertrophy. The control group contained 20 children without sleep breathing disorders. The age of children was between five and 14 years. Functional and structural echocardiographic parameters were assessed before and at three and six months after ENT surgery.
Results:
The echocardiographic evaluation showed that the values of selected parameters describing the left ventricular anatomy and systolic-diastolic function were normal and did not differ significantly between the study group and the control group at any stage of the study.
Conclusions:
Snoring reported by parents does not affect adversely left ventricle structure or function in children. Unlike in adults, myocardial overload is not common in snoring children.
REFERENCES (15)
1.
Kara CO, Ergin H, Kocak G, et al. Prevalence of tonsillar hypertrophy and associated oropharyngeal symptoms in primary school children in Denizli, Turkey. Int J Pediatr Otorhinolaryngol 2002; 66: 175-179.
2.
Niiranen TJ, Kronholm E, Rissanen H, et al. Self-reported obstructive sleep apnea, simple snoring, and various markers of sleep-disordered breathing as predictors of cardiovascular risk. Sleep Breath 2016; 20: 589-596.
3.
Baguet JP, Nadra M, Barone-Rochette G, et al. Early cardiovascular abnormalities in newly diagnosed obstructive sleep apnea. Vasc Health Risk Manag 2009; 5: 1063-1073.
4.
Drager LF, Bortolotto LA, Figueiredo AC, et al. Obstructive sleep apnea, hypertension, and their interaction on arterial stiffness and heart remodeling. Chest 2007; 131: 1379-1386.
5.
Martha VF, Moreira Jda S, Martha AS, et al. Reversal of pulmonary hypertension in children after adenoidectomy or adenotonsillectomy. Int J Pediatr Otorhinolaryngol 2013; 77: 237-240.
6.
Cincin A, Sakalli E, Bakirci EM, Dizman R. Relationship between obstructive sleep apnea-specific symptoms and cardiac function before and after adenotonsillectomy in children with adenotonsillar hypertrophy. Int J Pediatr Otorhinolaryngol 2014; 78: 1281-1287.
7.
Drukteinis JS, Roman MJ, Fabsitz RR, et al. Cardiac and systemic hemodynamic characteristics of hypertension and prehypertension in adolescents and young adults: the Strong Heart Study. Circulation 2007; 115: 221-227.
8.
Chami HA, Devereux RB, Gottdiener JS, et al. Left ventricular morphology and systolic function in sleep-disordered breathing: the Sleep Heart Health Study. Circulation 2008; 117: 2599-2607.
9.
Amin RS, Kimball TR, Bean JA, et al. Left ventricular hypertrophy and abnormal ventricular geometry in children and adolescents with obstructive sleep apnea. Am J Respir Crit Care Med 2002; 165: 1395-1399.
10.
Villa MP, Ianniello F, Tocci G, et al. Early cardiac abnormalities and increased C-reactive protein levels in a cohort of children with sleep disordered breathing. Sleep Breath 2012; 16: 101-110.
11.
Litwin M, Niemirska A. In: Nadciśnienie tętnicze u młodzieży i młodych dorosłych, Litwin M, Januszewicz A, Prejbisz A, et al. (eds.). Medycyna Praktyczna, Kraków 2011; 241-269.
12.
Palatini P, Frigo G, Vriz O, et al. Early signs of cardiac involvement in hypertension. Am Heart J 2001; 142: 1016-1023.
13.
Cetin M, Bozan N. The effects of adenotonsillar hypertrophy corrective surgery on left ventricular functions and pulmonary artery pressure in children. Int J Pediatr Otorhinolaryngol 2017; 101: 41-46.
14.
Kaditis A. Blood pressure after adenotonsillectomy in children with obstructive sleep-disordered breathing. Am J Respir Crit Care Med 2008; 178: 882.
15.
Jankowska A, Dudziak M. Nowe techniki echokardiograficzne w ocenie funkcji lewej komory. In: Standardy kardiologiczne 2016 okiem echokardiografisty, Płońska-Gościniak E (ed.). Medical Tribune, Warszawa 2016: 189.
Share
RELATED ARTICLE
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
