Echocardiographic Evaluation of Cardiac Functions in Children with Chronic Adenotonsillar Hypertrophy

Abstract

Objective: Chronic adenotonsillar hypertrophy (ATH) causing upper airway obstruction may lead to pulmonary hypertension and other cardiac abnormalities. This study aimed at the clinical and echocardiographic evaluation of cardiac abnormalities in children with chronic ATH and evaluation of these abnormalities after adenotonsillectomy. Subjects and method: We studied 40 children with ATH indicated for adenotonsillectomy (group I) compared with another 35 sex and age matched normal children (Group II). Both groups were examined by otorhinolaryngologist and adenotonsillar hypertrophy was diagnosed with lateral neck x-ray. Clinical and echocardiographic examinations were compared in both groups. Adenotonsillectomy were performed in group I and reevaluation of clinical and echocardiographic findings were performed 6 months later in this group and results were compared with the preoperative findings in the same group. Results: Compared with group II, group I has a significantly higher pulmonary artery pressure, right ventricular size, Interventricular septal wall thickness, left ventricular end-diastolic dimension, and longer E-wave deceleration time. Postoperative echocardiographic findings showed statistically significant decrease only in pulmonary artery pressure and E-wave deceleration time. Significant improvement in clinical symptoms and growth parameters were also noted postoperatively in group II. Conclusion: Upper airway obstruction in children with ATH is associated with cardiac structural and functional abnormalities as demonstrated by echocardiography. Some of these abnormalities i.e. pulmonary hypertension and delayed LV diastolic relaxation are reversible after adenotonsillectomy.