Effect of inhaled procaterol and budesonide on right ventricular diastolic function in children with asthma
Keywords:
asthma, right ventricular diastolic function, TAPSE
Abstract
Objectives To study changes in parameters of right ventricular(RV) diastolic function after procaterol and budesonide inhalation
in children with asthma.
Methods This was a one-group pretest-posttest design to determine
changes in right ventricular diastolic function following
four weeks of inhaled procaterol and budesonide administration.
Subjects were children aged 8 to 18 years with frequent episodic
asthma recruited consecutively at the Department of Child
Health, Cipto Mangunkusumo Hospital. M-mode and 2-D
echocardiography examinations were performed to determine RV
isovolumetric relaxation time (IVRT), acceleration time (AT),
deceleration time (DT), E wave, A wave, E/ A ratio, and tricuspid
annular plane systolic excursion (TAPSE). Means of the RV
function parameters before and after treatment were compared
using the paired t-test or Wilcoxon test.
Results There were 29 patients comprising 16 boys and 13 girls. The
means or medians of theE wave, A wave, E/A ratio, acceleration
time (AT), deceleration time (DT), and isovolumetric relaxation
time (IVRT) before and after treatment were 0.55 and 0.55 em/sec
(P=0.709), 0.45 and 0.35 em/sec (P<O.OOOl), 1.17 and 1.58 em/sec
(P<0.0001), 52.73 and 55.03 m/sec (P=0.04), 55.39 and 58.10 m/
sec (P=0.03), and 46.50 and 70.0 m/sec (P<0.0001), respectively.
The median pre- and post-inhalation TAPSE were 1.63 and 1.84
em, respectively (P<0.001).
Conclusions In children with frequent episodic asthma, there
are changes in RV diastolic functions IVRT, AT, DT, E/A ratio
and A wave following procaterol and budesonide inhalation.
There was no increase in E wave following inhalation. TAPSE
was increased following procaterol and budesonide inhalation.
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RE, Kligman RM, eds. Nelson textbook of pediatrics. 16th ed.
Philadelphia: WB Saunders, 2006; p. 760-73.
3. Neder JA, Nery LE, Silva AC. Short term effects of aerobic
training in the clinical management of moderate to severe
asthma in children. Thorax. 1999;54:202-06.
4. Roche WR, Jeffery PK. Remodelling and inflammation. In:
Silverman M, eds. Childhood asthma and other wheezing
disorders. 2nd ed. Oxford: Arnold, 2002; p. 93-277.
5. Raby BA, Steen KV, Celedon JC, Augusto. Paternal history
of asthma and airway responsiveness in children with asthma.
Am J Respir Crit Care Med. 2005; 172:552-8.
6. Jardin F, Dubourg 0, Margairaz. Inspiratory impairment in
right ventricular performance during acute asthma. Chest.
1987;92:789-95.
7. Veler H, Clayton G. Asthma. In: Panitch HB, penyunting.
Pediatric Pulmonology. The Requisites in Pediatrics.
Philadelphia: Mosby, 2005; p. 95-115.
8. Woolcock A, Keena V, Peat J. Definition, classification,
epidemiology and risk factors. In: O'Byme M, Thomphson
C, eds. Manual of asthma management. 2nded. Philadelphia:
WB Saunders, 2001; p. 3-37
9. Vetter VL.Heart failure in pediatrics. In: Vetter VL, Bell
LM, eds. Pediatric Cardiology. Philadelphia: Mosby, 2006;
p. 159-67.
10. Bernstein D. The cardiovascular system. In: Behrman RE,
Kliegman RM, eds. Nelson textbook of pediatrics. 16th ed.
Philadelphia: WB Saunders, 2006; p. 1475-99.
11. Santoso H. Penyakit jantung paru. In: Sastroasmoro S.
Madiyono B, eds. Buku ajar kardologi anak. Jakarta:
Binakarya Aksara, 1994; p. 391-403.
12. Zhendong Y. Effect of age and respiration on right ventricular
diastolic filling patterns in normal children. Pediatr Cardia!.
1998;19:218-20.
13. Ayten P, Ozyurek H. Assessment of right ventricular diastolic
filling parameters by Doppler echocardiography. Pediatr
International. 2003;45:263-7.
14. Okada Y, Ono S, Morikawa A. Doppler echocardiographic
evaluation of right ventricular diastolic function in children.
Pediatr Cardia!. 2000;21 :358-62.
15. Burgess M, Bright-Thomas RJ, Ray GS. Echocardiographic
evaluation of right ventricular function. Eur J Echocardiography.
2002;3:252-62.
16. De Groff CG. Doppler echocardiography. In: Valdez-cruz LM,
Cayre RO, eds. Echocardiographic diagnosis of congenital
heart disease. Philadelphia: Lippincot-Raven publisher, 1999;
p. 101-144.
17. Snider R, Bengur RA. Doppler echocardiography. In: Moss
and Adams, eds. Heart disease in infants, children and
adolescents including the fetus and young adult. 5th ed.
Philadelphia: Williams and Wilkins,1995; p. 270-93.
18. Karvandi M, Piranfar MA, Ghaffaripour M. An alternative
method for perioperative estimation of pulmonary artery
systolic pressure by echocardiography. Shiraz E-Medical J.
2007;8:1-13.
19. Tamborini G, Pepi M, Galli CA. Feasibility and accuracy of
a routine echocardiographic assessment of right ventricular
function. IntJ Cardia!. 2007;115:86-9.
20. Wiedemann HP, Matthay RA. Management of cor
pulmonale. In: Scrarf SM, eds. heart-lung interactions in
Health and Disease. 1" ed. New York: Marcel Decker, 1989;
p. 920-6.
21. Marangoni, Scalvini, Schena. Right ventricular diastolic
function in chronic obstructive lung disease. Eur Respir J.
1992;5:438-43.
Published
2009-07-01
How to Cite
1.
Utamayasa A, Advani N, Boediman I, Sastroasmoro S, Madiyono B. Effect of inhaled procaterol and budesonide on right ventricular diastolic function in children with asthma. PI [Internet]. 1Jul.2009 [cited 28Apr.2024];49(3):131-. Available from: https://www.paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/540
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Received 2016-09-10
Accepted 2016-09-10
Published 2009-07-01
Accepted 2016-09-10
Published 2009-07-01
