Changes in Pulmonary Functions in Children in Response to Pulmonary Hypertension Associated with Cardiac Diseases in Suez Canal Area in Egypt
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Changes in Pulmonary Functions in Children in Response to Pulmonary Hypertension Associated with Cardiac Diseases in Suez Canal Area in Egypt,AYMAN F. SABRY, HALA F. EL-HAGRASI, HAGAR M.HOSSAM and AMANI A. EL-BAZ
Abstract
Introduction: Alteration in pulmonary blood flow and respiratory mechanics are always present in infant and children with heart disease. We aimed to study the respiratory functions in subjects suffering from pulmonary arterial hypertension (PAH) associated with either congenital heart disease (CHD) or rheumatic heart disease (RHD).
Methods: 90 children were enrolled in this study. 30 children with CHD associated with PAH, 30 children with RHD associated with PAH and 30 normal control age matched children. Echocardiography was performed for calculating the systolic pulmonary artery pressure (SPAP). Spirometry was performed to evaluate pulmonary function: Forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC and forced expiratory flow (FEF). Com-plete history, clinical examination and ECG were also per-formed for each subject before doing the echocardiography and pulmonary function test.
Results: The mean pulmonary arterial blood pressure (PABP) in the children with PAH was higher significantly in comparison to control group (p<0.0001). All pulmonary functions tests in the children suffering from cardiac diseases associated with PAH were lowered significantly in comparison to control group (p<0.0001). However, there were no statisti-cally significant differences between children with CHD in comparison to RHD. The mean PABP of the children with restrictive and mixed patterns of pulmonary functions was higher significantly in comparison to obstructive ones. There were significant negative correlations between PABP and FVC (r=-0.386, p=0.003).
Conclusion: Deterioration of Pulmonary function tests is characteristic in children suffering from pulmonary hyperten-sion, either due to CHD or RHD. Restrictive pattern is the most common respiratory abnormality accompanying PAH, followed by the mixed then the obstructive patterns.