title: Early cardiac abnormalities and increased C-reactive protein levels in a cohort of children with sleep disordered breathing.
abstract: BACKGROUND
  This study aims to evaluate left ventricular (LV) structure and function and inflammation in a paediatric population with sleep disordered breathing (SDB) and in control subjects.
  
  
  METHODS
  Forty-nine children with SDB and 21 healthy, age-matched subjects were enrolled. The diagnosis of obstructive sleep apnoea syndrome (OSAS) was confirmed by the laboratory polysomnography, showing an obstructive apnoea/hypopnoea index of more than one per hour, according to the criteria of the American Academy of Sleep Medicine and modified for paediatric population. Fasting blood samples for the biochemical evaluation (including high-sensitivity C-reactive protein (hsCRP) were drawn in the morning, after the polysomnographic examination in all patients with SDB and in the control group. All children underwent a two-dimensional colour Doppler cardiac examination with LV mass assessment and systolic and diastolic function evaluation.
  
  
  RESULTS
  Higher hsCRP levels were observed in subjects with OSAS than in children with primary snoring and in controls (0.8 ± 0.7 vs 0.3 ± 0.1 ng/dl, p = 0.001, and 0.4 ± 0.2 ng/dl, p = 0.01, respectively). The LV diastolic dysfunction was significantly more frequent in patients with severe OSAS and higher hsCRP levels than in control group.
  
  
  CONCLUSIONS
  This study shows that OSAS in children is associated with higher LV mass, early LV diastolic dysfunction and a pro-inflammatory state (high CRP levels). These findings might help to explain the higher incidence of cardiovascular morbidity in patients with OSAS.
authors.affiliation: Division of Paediatrics, II Faculty of Medicine, La Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy. mariapia.villa@uniroma1.it
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Villa
authors.forename: Filomena
authors.initials: F
authors.lastname: Ianniello
authors.forename: Giuliano
authors.initials: G
authors.lastname: Tocci
authors.forename: Melania
authors.initials: M
authors.lastname: Evangelisti
authors.forename: Silvia
authors.initials: S
authors.lastname: Miano
authors.forename: Andrea
authors.initials: A
authors.lastname: Ferrucci
authors.forename: G Massimo
authors.initials: GM
authors.lastname: Ciavarella
authors.forename: Massimo
authors.initials: M
authors.lastname: Volpe
mesh_terms: D000293:Adolescent; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003971:Diastole / Q000502:physiology; D018618:Echocardiography, Doppler, Color; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D010100:Oxygen / Q000097:blood; D017286:Polysomnography; D012016:Reference Values; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D012913:Snoring / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology
chemical_list: D002097:C-Reactive Protein; D010100:Oxygen