title: Clinical asthma phenotypes: is there an impact on myocardial performance?
abstract: BACKGROUND
  Asthma is a systemic disease, which affects various body systems. We aimed to assess the impact of clinical asthma phenotypes on myocardial performance in asthmatic children using tissue Doppler imaging (TDI).
  
  
  METHODS
  We enrolled 58 children with moderate persistent asthma and 62 age- and sex-matched healthy controls. Asthmatic children were classified according to clinical asthma phenotypes into shortness of breath group (n = 26) and wheezy group (n = 32). Pulmonary function tests, and conventional and TDI echocardiography were performed.
  
  
  RESULTS
  TDI echocardiography assessment of the studied groups showed that asthmatic children as a group had significant left and right ventricular dysfunction when compared with healthy controls. Children in the shortness of breath group had a significant diastolic dysfunction of both ventricles in the form of lower tricuspid and mitral annular early myocardial diastolic velocity (Em), early to late myocardial diastolic velocity (Em/Am) ratio, and prolonged isovolumetric relaxation time when compared with wheezy group (P < 0.001). In the shortness of breath group, TDI-derived myocardial performance index (MPI) of both ventricles was significantly higher when compared with wheezy group (P < 0.001) reflecting global myocardial dysfunction. Conventional echocardiography of both ventricles showed RV diastolic dysfunction in the form of a significantly lower tricuspid E/A ratio in the shortness of breath group when compared with wheezy group.
  
  
  CONCLUSIONS
  Clinical asthma phenotypes have an impact on myocardial function especially those presented with shortness of breath. Thus, measurement of MPI by TDI can detect subclinical changes in the cardiac performance in asthmatic children.
authors.affiliation: Pediatric Allergy and Pulmonology, Children's Hospital, Mansoura University, Mansoura, Egypt.
authors.forename: Magdy
authors.initials: M
authors.lastname: Zedan
authors.forename: Gehan Attia
authors.initials: GA
authors.lastname: Alsawah
authors.forename: Mohamed M
authors.initials: MM
authors.lastname: El-Assmy
authors.forename: Bothina
authors.initials: B
authors.lastname: Hasaneen
authors.forename: Mohamed M
authors.initials: MM
authors.lastname: Zedan
authors.forename: Nehad Abdelsalam
authors.initials: NA
authors.lastname: Nasef
mesh_terms: D001249:Asthma / Q000145:classification / Q000150:complications* / Q000000981:diagnostic imaging*; D002675:Child, Preschool; D004417:Dyspnea / Q000150:complications* / Q000000981:diagnostic imaging*; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D012135:Respiratory Sounds; D012680:Sensitivity and Specificity; D018754:Ventricular Dysfunction / Q000150:complications* / Q000000981:diagnostic imaging*