title: Effect of adenotonsillar hypertrophy on right ventricle function in children.
abstract: OBJECTIVE
  Chronic upper airway obstruction causes hypoxemic pulmonary vasoconstriction, which may lead to right ventricle (RV) dysfunction. Adenotonsillar hypertrophy (ATH) is the most common cause of upper airway obstruction in children. Therefore, we aimed to evaluate RV function in children with ATH.
  
  
  METHODS
  Twenty-one children (male/female, 15/6; mean age, 92.3¡¾39.0 months; age range, 4-15 years) with ATH and 21 healthy age- and gender-matched controls were included in this study. Tricuspid annular plane systolic excursion and RV myocardial performance index were measured by transthoracic echocardiography. Further, the plasma level of N-terminal of probrain natriuretic peptide (NT-proBNP), an indicator of RV function, was determined.
  
  
  RESULTS
  The snoring-tiredness during daytime-observed apnea-high blood pressure (STOP) questionnaire was completed by the patients' parents, and loud snoring was noted in the ATH group. The plasma NT-proBNP level was significantly higher in the ATH group than that in the controls (66.44±37.63 pg/mL vs. 27.85±8.89 pg/mL, P=0.001). The echocardiographic parameters were not significantly different between the groups.
  
  
  CONCLUSIONS
  We were unable to confirm the significance of echocardiographic evidence of RV dysfunction in the management of children with ATH. However, the plasma NT-proBNP level was significantly higher in the ATH group than that in the control, suggesting that chronic airway obstruction in children may carry a risk for cardiac dysfunction. Therefore, more patients should be examined using transthoracic echocardiography. In addition, pediatricians and otolaryngologists should consider cardiologic aspects during the management of children with severe ATH.
authors.affiliation: Department of Pediatrics, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Jin Hwan
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Jung Min
authors.initials: JM
authors.lastname: Yoon
authors.affiliation: Department of Pediatrics, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Jae Woo
authors.initials: JW
authors.lastname: Lim
authors.affiliation: Department of Pediatrics, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Kyung Og
authors.initials: KO
authors.lastname: Ko
authors.affiliation: Department of Otolaryngology, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Seong Jun
authors.initials: SJ
authors.lastname: Choi
authors.affiliation: Department of Otolaryngology, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Jong-Yeup
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Eun Jung
authors.initials: EJ
authors.lastname: Cheon
keywords: Airway obstruction; Echocardiography; Hypertrophy; Obstructive sleep apnea; Probrain natriuretic peptide