title: Pulmonary hypertension evaluation by Doppler echocardiogram in children and adolescents with mouth breathing syndrome.
abstract: BACKGROUND
  Adenotonsillar hyperplasia (ATH) and allergic rhinitis (AR) are the most common causes of upper airway obstruction in children. Such diseases, by affecting the upper airways, can cause chronic alveolar hypoventilation, pulmonary vasoconstriction and pulmonary hypertension, which in some cases, are irreversible.
  
  
  OBJECTIVE
  This cross-sectional study aimed to evaluate the prevalence of pulmonary hypertension in two groups of mouth-breathing (MB) 2-12 years old children with ATH and isolated allergic rhinitis, through Doppler echocardiography.
  
  
  METHODS
  54 patients with ATH and indications for adenoidectomy and/or tonsillectomy and 24 patients with persistent allergic rhinitis were selected and submitted to Doppler echocardiography. The Systolic Pulmonary Artery Pressure (SPAP) was determined by tricuspid regurgitation and the Mean Pulmonary Artery Pressure (MPAP) was calculated from the SPAP. Similar measurements were carried out in 25 nasal breathing (NB) individuals.
  
  
  RESULTS
  The mean MPAP and SPAP were higher in the MB than in the NB group (17.62±2.06 [ATH] and 17.45±1.25 [AR] vs. 15.20±2.36 [NB] mmHg, p<0.005, and 25.61±3.38 [ATH] and 25.33±2.06 [AR] vs. 21.64±3.87 [NB] mmHg, p<0.005, respectively) and the mean acceleration time of pulmonary flow trace (Act) was higher in the NB than in the MB group (127.24±12.81 [RN] vs. 114.06±10.63ms [ATH] and 117.96±10.28 [AR] MS [AR]; p<0.0001).
  
  
  CONCLUSIONS
  None of the MB children (ATH and AR) met the PH criteria, although individuals with both ATH and isolated AR showed significant evidence of increased pulmonary artery pressure by Doppler echocardiography in relation to NB individuals. No differences were observed between the ATH and AR groups.
authors.affiliation: Universidade Federal de Minas Gerais (UFMG), Departamento de Cirurgia e Oftalmologia, Belo Horizonte, MG, Brazil. Electronic address: marcelasl03@yahoo.com.br.
authors.forename: Marcela Silva
authors.initials: MS
authors.lastname: Lima
authors.affiliation: Faculdade de Saúde e Ecologia Humana (FASEH), Vespasiano, MG, Brazil; Faculdade de Saúde e Ecologia Humana (FASEH), Fundação de Amparo a Pesquisa do Estado de Minas Gerais (FAPEMIG), Programa Institucional de Bolsas de Iniciação Científica e Tecnológica (PROBIC), Vespasiano, MG, Brazil.
authors.forename: Carolina Maria Fontes Ferreira
authors.initials: CMFF
authors.lastname: Nader
authors.affiliation: Universidade Federal de Minas Gerais (HC-UFMG), Hospital das Clínicas, Belo Horizonte, MG, Brazil; Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Belo Horizonte, MG, Brazil.
authors.forename: Letícia Paiva
authors.initials: LP
authors.lastname: Franco
authors.affiliation: Universidade Federal de Minas Gerais (UFMG), Departamento de Pediatria, Belo Horizonte, MG, Brazil.
authors.forename: Zilda Maria Alves
authors.initials: ZMA
authors.lastname: Meira
authors.affiliation: Núcleo de Inovação Tecnológica, Fundação Hospitalar do Estado de Minas Gerais (FHEMIG), Santa Efigênia, MG, Brazil.
authors.forename: Flavio Diniz
authors.initials: FD
authors.lastname: Capanema
authors.affiliation: Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Departamento de Oftalmologia, Otorrinolaringologia e Fonoaudiologia, Belo Horizonte, MG, Brazil.
authors.forename: Roberto Eustáquio Santos
authors.initials: RES
authors.lastname: Guimarães
authors.affiliation: Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Departamento de Oftalmologia, Otorrinolaringologia e Fonoaudiologia, Belo Horizonte, MG, Brazil; Universidade Federal de Minas Gerais (HC-UFMG), Hospital das Clínicas, Centro Multidisciplinar de Atenção ao Respirador Oral, Belo Horizonte, MG, Brazil.
authors.forename: Helena Maria Gonçalves
authors.initials: HMG
authors.lastname: Becker
mesh_terms: D000234:Adenoids / Q000473:pathology*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000150:complications; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D009058:Mouth Breathing / Q000150:complications*; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D065631:Rhinitis, Allergic / Q000150:complications*; D013577:Syndrome
keywords: Adenoidectomia; Adenoidectomy; Doppler echocardiography; Ecodopplercardiografia; Hipertensão pulmonar; Mouth breathing; Pulmonary hypertension; Respiração bucal; Rhinitis; Rinite