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Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii
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1/2021
vol. 38
 
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abstract:
Original paper

Functional assessment of the right ventricle in patients with bronchial asthma of various severity

Grzegorz Mincewicz
1
,
Grzegorz Siergiejko
2
,
Marek Piepiorka
3
,
Agnieszka Świdnicka-Siergiejko
4
,
Zenon Siergiejko
5
,
Grzegorz Krzykowski
6

  1. Department of Molecular Biology, University of Gdansk, Gdansk, Poland
  2. Department of Paediatrics, Gastroenterology, Hepatology, Nutrition and Allergology, Medical University of Bialystok, Bialystok, Poland
  3. Department of Cardiology, Specialist Hospital, Wejherowo, Poland
  4. Department of Gastroenterology and Internal Medicine, Medical University of Bialystok, Bialystok, Poland
  5. Respiratory System Diagnostic and Bronchoscopy Department, Medical University of Bialystok, Bialystok, Poland
  6. WSB University, Gdansk, Poland
Adv Dermatol Allergol 2021; XXXVIII (1): 52-56
DOI: https://doi.org/10.5114/ada.2021.104278
Online publish date: 2021/03/10
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Introduction
Pulmonary artery hypertension and its consequences still constitutes an underestimated clinical problem in asthma patients and its non-invasive early detection may influence proper treatment. Aim: To non-invasively examine the pulmonary artery flow parameters and right ventricular function in patients with asthma of various severity.

Material and methods
The analysis of parameters of echocardiography and first-pass and gated radionuclide angiography, and baseline examination in 31 patients with bronchial asthma and 16 healthy controls.

Results
Patients with severe asthma had higher mean pulmonary artery pressure (MPAP) compared to the healthy controls. The subgroup analysis of patients who suffered from asthma in their childhood showed that individuals with severe asthma were characterized by significantly higher MPAP than those with the mild/moderate condition (19.16 ±7.51 mm Hg vs. 5.0 ±1.15 mm Hg, p = 0.025). Gated, but not first-pass, radionuclide angiography revealed that individuals with severe asthma were characterized by a lower right ventricular ejection fraction (RVEF). Further analysis of the subgroup of patients in whom the initial manifestation of dyspnoea occurred no earlier than 6 years prior to the study showed that the RVEF of individuals with severe asthma was significantly lower compared to those with mild/moderate asthma (39.8 ±4.79% vs. 51.4 ±8.65%, p = 0.019).

Conclusions
The pulmonary artery pressure in patients with severe asthma is significantly higher than in healthy individuals; in contrast, these two groups did not differ significantly in terms of the right ventricular echocardiographic characteristics. Gated radionuclide angiography, but not the first-pass technique, allowed for the detection of subtle right ventricular ejection fraction changes in asthma patients.

keywords:

asthma, echocardiography
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