The improvement of right ventricular function after adenotonsillectomy in children with obstructive sleep apnea

Kim, Dong Yeop; Ko, Kyung Ok; Lim, Jae Woo; Yoon, Jung Min; Song, Young Woo; Cheon, Eun Jung

doi:10.3345/kjp.2018.06436

Cited by 9 publications

(12 citation statements)

References 23 publications

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“…Adenotonsillectomy increased the RV myocardial performance index in children with sleep apnea induced by adenotonsillar hypertrophy (Kim et al 2018). PFO closure in OSA patients did not significantly change the AHI and oxygen desaturation index but improved their quality of life and Epworth's score (Hoole et al 2017).…”

Section: Effect Of Osa Treatment On Patients' Cardiac Functionmentioning

confidence: 90%

Cardiac function and cognitive function in patients with obstructive sleep apnea

Vahedi

Khosravi

Alizadian

et al. 2021

Sleep Science Practice

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Objectives This study was designed to evaluate echocardiographic findings in patients with obstructive sleep apnea (OSA) with cognitive impairment and compare it with the control group. Methods Sixty-seven OSA patients and 52 group of healthy controls were evaluated prospectively by Mini-Mental State Examination questionnaire and trans-thoracic echocardiography. Results The cognitive impairment and diastolic dysfunction were 19.6% (P = .002) and 18.4% (P = .016) more prevalent in OSA group compared to the control group. The mean tricuspid regurgitant gradient, pulmonary artery size, and transmitral A velocity were higher, but mean right ventricular peak systolic velocity, tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC), transmitral E/A ratio, and annular E’ velocity were lower in the OSA group than the control group. Comparing the patients with and without cognitive disorders, showed significant differences regarding the size of right atrium, TAPSE and FAC (P < .05). Conclusions OSA patients need accurate cardiac examinations, early diagnosis, and interventions to prevent the progression of cardiac dysfunction, especially older male patients with higher BMI and impaired cognition. Further studies are needed to determine the exact link between the OSA, obesity, and cardiac physiology.

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Section: Effect Of Osa Treatment On Patients' Cardiac Functionmentioning

confidence: 90%

Cardiac function and cognitive function in patients with obstructive sleep apnea

Vahedi

Khosravi

Alizadian

et al. 2021

Sleep Science Practice

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“…4 Sub-group analysis for adenoidectomy and adenotonsillectomy, pre-and post-surgery (SMD: standardized mean difference; CI: confidence interval) which make this meta-analysis all the more important [23,[25][26][27][28][29]. Pediatric SDB attracts the sleep physicians', pediatricians', and otolaryngologists' concerns much more because of its increasing prevalence rate and its sequelae if left alone which include pediatric hypertension [30], increased risk of upper respiratory tract infection [31], failure to thrive [32], and neuropsychiatric problems such as attention deficiency [33], and other mood disorders such as depression [34,35]. Previous studies have indicated an increase in pediatric hypertension rates in patients with pediatric SDB even in non-obese pediatric groups [4,30].…”

Section: Discussionmentioning

confidence: 99%

Mean platelet volume levels in children with sleep-disordered breathing: a meta-analysis

2020

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Background: Pediatric sleep-disordered breathing (SDB) correlated with respiratory conditions of snoring and hypopnea. Mean platelet volume (MPV) was an inflammatory marker, related to increased inflammatory condition of pediatric patients. Increase of MPV level may cause failure to thrive or increased upper airway infection rate. The aim of this study was to perform systematic review and meta-analysis to investigate the difference on MPV values for pediatric SDB, and compare the change on MPV after surgery in patients with pediatric SDB. Methods: A systemic review of the studies from PubMed, EMBASE, and Cochrane Library databases was conducted in March 2020, supported by reviewing of published articles for studies comparing MPV in pediatric SDB. Metaanalysis was used to compare the change of MPV in pediatric SDB, and subgroup analysis was also used to compare the MPV decrease after surgeries of adenoidectomy or adenotonsillectomy. Results: There were seven studies included in the review. Six of them including 963 subjects showed that a significant increase of MPV was noted in pediatric SDB compared to those in pediatric non-SDB (P < 0.05). Total standardized mean difference (SMD) in MPV between pediatric SDB and non-SDB was 0.51 (95% CI = 0.30-0.72, P < 0.05). A significant decrease of MPV was found in pediatric SDB patients who underwent surgery (total SMD = − 0.36; 95% CI = − 0.70-0.02, P < 0.05). Decreases of MPV after adenoidectomy and adenotonsillectomy were observed, but only the effect of adenotonsillectomy had a statistical significance (total SMD = − 0.72; 95% CI = − 1.18-0.26, P < 0.05). Conclusion: The MPV was significantly higher in patients with pediatric SDB, indicating the presence of increased platelet activity in pediatric SDB patients. The level of MPV could be reduced by the two surgeries, especially adenotonsillectomy.

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“…Tables 1 and 2 show studies conducted over the past 20 years, each with a different research purpose and study methods. The available studies can be classified as observational studies (n.2) [16,17], retrospective studies (n.3) [18][19][20], cross-sectional studies (n.4) [21][22][23][24], comparative studies (n.2) [25,26], prospective studies (n.8) [27][28][29][30][31][32][33][34], and clinical trial (n.1) [35].…”

Section: Marangu D Et Al (2014) [24]mentioning

confidence: 99%

“…Diagnosis of adenoid/tonsillar hypertrophy was obtained using Brodsky's Scale in three studies [22][23][24] and by taking X-rays in four studies [22,30,32,35]. ENT surgery was reported as adenoidectomy [16,17,[20][21][22]25,[27][28][29][30][31][32][33]35], tonsillectomy [29,32], and A&T [16,17,[20][21][22]25,[28][29][30][31][32][33]35]. A cardiac evaluation was performed by Doppler echocardiography [16,17,22,24,[27][28][29][30] and the analysis of various cardiac parameters [16,17,25,27,…”

Section: Marangu D Et Al (2014) [24]mentioning

confidence: 99%

“…ENT surgery was reported as adenoidectomy [16,17,[20][21][22]25,[27][28][29][30][31][32][33]35], tonsillectomy [29,32], and A&T [16,17,[20][21][22]25,[28][29][30][31][32][33]35]. A cardiac evaluation was performed by Doppler echocardiography [16,17,22,24,[27][28][29][30] and the analysis of various cardiac parameters [16,17,25,27,[29][30][31][32]. Some studies also involved monitoring biomarkers such as CRP [18] and NT-proBNP [18].…”

Section: Marangu D Et Al (2014) [24]mentioning

confidence: 99%

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Cardiac Implications of Adenotonsillar Hypertrophy and Obstructive Sleep Apnea in Pediatric Patients: A Comprehensive Systematic Review

Zaffanello,

Ersu,

Nosetti

et al. 2024

Children

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This review investigates the relationship between pediatric obstructive sleep apnea, often associated with adenotonsillar hypertrophy, and cardiovascular health, particularly pulmonary hypertension. We conducted a comprehensive literature search using electronic databases, including Medline Pub-Med, Scopus, and the Web of Science. The study analyzed a total of 230 articles and screened 48 articles, with 20 included in the final analysis, involving 2429 children. The PRISMA flowchart visually illustrates the selection process, and the ROBINS-E and –I tools help ensure the reliability and validity of the evidence produced by these studies. These studies explored various aspects, including the severity of obstructive sleep apnea, cardiac anomalies, cardiac stress markers, risk factors for pulmonary hypertension, and the impact of adenoidectomy and tonsillectomy on cardiac function. The research found that adenotonsillar hypertrophy and obstructive sleep apnea are significant risk factors for cardiovascular complications, especially pulmonary hypertension, in children. Adenoidectomy and tonsillectomy may provide effective treatments. Following adenoidectomy in relation to obstructive sleep apnea, there appears to be a reduction in mean pulmonary artery pressure during echocardiographic examination. However, the efficacy of these procedures can vary based on the severity of obstructive sleep apnea and individual cardiac conditions. The study also identified concerns regarding data bias. The authors emphasize the need for well-designed clinical studies, including both healthy patients with adenotonsillar hypertrophy and vulnerable children with genetic disorders, to ensure that clinical decisions are based on solid scientific evidence.

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The improvement of right ventricular function after adenotonsillectomy in children with obstructive sleep apnea

Cited by 9 publications

References 23 publications

Cardiac function and cognitive function in patients with obstructive sleep apnea

Cardiac function and cognitive function in patients with obstructive sleep apnea

Mean platelet volume levels in children with sleep-disordered breathing: a meta-analysis

Cardiac Implications of Adenotonsillar Hypertrophy and Obstructive Sleep Apnea in Pediatric Patients: A Comprehensive Systematic Review

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