Evaluation of biventricular function in asthmatic children with different severity by new echocardiographic modalities

Abstract Background This study aimed to evaluate the impact of asthma severity on biventricular cardiac functions using tissue Doppler imaging (TDI), two-dimensional speckle tracking echocardiography (2D-STE), and three-dimensional speckle tracking echocardiography (3D-STE). Methods Sixty-three children with asthma, aged between 5 and 16 years, were enrolled in the study along with 63 matched controls. All participants underwent cardiac assessments, including TDI, 2D-STE, 3D-STE, conventional echocardiography, and pulmonary function testing with spirometry. Results Sixty-three asthmatic children with a mean age of 9.96 ± 3 years were enrolled in the patient group. Based on the severity of asthma, they s were categorized into three subgroups: mild, moderate, and severe persistent. The TDI examination revealed a significant decline in right ventricular (RV) diastolic and systolic functions, indicated by lower tricuspid E’/A’ ratio and RV S respectively. Additionally, there was a notable increase in both the RV and LV myocardial performance index (MPI) in the severe asthma group compared to other severity subgroups. Children with severe asthma also demonstrated significantly lower values in three-dimensional global longitudinal strain (3D GLS), three-dimensional global circumferential strain (3D GCS), three-dimensional global area strain (3D GAS), and three-dimensional global radial strain (3D GRS) during (3D-STE examination compared to other severity subgroups. However, there was no discernible difference between the severity subgroups when 2D-STE was used. Conclusion TDI and 3D-STE exhibited the ability to identify early biventricular dysfunction in pediatric patients diagnosed with severe bronchial asthma.