Relation Between Vascular Endothelial Markers and Right Ventricular Function in the Children With Asthma

Abstract

Objectives: The aim of the study was to evaluate the possible relationship of clinical severity during asthmatic exacerbation with the ventricular functions and the levels of vascular endothelial-related biomarkers endothelin-1 (ET-1) and platelet-derived growth factor-BB (PDGF-BB) in the condensed breathing air in the children with asthma. Methods: The study included a total of 80 children with acute asthmatic episode; of these, 28 had a mild, 26 had a moderate, and 26 had a severe attack. Samples of condensed breathing air were obtained for being analyzed for ET-1 and PDGF-BB levels during the study. All patients were evaluated by echocardiography at the beginning of the study and two weeks after the treatment of asthmatic episode. Results: Before treatment, mPAP in moderate and severe asthma groups was significantly higher than in mild asthma group (21.6 +/- 7.3, 30.1 +/- 9.8 and 32.7 +/- 7.8; P < 0.01, P < 0.001, respectively). After treatment, no significant difference was detected between the asthma groups (P > 0.05). Am and Em waves, and IVRT, IVCT, ET and RV MPI during the asthmatic attack and after treatment did not change significantly between the groups; pre-and post-treatment values of these parameters also did not show significant differences. In exhaled air samples of the group with severe asthma exacerbation ET-1 and PDGF-BB were higher than those in the moderate and mild group (0.80 +/- 0.42, 0.58 +/- 0.30, 0.50 +/- 0.15; P = 0.002 and 281.7 +/- 253.2, 167.3 +/- 148.1, 135.9 +/- 74.9; P = 0.008 respectively). Conclusions: Ourstudy resultsshowedthatmPAPin direct proportion with the increasedinflammatory cytokineswassignificantly higher in asthma attacks and levels of ET-1 and PDGF-BB were significantly increased with severity of asthma, indicating a vascular response.