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Myocardial strain on admission predicts disease severity in infants hospitalized for bronchiolitis
Author(s) -
Claudia Massolo Anna,
Vanina Cantone Giulia,
Maria Caterina Musolino Anna,
Corsini Iuri,
Patel Neil,
Evangelisti Melania,
Monaco Francesca,
Pia Villa Maria,
Braguglia Annabella
Publication year - 2020
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.24712
Subject(s) - medicine , bronchiolitis , cardiology , ventricle , cardiac function curve , prospective cohort study , respiratory system , heart failure
Abstract Objective To assess cardiac function in infants with bronchiolitis and the association with disease severity and outcomes. Working Hypothesis Cardiac function may be impaired in bronchiolitis and represent an early predictor of disease severity. Study Design A prospective cohort study. Patient Selection Infants with suspected bronchiolitis were included. Methodology All cases received antigen detection and viral genome detection from nasal lavage or swabs and echocardiography within 24 hours from admission. Systolic and diastolic function in left ventricle (LV) and right ventricle (RV) were assessed using longitudinal strain (LS), a measure of myocardial deformation. Pulmonary artery pressures were estimated using tricuspid regurgitation jet (TR), when present, and end‐systolic eccentricity index (EI ES). Main outcomes (duration of respiratory support, length of stay [LOS], and type of respiratory support) were collected. Data were compared to normative existing data, and a group of healthy infants, matched in age. Results Twenty‐eight infants with bronchiolitis and 10 healthy comparators were included. Cases with bronchiolitis showed significantly lower values of RV LS and LV LS compared to healthy comparators (LV: p0.04 and RV: P < .001). Ten infants (36%) had a normal biventricular function, nine (32%) had LV impairment, and nine (32%) had a biventricular impairment. No significant differences were found in TR and EI ES. Infants with biventricular impairment demonstrated a significant increase in LOS (p0.04) and higher levels of respiratory support compared to the healthy comparators ( P = .03). Conclusions Bronchiolitis is associated with myocardial impairment. Cardiac function is related to disease severity and outcome.