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MYOCARDIAL STRAIN IN VASCULAR ANOMALIES WITH SEVERE UPPER AIRWAY OBSTRUCTION: PRELIMINARY RESULTS

Abstract

Background

Vascular anomalies (VA) may cause in some cases severe tracheomalacia. Chronic upper airway obstruction (UAO) is the most common symptom. Increased pulmonary pressure and cardiac dysfunction have been described in patients with chronic UAO, but not in infants with VA-associated UAO.

Objectives

To evaluate myocardial strain in infants with VA-associated UAO.

Methods

Demographic characteristics, respiratory symptoms and the percentage of tracheal obstruction measured on CT were collected. Left and right ventricle (LV, RV) systolic function were measured with speckle tracking longitudinal strain analysis (LS). Pulmonary artery pressure (PAP) was evaluated on tricuspid regurgitation jet (TR) and quantified by end-systolic eccentricity index (EI).

Results

15 cases were included, of which six had a tracheal occlusion <50%, and nine >50%. Cases with tracheal occlusion >50% had significantly more pronounced respiratory symptoms and LV and RV function were significantly reduced compared to those with occlusion <50% (LV -15.9% vs -19.9%; RV -15.7% vs -20.5%, respectively). Degree of UAO did not seem to have a significant impact on PAP.

Conclusion

In cases with VA with severe tracheomalacia RV and LV myocardial strain are reduced, suggesting myocardial impairment. Future studies with larger sample size are needed to confirm these data and investigate cardiac function. Association with lung function test may be investigated too.

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