Evaluation of Cardiac Mechanics in Asthmatic Female Patients During Exacerbation and After Stabilization: A Speckle-tracking Echocardiography Study

Yıl 2024, Cilt: 14 Sayı: 2, 150 - 155, 29.08.2024

Timor Omar , Gökhan Perinçek İnanç Artaç , Muammer Karakayalı , Doğan İliş , Ayça Arslan , Yavuz Karabağ , İbrahim Rencüzoğulları

Öz

Aim: There is a complex relationship between asthma and cardiac functions. According to speckle-tracking echocardiography studies, asthma, especially severe asthma, was associated with left and right ventricular subclinical dysfunction. The literature lacks data comparing the cardiac functions during exacerbations and stable periods in patients with asthma. In this study, we aimed to investigate cardiac functions using speckle-tracking echocardiography during exacerbations and in the stable phase in female patients with asthma.
Material and method: A total of 51 female adult asthma patients who were admitted to our center due to asthma exacerbations were included in this study. All participants had a previous diagnosis of asthma. Transthoracic echocardiography was performed both during hospitalization and after the asthma exacerbation was stabilized. Echocardiographic findings, including left ventricular longitudinal strain, in the two periods were compared. All patients were discharged in good condition after their asthma attacks stabilized.
Results: White blood cell count (WBC) and C-reactive protein (CRP) levels were significantly higher during exacerbation than in the stable phase. Regarding echocardiographical findings, isovolumetric contraction time (IVCT) was significantly longer and left ventricular global longitudinal strain (LVGLS) was significantly lower during exacerbation compared to the stable phase [median (IQR), 70 (61–76) msec vs. 66 (57–72) msec, p=0.011 and -12.9 (-13.8 – -12.1) vs. -14.2 (-14.8 – -13.2), p<0.001, respectively]. According to the multivariate analysis, IVCT, LVGLS, and WBC were independently associated with asthma exacerbation.
Conclusion: Our study showed that asthma exacerbations might have an oppressive and adverse impact on cardiac functions, particularly when analyzed by STE.

Anahtar Kelimeler

asthma exacerbation, heart function, left ventricular longitudinal strain

Kaynakça

• 1. Wang E, Wechsler ME, Tran TN, Heaney LG, Jones RC, Menzies-Gow AN, et al. Characterization of Severe Asthma Worldwide: Data From the International Severe Asthma Registry. Chest. 2020;157(4):790–804.
• 2. Soriano JB, Abajobir AA, Abate KH, Abera SF, Agrawal A, Ahmed MB, et al. Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Respir Med. 2017;5(9):691–706.
• 3. Chowdhury NU, Guntur VP, Newcomb DC, Wechsler ME. Sex and gender in asthma. Eur Respir Rev 2021:30(162):210067.
• 4. Hillas G, Perlikos F, Tsiligianni I, Tzanakis N. Managing comorbidities in COPD. Int J Chron Obstruct Pulmon Dis. 2015;10:95–109.
• 5. Tuleta I, Eckstein N, Aurich F, Nickenig G, Schaefer C, Skowasch D, et al. Reduced longitudinal cardiac strain in asthma patients. J Asthma. 2019;56(4):350–359.
• 6. De-Paula CR, Magalhães GS, Jentzsch NS, Botelho CF, Mota CCC, Murça TM, et al. Echocardiographic Assessment of Ventricular Function in Young Patients with Asthma. Arq Bras Cardiol. 2018;110(3):231–239.
• 7. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28(1):1–39. e14.
• 8. Schiller NB, Acquatella H, Ports TA, Drew D, Goerke J, Ringertz H, et al. Left ventricular volume from paired biplane twodimensional echocardiography. Circulation. 1979;60(3):547–55.
• 9. Voigt JU, Pedrizzetti G, Lysyansky P, Marwick TH, Houle H, Baumann R, al. Definitions for a common standard for 2D speckle tracking echocardiography: consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. Eur Heart J Cardiovasc Imaging. 2015;16(1):1–11.
• 10. Badano LP, Kolias TJ, Muraru D, Abraham TP, Aurigemma G, Edvardsen T, et al. Standardization of left atrial, right ventricular, and right atrial deformation imaging using two-dimensional speckle tracking echocardiography: a consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. Eur Heart J Cardiovasc Imaging. 2018;19(6):591–600.
• 11. Shedeed, Soad A. Right ventricular function in children with bronchial asthma: a tissue Doppler echocardiographic study. Pediatr Cardiol. 2010;31(7):1008–15.
• 12. Alhakak AS, Møgelvang R, Schnohr P, Modin D, Brainin P, Gislason G, et al. The cardiac isovolumetric contraction time is an independent predictor of incident heart failure in the general population. Int J Cardiol. 2020;312:81–86.
• 13. Arnlöv J, Ingelsson E, Risérus U, Andrén B, Lind L. Myocardial performance index, a Doppler-derived index of global left ventricular function, predicts congestive heart failure in elderly men. Eur Heart J. 2004;25(24):2220–5.
• 14. Fukuta, Hidekatsu, William C Little. The cardiac cycle and the physiologic basis of left ventricular contraction, ejection, relaxation, and filling. Heart Fail Clin. 2008;4(1):1–11.
• 15. Luo, Min, Mark E Anderson. Mechanisms of altered Ca²⁺ handling in heart failure. Circ Res. 2013;113(6):690–708.
• 16. Bruch C, Schmermund A, Marin D, Katz M, Bartel T, Schaar J. Tei-index in patients with mild-to-moderate congestive heart failure. Eur Heart J. 2000;21(22):1888–95.
• 17. Ardahanli I, Akhan O, Sahin E, Akgun O, Gurbanov R. Myocardial performance index increases at long‐term follow‐up in patients with mild to moderate COVID‐19. Echocardiography 2022, 39(4), 620–625.
• 18. Russo C, Jin Z, Elkind MS, Rundek T, Homma S, Sacco RL, et al. Prevalence and prognostic value of subclinical left ventricular systolic dysfunction by global longitudinal strain in a communitybased cohort. Eur J Heart Fail. 2014;16(12):1301–9.
• 19. Akyüz Özkan E, Khosroshahi HE. Evaluation of the left and right ventricular systolic and diastolic function in asthmatic children. BMC Cardiovasc Disord. 2016;16(1):145.
• 20. Cukic V, Lovre V, Dragisic D, Ustamujic A. Asthma and Chronic Obstructive Pulmonary Disease (COPD) - Differences and Similarities. Mater Sociomed. 2012;24(2):100–5.
• 21. Yalta K, Yalta T, Gurdogan M, Palabıyık O, Yetkın E. Cardiac Biomarkers in the Setting of Asthma Exacerbations: a Review of Clinical Implications and Practical Considerations. Curr Allergy Asthma Rep. 2020;20(6)17