Abstract 6.  (1)14



Right Ventricular Strain in Children with Sleep-Disordered Breathing in University of Calabar Teaching Hospital, Nigeria


A.N. Umana1, D. Bassey2, M. Anah3, A. Etiuma1, V. Onoyom-Ita1; J.J. Udo3; I. S. Etuk3; A. Adekanye1 and E. E. B Ukpong1.


Departments of Surgery1, Radiology2, Paediatrics3

College of Medical Sciences, University of Calabar Teaching, Nigeria.


Abstract: To evaluate the association between chronic upper-airway obstruction and asymptomatic ventricular strain in children, with the aim of reducing the complications of chronic adenotonsillar hypertrophy. This was a study of 34 children with sleep-disordered breathing due to chronic adenotosillar hypertrophy admitted for surgery at the University of Calabar Teaching, Calabar, Nigeria. The control group consisted of 34 normal children of comparable ages. In the study group, cardiothoracic (CT) ration and the degree of nasopharyngeal narrowing were determined by plain chest and lateral neck x-ray respectively. The degree of nasopharyngeal narrowing was characterized as very mild, mild, moderate, severe or obliterated. In both groups, electrocardiogram (ECG) was done and analyzed for abnormalities. The age range was 7 months to 13 years with 26 (76.5%) patients between 1 and 5 years while 3 (8.8%) were under 12 months. In 21 (61.76%) of patients over 50% of the nasopharyngeal-airway was narrowed. The mean Cardiothoracic (CT) ratio was 51.180.47% with a range of 39.1-62.8%. The mean Q-Tc interval was 0.45 with a range of 0.38-0.53 in the study group and 0.39 with a range of 0.36.052 in the control group. The Q-Tc interval was prolonged in 21 (61.76%) of study cases, out of which 15 (71.40%) had significant upper airway obstruction while in the control group 2 (5.88%) were prolonged. These difference in Q-Tc interval between both groups were statistically significant (p<0.05). the correlation coefficient between degree of nasopharyngeal obstruction and Q-Tc interval as well as between CT ratio and Q-Tc interval in the study group were not statistically  significant. We therefore conclude that chronic upper airway obstruction secondary to obstructive adenoids and tonsils has a direct effect on cardiac function I children. ECG and plain radiographs can be useful and affordable means of assessing severity and prioritizing treatment in the absence of polysomnography. Early intervention to prevent cardiac complication is advocated.

Key words: Chronic upper-airway obstruction, Q-Tc interval, Cardiac dysfunction.

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