Evaluation of electrocardiographic and echocardiographic findings of ASTHMA patients

Introduction and Aim: Although asthma generally manifests with respiratory symptoms, it can also cause cardiac symptoms. In patients with asthma, resistance in the pulmonary capillaries increases due to chronic hypoxia and inflammation, leading to an increase in pulmonary arterial pressure. The increased pulmonary vascular resistance can affect the functions of the right heart, and therefore, right ventricular hypertrophy or dilation may be observed. In this study, it was aimed to compare patients with asthma with a control group using echocardiographic and electrocardiographic methods and to investigate whether cardiac involvement varies. Material and Methods: In this study, data from a total of 100 patients, including 50 control and 50 asthmatic patients, who were retrospectively examined, were included. These patients were either diagnosed with asthma and followed up at the Pediatric Allergy and Immunology outpatient clinic of Dicle University Faculty of Medicine between 01.01.2022 and 01.01.2023, or children of the same age and gender with no diseases who applied to the Pediatric Cardiology outpatient clinic. Results: A total of 100 participants were included in the study, consisting of 50 control subjects and 50 patients diagnosed with asthma. The average age of the asthma patient group was 10.1 while the control group had an average age of 10.7. No statistically significant difference was found between groups regarding median age values, gender ratios, and median weight values with respective p-values of 0.342, 0.317, and 0.255. There was no significant difference between the groups in terms of median BMI (body mass index) values (p=0.446), however, a significant difference was found between the mean BMI Z-score values (p=0.014). A statistically significant difference was found between groups in terms of average pulse rates (p=0.001). The average pulse rate for the asthma patient group was 97.4, while the control group had an average pulse rate of 85.5. The rate of sinus tachycardia was 52% in the asthma patient group, while it was 24% in the control group. Statistically significant differences were found between median QTc values and median QT dispersion values with respective p-values of 0.028 and 0.001. A significant difference was found between the TAPSE (Tricuspid annular plane systolic excursion) average values (p=0.014). The average TAPSE value was 22.3 in the asthma patient group, while it was 24.1 in the control group. Significant differences were found between the groups in terms of median values of FEV1 (forced expiratory volume in the first second of FVC), FEV1/FVC, FVCex (forced vital capacity), PEF (Peak Expiratory Flow) with respective p-values of 0.001, 0.005, 0.001, 0.001. Discussion: Asthma is not a disease limited to the respiratory system and can also affect the cardiovascular system. Asthma symptoms such as dyspnea, tachypnea (rapid breathing), and tachycardia (rapid heartbeat) can lead to inflammation and airway obstruction in the lungs, resulting in an increase in pulmonary vascular resistance. In long-term and poorly controlled asthma, increased pulmonary vascular resistance can strain the right heart and affect the preload of the left heart. This situation can lead to chronic hypoxia, hypertrophy, and remodeling in the left ventricular muscle and can affect the functions of the left ventricle. Moreover, increased intrathoracic pressure during an asthma attack can affect the preload of the right heart and cause the right ventricle to work harder. Due to the effects of asthma on the cardiovascular system, it is important to evaluate patients' cardiac functions and monitor their cardiac health. Our study investigated whether asthma has an effect on cardiac involvement. We believe our study will contribute to the literature by determining the effects of asthma, a disease common in the community causing significant morbidity and economic loss, on the cardiovascular system, identifying any risk factors, and if cardiovascular system pathology is detected; reducing cardiovascular system morbidity by early cardiovascular evaluation of asthmatic cases.