Rigidez arterial e qualidade de vida em crianças com Distúrbio Respiratório Obstrutivo do Sono submetidas a adenoamigdalectomia

Abstract

Purpose: This study investigated vascular, hemodynamic, arterial stiffness parameters and quality of life (QoL) in children with Obstructive Sleep-Disordered Breathing (oSDB) due to adenotonsillar hypertrophy and compared them before and three years after tonsillectomy and adenoidectomy (T&A). Methods: Mixed study, cross-sectional and longitudinal, conducted in a tertiary hospital from June/2018 to September/2022. The longitudinal study compared cardiovascular parameters and quality of life (OSA-18 questionnaire) in children with oSDB before (T1, n=48) and three years after T&A (T2, n=36). The cross-sectional study compared T2 with a control group, matched by sex and age. Cardiovascular parameters were measured non-invasively by brachial artery oscillometry with a portable device. The main stiffness indices evaluated were pulse wave velocity (PWV) and augmentation index corrected to 75 beats per minute (AIx@75), which expresses the ratio between augmentation pressure and pulse pressure in percentage. Results: Children with oSDB had a reduction in the augmentation index normalized to heart rate of 75 bpm (AIx@75) 3 years after T&A. Quality of life significantly improved after T&A and was maintained throughout follow-up. Although within adequate levels, the T2 group had higher systolic, diastolic and mean blood pressure. Systolic volume increased and heart rate decreased. When comparing the oSDB and control groups, it was observed that the AIx@75 did not differ between the groups. The higher T2 pulse wave velocity compared to control was within the expected progression. Conclusions: Children treated for oSDB with T&A showed improvement in quality of life and in AIx@75, an independent predictor of cardiovascular complications. The improvement in this index suggests that early treatment of oSDB may be a modifiable factor in reducing cardiovascular risk in children.