Pulmonary arterial pressure and nasal obstruction in mouth-breathing children: similarities between adenotonsillar hypertrophy and allergic rhinitis

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Background Upper airway obstruction may cause pulmonary hypertension in childhood In this study we aimed to identify a possible correlation of systolic pulmonary arterial pressure SPAP using Doppler echocardiography with nasal patency NP as measured by rhinomanometry in mouth-breathing MB children with allergic rhinitis AR and adenotonsillar hypertrophy ATH.Methods In this cross-sectional study we evaluated patients from to years of age at an MB referral clinic in Brazil from December 2013 to 2017.We allocated patients to etiology groups: group 1,60 MBs with ATH;group 2,47 MBs with AR; group 3,43 MBs with both ATH and AR;and group 4,33 nasal breathing control subjects. The ratio of total nasal inspiratory flow (assessed by active anterior rhinomanometry and expected inspiratory flow adjusted for height determined the percent NP(%NP). Results: The median %NP was higher in controls than in the MB groups controls,114%[79-147%]: ATH:65%[5-116%]; AR:57%[23-144%]; ATH and AR:64%[3-120%]; p<0.001).Median SPAp was higher in the MB groups than in controls(SPAP:ATh 26.0[20.0-35.0] mmHg; Ar,26.0[22.0-32.0] mmHg; ATH and AR 26.30[20.0-34.0] mmHg control,22.0[16.0-30.0] mmHg; p<0.001) SPAP showed a negative association with %NP(Spearman's rho=-0,24:p<0,0001). Conclusion: Reduced nasal airflow in MB children showed a correlation with higher levels of systolic pulmonary arterial pressure. The AR and ATH groups were similar in nasal obstruction severity and systolic pulmonary arterial pressurelevel distribution © 2020 ARS-AAOA, LLC.

Abstract

Assunto

Rinite alérgica, Respiração bucal, Hipertensão pulmonar

Palavras-chave

Allergic rhinitis, Mouth breathing, Pulmonary hypertension

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https://onlinelibrary.wiley.com/doi/full/10.1002/alr.22651

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