Disorders of cardiac hemodynamic in attack period of bronchial asthma in children.

Анотація

Bydopplerechocardiographymethodtherewasstudiedfunctionalstateofcardiacventriclesandcharacterofhemodynamicdisordersin 48 patients aged 5-17 years in attack period of moderately-severe and severe bronchial asthma. Group of comparison included 40 healthy peers. Disordersofcentralandperipheralhemodynamicinattackperiodofbronchialasthmainchildrenwereaccompaniedbothbysystolicanddiastolicdysfunctionoftheleftandrightheartventricles, herewith right ventricle was functioning in the mode of hyperdynamic, and left one – in the mode of hypodynamic. Combinedsystolic-diastolicvariantofdysfunctionbothofrightandleftventricleswasdevelopingin 58,3% of patients with moderately-severe and in 91,6% of patients with severe bronchial asthma. Intheattackperiodofbronchialasthmainchildrenequaldirectionalityofsystolicanddiastolicdysfunctionofheartventricleswasdeveloping; this was characterized by synchronization of their function.Assessmentoffunctionalinteractionoftheventriclesunderconditionsofsevereasthmaattackshoweddirectandhigh (r=0,67) correlativeinteractionbetweenfindingofTeiindexoftheleftandrightventricles, whichcharacterizetheirsystolicfunction; this, under conditions of increased hemodynamic pre-loading testified to compensatory  increase of systolic interaction of ventricles. Direct and high (r=0,69) correlativeinteractionbetween time indices of isovolumic relaxation of the left and right ventricles, characterizing their diastolic function, testified to compensatory increase of diastolic interaction of ventricles under conditions of increase of hemodynamic post-loading.  Imbalance of central and peripheral link of hemodynamic in attack period ofbronchialasthmainchildrentestified to development of cardiac insufficiency, which was compensated predominantly at the expense of increase of heart contractions rate.