Structural and functional changes of cardiovascular system in children with asthma

Abstract Objective. To study the cardiovascular system status in schoolchildren depending on the level of bronchial asthma control. Materials and methods. The study enrolled 189 children with persistent BA aged 6–17 years and 30 gender- and age-matched apparently healthy individuals who made up a control group. In addition to clinical examinations assessment electrocardiogram (ECG) monitoring results and markers of myocardial damage (total creatine phosphokinase and lactic dehydrogenase, isoenzymes CPK–MB and LDH1) as well as electrolytes (K+ in serum and erythrocytes) were studied to assess the cardiovascular system status in children with various levels of BA control. Results. Rhythm disturbances in the form of sinus tachycardia was detected in 30.6 % of children with UC BA, and it was significantly more frequent compared to the children with C BA – 8.05 % (P < 0.01) and the control group – 6.06 % (P < 0.001). Bradycardia occurred significantly more often in those with uncontrolled BA (19.3 %) compared to the control group (3.03 %) and the patients with C BA (8.5 %), P < 0.05. Supraventricular extrasystoles were detected significantly more often in the children with UC BA (29.0 %) compared to those with C BA (8.5 %, P < 0.01). In the children with UC BA serum K+ was significantly lower compared to the control group, the children with C BA and PC BA (P < 0.001). In the children with well controlled BA serum K+ level was also significantly decreased compared to the control group and those with C BA (P < 0.01). The analysis of the blood serum K+ level to that in erythrocytes ratio showed that 32.2 % of children with UC BA and 13.3 % of those with PC BA (P < 0.05) had hypokalemia. Hypokalihistia was found in 18.5 % of the children with UC BA and 10.0 % of those with PC BA (P < 0.05). Total serum LDH level was found to be significantly increased in the children with UC BA compared to the control group, children with C BA (P < 0.001) and PC BA (P < 0.01). Thus, in the children with UC BA total CPK was significantly higher compared to the control group, the children with C BA (P < 0.001) and PC BA (P < 0.01). Conclusions. Patients with uncontrolled bronchial asthma commonly have functional cardiovascular disorders, decreased K+ level in blood serum and erythrocytes as well as increase in total CPK, isoenzyme CPK–MB, total lactate dehydrogenase and lactate dehydrogenase isoenzyme 1.