الفهرس 
Introduction.Only 14 pages are availabe for public view
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Abstract
Cardiopulmonary interaction is the term that is used to describe the inseparable
connection between the heart and lungs. In health, the cardiovascular and pulmonary
systems are in perfect balance, In disease, derangements of either system leads to
dysfunction in the other. We attempt to assess the pulmonary system in children with
disease in cardiovascular system.
This study is a case-control study which was performed to assess the pulmonary
functions among children with congenital and rheumatic heart disease associated with
pulmonary hypertension, to assess the correlation between pulmonary arterial blood
pressure and pulmonary functions parameters, and to assess the effect of age, sex, weight
and height on pulmonary functions in children with congenital and rheumatic heart
disease associated with pulmonary hypertension.
The patients were selected from the Cardiology Unit of Pediatric Clinic, Suez
Canal University Hospital. The patients included 60 children with age ranged from 5 to
18 years subdivided into two groups; 30 children with CHD associated with PAH and 30
children with RHD associated with PAH.
The mean age of the patients was 12.41±3.58 years, while the mean age of the
control was 11.9±4.08 years. The frequency of males in PAH group was 29 (48.3%) and
the frequency of females was 31 (51.7%). Both genders were equal in the control group
(50% each). There were no statistically significant differences between children with
PAH and healthy control regarding age and gender (p>0.05). The mean age of the
children with RHD was higher significantly than children with CHD (14.93 vs. 9.79
years, respectively) (p<0.0001). Sixty percent of CHD patients were males and 40% of
them were females, while 36.7% of RHD patients were males and 63.3% of them were
females. The frequency of males was higher significantly in children with CHD than in
Summary and conclusions
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children with RHD, while the frequency of females was higher significantly in children
with RHD than in children with CHD (p=0.001).
The mean weight of the patients was 45.73±14.01 kg and the mean height of the
patients was 142.93±16.09 cm, the mean weight of the control was 42.2±13.57 kg and the
mean height of the control was 138.2±15.73 cm.
There were no statistically significant differences between children with PAH and
healthy control regarding weight and height (p>0.05). The mean weight and height of the
children with RHD was higher significantly than children with CHD (54.93kg, 152.67cm
vs. 36.21kg, 132.86cm, respectively) (p<0.0001).
MR was higher in children with RHD (40%) .
The mean PABP in the children with PAH was higher significantly than in
healthy children (42.07 vs. 21.35 mmHg, respectively) (p<0.0001). There was no
statistically significant difference between children with CHD and RHD regarding mean
PABP (41.028 vs. 42.07 mmHg, respectively) (p>0.05). The mean FVC, FEV1,
FEV1/FCV ration and FEF25-75% were measured in both groups. All pulmonary
functions tests in the children with PAH was lower significantly than healthy children
(p<0.0001). There were no statistically significant differences between children with
CHD and RHD regarding the results of pulmonary functions tests (p>0.05).
Restrictive pattern of pulmonary functions was present in 65% of all PAH
children, obstructive pattern was present in 20%, mixed pattern was present in 5% and
10% of the children show normal pulmonary functions. There were no statistically
significant differences between children with CHD and RHD regarding the patterns of
pulmonary functions in the studied patients (p>0.05). The mean PABP of the children
with restrictive and mixed patterns of pulmonary functions were higher significantly than
obstructive ones. There were no statistically significant differences between children with
Summary and conclusions
85
restrictive, mixed and normal patterns of pulmonary functions regarding mean PABP
(p>0.05).
Four children with restrictive pattern of pulmonary functions had PABP
>60mmHg, and no children with obstructive and mixed patterns of pulmonary functions
had PABP >60mmHg., fifteen’s children with restrictive pattern of pulmonary functions
had PABP 45-60mmHg, while twenty of children with restrictive pattern of pulmonary
functions had PABP 25-45mmHg , six of children with normal pattern had PABP 25-45mmHg.
There were significant positive correlations between children with RHD and age
(r=0.724, p=0.000), mean weight (r=0.674, p=0.000) and mean height (r=0.62, p=0.000).
This means that children with RHD had older age, high weight and height. The other
variables show insignificant correlations (p>0.05). There were significant negative
correlations between PABP and FVC (r=-0.386, p=0.003). This means that children with
higher PABP had lower FVC. The other variables show insignificant correlations
(p>0.05).
In conclusions:
o PAH is a common problem in patients with CHD and RHD.
o The mean age, weight and height of the children with RHD was higher
significantly than children with CHD.
o Restrictive pattern of pulmonary functions was more common than obstructive
pattern of all PAH children (56% vs. 20%, respectively).
o The mean FVC, FEV1, and FEF25-75 the children with PAH was lower
significantly than healthy children (p<0.0001).
o There were significant negative correlation between PABP and FVC (r=-0.386,
p=0.003).