Relation between Vascular Endothelial Markers and Right Ventricular Function in the Children with Asthma

The aim of the study was to evaluate the possible relationship of clinical severity during asthmatic exacerbation with the ventricular functions and the levels of vascular endothelial-related biomarkers endothelin-1 (ET-1) and platelet-derived growth factor-BB (PDGF-BB) in the condensed breathing air in the children with asthma.
The study included a total of 80 children with acute asthmatic episode; of these, 28 had a mild, 26 had a moderate, and 26 had a severe attack. Samples of condensed breathing air were obtained for being analyzed for ET-1 and PDGF-BB levels during the study. All patients were evaluated by echocardiography at the beginning of the study and two weeks after the treatment of asthmatic episode.
Before treatment, mPAP in moderate and severe asthma groups was significantly higher than in mild asthma group (21.6 ± 7.3, 30.1 ± 9.8 and 32.7 ± 7.8; P 0.05). Am and Em waves, and IVRT, IVCT, ET and RV MPI during the asthmatic attack and after treatment did not change significantly between the groups; pre- and post-treatment values of these parameters also did not show significant differences. In exhaled air samples of the group with severe asthma exacerbation ET-1 and PDGF-BB were higher than those in the moderate and mild group (0.80 ± 0.42, 0.58 ± 0.30, 0.50 ± 0.15; P = 0.002 and 281.7 ± 253.2, 167.3 ± 148.1, 135.9 ± 74.9; P = 0.008 respectively).
Our study results showed that mPAP in direct proportion with the increased inflammatory cytokines was significantly higher in asthma attacks and levels of ET-1 and PDGF-BB were significantly increased with severity of asthma, indicating a vascular response.