Evaluation of Cardiac Functions in Children with Lower Respiratory Tract Infections

Salah, Khaled Mohamed; Sarhan, Dina Tawfeek; Ahmed, Hanan Samir; Mohamed, Asmaa Mohamed Mohamed; Rashad, Marwa Lotfy Mohammed

doi:10.21608/zumj.2025.375724.3908

Evaluation of Cardiac Functions in Children with Lower Respiratory Tract Infections

Document Type : Original Article

Authors

¹ Professor of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt

² Professor of Clinical Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt

³ MBBCH, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

⁴ Lecturer of Pediatric, Faculty of Medicine, Zagazig University, Zagazig, Egypt

10.21608/zumj.2025.375724.3908

Abstract

Background: Lower respiratory tract infections (LRTIs) are among the major causes of morbidity and mortality in children under five years. This study aimed to assess myocardial involvement in pediatric LRTI cases by evaluating cardiac functions using echocardiography and measuring high-sensitive cardiac troponin T levels.

Methods: This case-control study included 52 children aged 2 months to 5 years. The patient group (n=39) had confirmed LRTIs and was subdivided into 3 groups (n=13 in each): pneumonia (Group I), bronchiolitis (Group II), and pleural effusion (Group III). Group IV included 13 age- and sex-matched healthy children serving as controls. All were tested for hs-Troponin T and C reactive protein, with detailed echocardiographic evaluation of both left and right ventricular functions.

Results: Children with LRTIs had significantly elevated high-sensitive troponin T and CRP levels. Echocardiography revealed reduced left ventricular ejection fraction in bronchiolitis and pleural effusion groups (p < 0.001), but with preserver systolic functions. LV diastolic dysfunction affected by decreased A-wave velocity (p < 0.001). TDI of mitral valve showed significant rise of S` and significant decline regarding E/e` among the cases compared to the control (p < 0.001). while TDI of tricuspid valve revealed significant decline regarding S` among the cases compared to the control (p < 0.001).

Conclusion: LRTIs in young children are associated with subclinical and overt cardiac involvement, affecting both ventricles. Echocardiographic assessment and cardiac biomarkers, especially high-sensitive troponin, can provide valuable insights for early detection of potential cardiac complications in this population.

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