Doppler echocardiographic evaluation of pulmonary arterial pressure in children with allergic rhinitis

In children, persistent upper airway obstruction may lead to increased pulm onary arterial pressure (PAP). Allergic rhinitis (AR) is one of the frequen t cause of persisting upper airway obstruction by nasal blockage in childho od. Regular use of nasal topical corticosteroids are effective in reducing nasal blockage and obstruction. However, whether symptomatic children with AR have increased PAP and curative effect of topical steroids are not known . The aims of this study were to clarify whether children having active sym ptoms of AR have increased PAP and to investigate the curative effect of re ducing nasal obstruction by topical corticosteroids. Twenty-three children, aged between 5 and 16, diagnosed as AR, consisted of 17 seasonal AR (SAR) and seven perennial AR (PAR), were included in the study. Nineteen age and sex matched healthy children were received as controls. PAP was measured by using Doppler echocardiography in all subjects and symptom scores of AR we re recorded in rhinitis group. After first evaluation, nasal steroid, budes onid, was given to rhinitis group for three months. Mean systolic PAP was 3 3.4 +/- 3.1 for children with AR mmHg and 23.6 +/- 4.3 mmHg for the control group. The difference was statistically significant (P < 0.05). Mean systo lic PAP of children with PAR was significantly higher than children with SA R (P < 0.05). In rhinitis group, mean PAP decreased significantly after rel ief of upper airway obstruction by nasal corticosteroid therapy to normal l evel of 24.9 +/- 3.6 mmHg (P < 0.05). Our results showed that children with AR may have significantly higher PAP than healthy subjects and decreased t o normal levels after relieving nasal blockage by nasal corticosteroids. Ne vertheless, Doppler echocardiography is a safe, non-invasive and practical tool for cardiac investigation of children with AR. Therefore, in symptomat ic period, evaluation of PAP of children with AR by using Doppler echocardi ography may be useful in the planning and following of their therapy. (C) 2 001 Elsevier Science Ireland Ltd. All rights reserved.