Lung function tests in children with rheumatic mitral valve diseases

Alterations in cardio-respiratory interactions can cause significant changes in cardio-respiratory function including alterations of pulmonary blood flow and respiratory mechanics. The effects of cardio-respiratory interactions are exaggerated in infants and children with heart disease. In this study, we aim to detect and evaluate the pulmonary functional abnormalities in a group of children with isolated rheumatic mitral valve diseases at different stages using spirometry. This study included 30 patients with mitral valve disease with an age ranges from 7 to 15 [13.5 +/- 1.5] years, and 20 apparently normal children of comparable age, sex and socioeconomic status as a control group. All patients and control group have been divided into three groups: Group I: Patients with isolated mitral regurgitation [22 patients]. Group II: Patients with double mitral disease [8 patients]. Group III: 20 apparently healthy children. All groups were subjected to: detailed history, thorough clinical examination, laboratory investigations [CBC, CRP, ESR and ASOT], plain X-ray for chest and heart, ECG, echocardiography and pulmonary function testing using spirometry. Our results showed that, there was a significant decrease in different spirometric parameters of group I and II when compared to group III. The patterns of pulmonary function impairment were restrictive, obstructive and combined. The only echocardiographic parameter that correlated with the impaired pulmonary function tests in our study was the pulmonary artery pressure which shows a statistically significant increase among different pulmonary dysfunction patterns. We concluded that, patients with mitral valve disease often demonstrate changes in the resting pulmonary functions