Effect of septoplasty on left ventricular myocardial performance in patients with nasal septum deviation

The Impact of Septoplasty on Cardiopulmonary Functions in Patients With Nasal Septal Deviation: A Prospective Comprehensive Analysis of Echocardiographic Outcome and Serum N-Terminal Pro BNP Levels

“…These findings support the consideration of an effective septoplasty surgery to offer improved quality of life not only by means of improved nasal airflow but also through associated positive systemic effects, mainly on the cardiovascular system. 14 Likewise, the association of NSD with increased PAP, whereas significant improvement in cardiopulmonary functions and TAPSE after septoplasty has also been reported in past studies. 12,[15][16][17] In a past study with 25 NSD patients and 27 control subjects, authors reported significantly lower TAPSE and tricuspid annulus early diastolic myocardial velocity (E 0 ) and significantly higher RV myocardial performance index and PAP in patients with NSD than in control subjects, while septoplasty was associated with decrease in PAP and increase in TAPSE.…”

“…[28][29][30][31] Besides the direct obstruction of the upper airway, inhibition of nasopulmonary reflex in NSD patients can also lead to hypoxia and hypercapnia; while the hypoxia, hypercapnia, and intrathoracic pressure changes caused by NSD are considered likely to result in impaired LV performance. 14,28,32 Pulsed Doppler tissue imaging is a unique method of measuring systolic and diastolic velocities of motion of both annulae, while a systolic annular velocity <11.5 cm/s was reported to predict RV dysfunction (ejection fraction <45%) with a sensitivity of 90% and a specificity of 85%. 33 In addition, TAPSE is considered a reliable quantitative method for assessment of RV function, which is a key determinant of prognosis and symptoms in patients with PHT.…”

“…[6][7][8][9] Accordingly, Doppler echocardiography studies in NSD patients, albeit investigated to a lesser extent than in patients with chronic tonsillitis and adenoid vegetation, indicated the adverse impact of NSD on cardiac functions, such as high PAP and right ventricular (RV) hypertrophy as well as positive impact of septoplasty on cardiovascular parameters. [10][11][12][13][14][15][16][17] Nonetheless, vast majority of studies have investigated PAP per se with detailed assessment of RV and LV functions only by a few studies, and thus effects of improved nasal breathing after septoplasty on cardiopulmonary functions have not yet been fully studied. 14,15,17 In addition, the relation of NSD with PHT and right heart failure has been investigated mainly by echocardiography in the literature with only limited number of studies addressing the serum Nterminal Pro BNP (NT-proBNP) levels, which is a useful marker in the diagnosis and follow-up of heart failure.…”

“…10 In a past study with 50 consecutive NSD patients who underwent septoplasty, transthoracic echocardiography revealed significantly higher LV myocardial performance index, longer isovolumetric relaxation time and isovolumetric contraction time, longer deceleration time, higher E/A ratio, and shorter ejection time before septoplasty when compared to values obtained 3 months after septoplasty. 14 Authors noted that the likelihood of subclinical LV diastolic dysfunction but not LV systolic dysfunction in patients with NSD and the chance of the diastolic impairment to be reversible after septoplasty. 14 Our findings revealed no significant alteration in ECG parameters after septoplasty in NSD patients.…”

“…[10][11][12][13][14][15][16][17] Nonetheless, vast majority of studies have investigated PAP per se with detailed assessment of RV and LV functions only by a few studies, and thus effects of improved nasal breathing after septoplasty on cardiopulmonary functions have not yet been fully studied. 14,15,17 In addition, the relation of NSD with PHT and right heart failure has been investigated mainly by echocardiography in the literature with only limited number of studies addressing the serum Nterminal Pro BNP (NT-proBNP) levels, which is a useful marker in the diagnosis and follow-up of heart failure. 18,19 This seems notable given that although patients with uncomplicated NSD patients are frequently asymptomatic in terms of cardiologic aspects, they are likely to be at risk of future cardiovascular diseases in the long term.…”