Ventricular Size May Impact Asthma Severity, Exacerbations

Disease severity may be worse and exacerbation rates may be higher among individuals with asthma who have smaller cardiac ventricular size, according to findings from the Severe Asthma Research Program (SARP) III.

To reach this conclusion, the researchers measured the pulmonary artery and aorta diameters of 233 participants in the SARP III. Right (eERVVI), left (eELVVI), and total (eETVVI) epicardial cardiac ventricular volume indices were also estimated.

The researchers then assessed how cardiac and pulmonary artery measurements are associated with clinical measurements of asthma severity, as well as how asthma severity is associated with exacerbation rate.

The results showed an association between asthma severity and smaller ventricular volumes. The participants who had severe asthma had 36.1 mL/m2 smaller eETVVI than healthy controls and 14.1 mL/m2 smaller eETVVI than participants with mild to moderate asthma.

A higher rate of asthma exacerbations was also associated with smaller ventricular volumes—an association that was present both retrospectively and prospectively. Participants who had an eETVVI less than the median had a 57% higher rate of exacerbations during follow-up than those with eETVVI greater than the median.

According to the study authors, asthma severity or exacerbations were not associated with the pulmonary artery-to-aorta ratio or the eERVVI-to-eELVVI ratio.

—Colleen Murphy


Ash SY, Sanchez-Ferrero GV, Schiebler ML, et al; SARP Investigators. Estimated ventricular size, asthma severity, and exacerbations: the Severe Asthma Research Program III cohort. Chest. 2020;157(2):258-267.