Journal article
Echocardiography assessment of Left Ventricular Function in Extremely Preterm Infants, Born less than 28 weeks Gestation, with Bronchopulmonary Dysplasia and Systemic Hypertension
Journal of the American Society of Echocardiography, Vol.37(2), pp.237-247
02/2024
DOI: 10.1016/j.echo.2023.08.013
PMID: 37619910
Abstract
Background
The survival of smaller and more immature premature infants has been associated with life-long cardiorespiratory comorbidities. Infants with bronchopulmonary dysplasia (BPD) undergo routine screening echocardiography to evaluate for development of chronic pulmonary hypertension, a late manifestation of pulmonary vascular disease (PVD).
Methods
Our aim was to evaluate left ventricular (LV) performance in infants with BPD and PVD, who developed systemic hypertension. We hypothesized that infants with hypertension were more likely to have impaired LV performance. We present a single center cross-sectional study of premature infants born less than 28 0/7 weeks GA with a clinical diagnosis of BPD. Infants were categorized by the systolic arterial pressure (SAP) at time of echocardiography as Hypertensive (SAP ≥90mmHg) or Normotensive (SAP <90mmHg). 64 patients were included.
Results
Infants with hypertension showed altered LV diastolic function with prolonged TDI-derived IVRT (54.2±5.1 vs. 42.9±8.2, p<0.001), lower E:A ratio and higher E:e’. Indices of left heart volume/pressure loading [LA:Ao and LV end-diastolic volume (6.1±2 vs. 4.2±1.2 p<0.001)] were also higher in the HT group. Finally, infants in the hypertensive group had higher pulmonary vascular resistance index (PVRi) (4.42±1.1 vs. 3.69±0.8 p=0.004).
Conclusions
We conclude that extremely preterm infants with BPD, who develop systemic hypertension are at risk of abnormal LV diastolic dysfunction. Increased PVRi in the hypertensive group may relate to pulmonary venous hypertension secondary to LV dysfunction. This is an important consideration in this cohort, when selecting the physiologically most appropriate treatment.
Details
- Title: Subtitle
- Echocardiography assessment of Left Ventricular Function in Extremely Preterm Infants, Born less than 28 weeks Gestation, with Bronchopulmonary Dysplasia and Systemic Hypertension
- Creators
- Melanie E. Reyes-HernandezAdrianne R. BischoffRegan E. GiesingerDanielle R. RiosAmy H. StanfordPatrick J. McNamara
- Resource Type
- Journal article
- Publication Details
- Journal of the American Society of Echocardiography, Vol.37(2), pp.237-247
- DOI
- 10.1016/j.echo.2023.08.013
- PMID
- 37619910
- ISSN
- 0894-7317
- eISSN
- 1097-6795
- Language
- English
- Electronic publication date
- 08/22/2023
- Date published
- 02/2024
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology; Internal Medicine
- Record Identifier
- 9984458258902771
Metrics
7 Record Views