Cardiopulmonary Function Abnormalities in Cohort of Adults following Bronchopulmonary Dysplasia as Preterm Infants

Abstract

Objective This study was aimed to describe the cardiopulmonary profiles of adult patients with bronchopulmonary dysplasia (BPD), comparing them to normative adult values. Study Design This study presents a retrospective chart review of all BPD patients followed in the adult BPD clinic, identified from institutional and archive databases, born preterm at ≤33 weeks estimated gestational age (EGA) between January 1980 and December 2000. Results Forty-four patients with BPD (26.4 ± 2.7 weeks of EGA) were included. Average age at follow-up was 19 years. Majority (61.4%) of the patients had a diagnosis of asthma. Mean spirometry values were: first second of forced expiration (FEV1) 74.1%, forced vital capacity (FVC) 80.7%, and FEV1/FVC 82.5%. Echocardiography (ECHO) images were reviewed, left ventricular (LV) structure and performance did not differ between obstructive and nonobstructive pulmonary function test (PFT) groups, but values of LV longitudinal strain were 4.8% lower than expected normal for adults. Patients with obstructive PFT had additional decreased right ventricular (RV) function by ECHO. Conclusion BPD patients in this study were found to have a burden of cardiorespiratory alterations that persisted into adulthood, with RV performance abnormalities found among patients with obstructive PFT. Key Points

Bronchopulmonary dysplasia in adults: Exploring pathogenesis and phenotype

“…108,109 Furthermore, recent studies of echocardiograms obtained from former preterm infants and survivors of BPD in adolescence and young adulthood confirmed modestly elevated pulmonary artery pressures (PAP) and right ventricle dysfunction, particularly among those with obstructive patterns on PFTs. 110,111 The primary manifestations of these cardiopulmonary abnormalities in adult survivors of prematurity are reduced exercise capacity and exercise tolerance. 18,112,113 Adults born premature have lower VO 2 max during exercise, decreased diffusion capacity, and impaired lung flow due to fixed obstruction.…”

“…Logistic regression analyses of the Swedish Pulmonary Arterial Hypertension and Congenital Heart Disease registries showed a three‐ to fivefold increase in risk for pulmonary hypertension among adult survivors of prematurity that persisted after adjustment for pulmonary disease and congenital heart defects 108,109 . Furthermore, recent studies of echocardiograms obtained from former preterm infants and survivors of BPD in adolescence and young adulthood confirmed modestly elevated pulmonary artery pressures (PAP) and right ventricle dysfunction, particularly among those with obstructive patterns on PFTs 110,111 …”