Echocardiographic evaluation of right ventricular function in preterm infants with bronchopulmonary dysplasia

Bokiniec, Renata; Własienko, Paweł; Borszewska−Kornacka, Maria Katarzyna; Szymkiewicz–Dangel, Joanna

doi:10.1111/echo.13489

Cited by 13 publications

(18 citation statements)

References 28 publications

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“…30 Beyond the first week of age, PAAT has been shown to increase in both term 9 and preterm infants. 10,11,34,43 The increase in PAAT over the first year of age mirrors the postnatal developmental patterns described in term infants, 9 but as expected, the values track lower in preterm infants at comparable time points. 9,21 The expected physiological rapid decrease in postnatal pulmonary vascular disease may be delayed in the preterm pulmonary vasculature with the resulting time to peak acceleration of flow in the pulmonary outflow tract shortened secondary to the persistence of elevated RV afterload.…”

Section: Maturational Patterns Of Paat and Paat/rvetsupporting

confidence: 72%

Echocardiographic Assessment of Right Ventricular Afterload in Preterm Infants: Maturational Patterns of Pulmonary Artery Acceleration Time Over the First Year of Age and Implications for Pulmonary Hypertension

Patel

Breatnach

James

et al. 2019

Journal of the American Society of Echocardiography

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Background: Assessment of pulmonary hemodynamics is critical in the diagnosis and management of cardiopulmonary disease of premature infants, but reliable non-invasive indices of pulmonary hemodynamics in preterm infants are lacking. Since pulmonary artery acceleration time (PAAT) is a validated non-invasive method to assess right ventricular (RV) afterload in infants and children, we investigated the maturational changes of pulmonary artery acceleration time (PAAT) measures in preterm infants over the first year of age, and discerned the impact of typical cardiopulmonary abnormalities on the measures. Methods:In a prospective multi-center study of 239 preterm infants (<29 weeks at birth), PAAT was assessed at days 1, 2, 5-7, 32 and 36 weeks post-menstrual age, and at 1 year corrected age. To account for heart rate variability, PAAT was adjusted for right ventricular ejection time (PAAT/

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Section: Maturational Patterns Of Paat and Paat/rvetsupporting

confidence: 72%

Echocardiographic Assessment of Right Ventricular Afterload in Preterm Infants: Maturational Patterns of Pulmonary Artery Acceleration Time Over the First Year of Age and Implications for Pulmonary Hypertension

Patel

Breatnach

James

et al. 2019

Journal of the American Society of Echocardiography

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“…pathobiology of chronic lung disease after preterm birth and contributes to clinically relevant long-term respiratory outcomes in childhood (14,17,(27)(28)(29). We further note that MV at 7 days was also strongly associated with subsequent LRD.…”

Section: Discussionmentioning

confidence: 51%

Early Pulmonary Vascular Disease in Preterm Infants Is Associated with Late Respiratory Outcomes in Childhood

Mourani

Mandell

Meier

et al. 2019

Am J Respir Crit Care Med

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Rationale: Early pulmonary vascular disease (PVD) after preterm birth is associated with a high risk for developing bronchopulmonary dysplasia (BPD), but its relationship with late respiratory outcomes during early childhood remains uncertain. Objectives: To determine whether PVD at 7 days after preterm birth is associated with late respiratory disease (LRD) during early childhood. Methods: This was a prospective study of preterm infants born before 34 weeks postmenstrual age (PMA). Echocardiograms were performed at 7 days and 36 weeks PMA. Prenatal and early postnatal factors and postdischarge follow-up survey data obtained at 6, 12, 18, and 24 months of age were analyzed in logistic regression models to identify early risk factors for LRD, defined as a physician diagnosis of asthma, reactive airways disease, BPD exacerbation, bronchiolitis, or pneumonia, or a respiratory-related hospitalization during follow-up. Measurements and Main Results: Of the 221 subjects (median, 27 wk PMA; interquartile range, 25-28 and 920 g; interquartile range, 770-1090 g) completing follow-up, 61% met LRD criteria. Gestational diabetes and both mechanical ventilator support and PVD at 7 days were associated with LRD. The combination of PVD and mechanical ventilator support at 7 days was among the strongest prognosticators of LRD (odds ratio, 8.1; confidence interval, 3.1-21.9; P , 0.001). Modeled prenatal and early postnatal factors accurately informed LRD (area under the curve, 0.764). Adding BPD status at 36 weeks PMA to the model did not change the accuracy (area under the curve, 0.771). Conclusions: Early echocardiographic evidence of PVD after preterm birth in combination with other perinatal factors is a strong risk factor for LRD, suggesting that early PVD may contribute to the pathobiology of BPD.

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“…Adding biochemical and echocardiographic markers as soon as 14 DOL could help identify VLBWIs at a higher risk of developing BPD. A delay in the MPI decrease measured by a power Doppler has been reported (4,37). TAPSE values have been related to early pulmonary hypertension in VLBWIs (38), but the association with the later development of BPD has not been previously explored.…”

Section: Discussionmentioning

confidence: 99%

Myocardial Function Maturation in Very-Low-Birth-Weight Infants and Development of Bronchopulmonary Dysplasia

et al. 2020

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Background: Myocardial function in very-low-birth-weight infants (VLBWIs) develops during early postnatal life, but different patterns of temporal evolution that might be related to the development of bronchopulmonary dysplasia (BPD) are not completely understood. Methods: A prospective cohort study including VLBWIs admitted to our NICU from January 2015 to 2017 was conducted. Plasma N-terminal pro B type natriuretic peptide (NTproBNP) levels were measured, and echocardiograms were performed at 24 and 72 h of life and weekly thereafter until 36 weeks of postmenstrual age (PMA). We measured the tricuspid annular plane systolic excursion (TAPSE) by M-mode; the lateral tricuspid E', A', and S' waves; and the myocardial performance index (MPI) by tissue doppler imaging (TDI). The subjects were divided into non-BPD and BPD groups. Results: We included 101 VLBWIs. The TAPSE and E', A', and S' waves increased while MPI-TDI decreased over time. Birth gestational age (GA) and postnatal PMA impacted these parameters, which evolved differently in those who developed BPD compared to those in the non-BPD group. The NTproBNP levels at 14 days of life and different echocardiographic parameters were associated with the development of BPD in different multivariate models. Conclusion: TAPSE and TDI values depend on GA and PMA and follow a different temporal evolution that is related to the later development of BPD. Combined biochemical and echocardiographic biomarkers can help identify which VLBWIs are at higher risk of developing BDP.

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Echocardiographic evaluation of right ventricular function in preterm infants with bronchopulmonary dysplasia

Abstract: Right ventricular myocardial performance index measured by pulsed-wave Doppler indicates impaired right ventricular function in preterm infants with severe bronchopulmonary dysplasia.

Cited by 13 publications

References 28 publications

Echocardiographic Assessment of Right Ventricular Afterload in Preterm Infants: Maturational Patterns of Pulmonary Artery Acceleration Time Over the First Year of Age and Implications for Pulmonary Hypertension

Echocardiographic Assessment of Right Ventricular Afterload in Preterm Infants: Maturational Patterns of Pulmonary Artery Acceleration Time Over the First Year of Age and Implications for Pulmonary Hypertension

Early Pulmonary Vascular Disease in Preterm Infants Is Associated with Late Respiratory Outcomes in Childhood

Myocardial Function Maturation in Very-Low-Birth-Weight Infants and Development of Bronchopulmonary Dysplasia

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