Evidence of Echocardiographic Markers of Pulmonary Vascular Disease in Asymptomatic Infants Born Preterm at One Year of Age

Levy, Paul C.; Patel, Meghna; Choudhry, Swati; Hamvas, Aaron; Singh, Gautam K.

doi:10.1016/j.jpeds.2018.02.006

Cited by 57 publications

(88 citation statements)

References 45 publications

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“…Levy et al showed that the presence of a PDA in preterm infants at 36 weeks PMA did not affect PAAT values measured later, at 1 year of age. However, only 4% of the patients had PDAs at 1 year of age, at the time that the PAAT values were measured . In our study, 77% of patients had PDAs at the time of PAAT measurement, and the majority had left‐to‐right shunting lesions.…”

Section: Discussioncontrasting

confidence: 99%

“…However, our results show that PAAT, corrected for HR, does correlate with mPAP and sPAP. We also showed that our PAAT/RVET ratios in preterm infants were significantly higher than those previously published by Levy et al . Our hypothesis is that the ratio of PAAT/RVET does not correlate with PA pressures because our patients have higher heart rates and therefore shorter RVETs compared to those in previous reports .…”

Section: Discussioncontrasting

confidence: 57%

“…Our study demonstrates a weak inverse association between PAAT measured by echocardiography and parameters of PAH derived from cardiac catheterization in a cohort of infants with a high incidence of prematurity and PDAs. The relationship between PAAT and PAH in our population is not as robust as previously reported in infants born preterm or term at 1 year of age and older …”

Section: Discussionmentioning

confidence: 65%

“…To further assess why PAAT/RVET did not correlate with PA pressures, we compared our data to prior published data. We found that the mean PAAT/RVET values in our cohort were significantly higher in preterm infants than previously published values (Table ) . Although RVET may be affected by RV dysfunction, we found no correlation between TAPSE, a quantitative measure of RV function, and RVET ( r = 0.18, P = 0.18) in our cohort (Figure ).…”

Section: Resultsmentioning

confidence: 99%

“…There is also emerging evidence suggesting the utility of PAAT for diagnosing PAH in the preterm population; however, the evidence is sparse . Most pediatric studies evaluating the relationship of PAAT and PAH excluded patients with a patent ductus arteriosus (PDA) .…”

Section: Introductionmentioning

confidence: 99%

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Relationship between pulmonary artery acceleration time and pulmonary artery pressures in infants

et al. 2019

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Background Pulmonary artery acceleration time measured by echocardiography inversely correlates with pulmonary artery pressures in adults and children older than 1 year of age. There is a paucity of data investigating this relationship in young children, particularly among preterm infants. Objective To characterize the relationship between pulmonary artery acceleration time (PAAT) and pulmonary artery pressures in infants. Design/Methods Patients ≤ 1 year of age at Children's Hospital of Philadelphia between 2011 and 2017 were reviewed. Infants with congenital heart disease were excluded, except those with a patent ductus arteriosus (PDA), atrial septal defect (ASD), or ventricular septal defect (VSD). Linear regression analysis was used to assess the correlation between PAAT measured by echocardiography and systolic pulmonary artery pressure, mean pulmonary artery pressure, and indexed pulmonary vascular resistance from cardiac catheterization. Results Fifty‐seven infants were included, of which 61% were preterm and 49% had a diagnosis of bronchopulmonary dysplasia. The median postmenstrual age and weight at catheterization were 51.1 weeks (IQR 35.8–67.9 weeks) and 4400 g (IQR 3100–6500 g), respectively. Forty‐four infants (77%) had a patent ductus arteriosus (PDA). There was a weak inverse correlation between PAAT with mPAP (r = −0.35, P = 0.01), sPAP (r = −0.29, P = 0.03), and PVRi (r = −0.29, P = 0.03). Conclusion There is a weak inverse relationship between PAAT and pulmonary artery pressures. This relationship is less robust in our population of infants with a high incidence of PDAs compared to previous studies in older children. Thus, PAAT may be less clinically meaningful for diagnosing pulmonary arterial hypertension in infants, particularly those with PDAs.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussioncontrasting

confidence: 57%

Section: Discussionmentioning

confidence: 65%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Relationship between pulmonary artery acceleration time and pulmonary artery pressures in infants

et al. 2019

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Cardiac Performance in the First Year of Age Among Preterm Infants Fed Maternal Breast Milk

et al. 2021

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IMPORTANCE There is a beneficial association between human breast milk exposure in the neonatal period and cardiac mechanics in adults who were born preterm. It is unknown whether this benefit is apparent in infants in the first year of age.OBJECTIVE To test the hypothesis that higher consumption of mother's own milk in preterm infants is associated with enhanced cardiac performance during the first year of age. DESIGN, SETTING, AND PARTICIPANTSThis cross-sectional study of cardiac and nutritional data at an academic medical center included 80 individuals born preterm and 100 individuals in the control group born full-term. All births were between 2011 and 2013. Two-dimensional echocardiograms were performed at 32 weeks' and 36 weeks' postmenstrual age and at 1 year's corrected age in individuals born preterm and at 1 month and 1 year of age in individuals born fullterm. Statistical analysis was performed from January to May 2021. EXPOSURES Consumption of mother's own milk. MAIN OUTCOMES AND MEASURESMain study outcomes included echocardiography measures of right and left ventricle longitudinal strain (function), left ventricle mass index and right ventricular areas (morphology), and pulmonary vascular resistance (pulmonary hemodynamics) at age 1 year. RESULTSOf 180 infants included in the study, 97 (54%) were Black infants and 89 (49%) were female infants. Among the 80 infants born in the preterm cohort, 43 (54%) were female infants and 43 (54%) were Black infants. The median gestational age at birth of the preterm infants was 27.0 weeks (interquartile range, 26.0-28.0 weeks) and the median birth weight was 960 g (interquartile range, 800-1138). For each week of exposure to mother's own milk, preterm infants had greater magnitudes of right ventricular strain (eg,

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Echocardiographic Assessment of the Transitional Circulation

Ashrafi

Altit

2021

Echocardiography in Pediatric and Congenital Heart Disease

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Evidence of Echocardiographic Markers of Pulmonary Vascular Disease in Asymptomatic Infants Born Preterm at One Year of Age

Cited by 57 publications

References 45 publications

Relationship between pulmonary artery acceleration time and pulmonary artery pressures in infants

Relationship between pulmonary artery acceleration time and pulmonary artery pressures in infants

Cardiac Performance in the First Year of Age Among Preterm Infants Fed Maternal Breast Milk

Echocardiographic Assessment of the Transitional Circulation

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