Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Aug;36(8):1524-1531.
doi: 10.1111/echo.14430. Epub 2019 Jul 1.

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

Jessica S Gaulton  1 , Laura M Mercer-Rosa  2 , Andrew C Glatz  2 , Erik A Jensen  1 , Valerie Capone  2 , Courtney Scott  2 , Scott M Appel  3 , Jason Z Stoller  1 , María V Fraga  1
Affiliations

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

Jessica S Gaulton et al. Echocardiography. 2019 Aug.

Abstract

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.

Keywords: Doppler echocardiography; patent ductus arteriosus; pediatric echocardiography; pulmonary artery; pulmonary artery hypertension; pulmonary hypertension.

PubMed Disclaimer

References

REFERENCES

    1. Simonneau G, Gatzoulis MA, Adatia I, et al. Updated clinical classification of pulmonary hypertension. J Am Coll Cardiol. 2013;62(25 suppl):D34-D41.
    1. Khemani E, McElhinney DB, Rhein L, et al. Pulmonary artery hypertension in formerly premature infants with bronchopulmonary dysplasia: clinical features and outcomes in the surfactant era. Pediatrics. 2007;120(6):1260-1269.
    1. Koestenberger M, Apitz C, Abdul-Khaliq H, Hansmann G. Transthoracic echocardiography for the evaluation of children and adolescents with suspected or confirmed pulmonary hypertension. Expert consensus statement on the diagnosis and treatment of paediatric pulmonary hypertension. The European Paediatric Pulmonary Vascular Disease Network, endorsed by ISHLT and D6PK. Heart. BMJ Publishing Group Ltd and British Cardiovascular Society. 2016;102(suppl 2):ii14-ii22.
    1. O'Byrne ML, Kennedy KF, Kanter JP, Berger JT, Glatz AC. Risk factors for major early adverse events related to cardiac catheterization in children and young adults with pulmonary hypertension: an analysis of data from the IMPACT (Improving Adult and Congenital Treatment) registry. J Am Heart Assoc. 2018;7(5):6-8.
    1. O'Byrne ML, Glatz AC, Hanna BD, et al. Predictors of catastrophic adverse outcomes in children with pulmonary hypertension undergoing cardiac catheterization. J Am Coll Cardiol. 2015;66(11):1261-1269.

Publication types

MeSH terms

LinkOut - more resources