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
. 2024 Apr 5:12:1349175.
doi: 10.3389/fped.2024.1349175. eCollection 2024.

Serial tissue Doppler imaging in the evaluation of bronchopulmonary dysplasia-associated pulmonary hypertension among extremely preterm infants: a prospective observational study

Krishna Revanna Gopagondanahalli  1   2   3   4 , Abdul Alim Abdul Haium  1   2   3   4 , Shrenik Jitendrakumar Vora  1   2   3   4 , Sreekanthan Sundararaghavan  2   3   4   5 , Wei Di Ng  1   2   3   4 , Tze Liang Jonathan Choo  2   3   4   5 , Wai Lin Ang  5 , Nur Qaiyimah Binte Mohamad Taib  5 , Nishanthi Han Ying Wijedasa  1 , Victor Samuel Rajadurai  1   2   3   4 , Kee Thai Yeo  1   2   3   4 , Teng Hong Tan  2   3   4   5
Affiliations

Serial tissue Doppler imaging in the evaluation of bronchopulmonary dysplasia-associated pulmonary hypertension among extremely preterm infants: a prospective observational study

Krishna Revanna Gopagondanahalli et al. Front Pediatr. .

Abstract

Objectives: To evaluate serial tissue Doppler cardiac imaging (TDI) in the evolution of bronchopulmonary dysplasia-associated pulmonary hypertension (BPD-PH) among extremely preterm infants.

Design: Prospective observational study.

Setting: Single-center, tertiary-level neonatal intensive care unit.

Patients: Infant born <28 weeks gestation.

Main outcome measures: Utility of TDI in the early diagnosis and prediction of BPD-PH and optimal timing for screening of BPD-PH.

Results: A total of 79 infants were included. Of them, 17 (23%) had BPD-PH. The mean gestational age was 25.9 ± 1.1 weeks, and mean birth weight was 830 ± 174 g. The BPD-PH group had a high incidence of hemodynamically significant patent ductus arteriosus (83% vs. 56%, p < 0.018), longer oxygen days (96.16 ± 68.09 vs. 59.35 ± 52.1, p < 0.008), and prolonged hospital stay (133.8 ± 45.9 vs. 106.5 ± 37.9 days, p < 0.005). The left ventricular eccentricity index (0.99 ± 0.1 vs. 1.1 ± 0.7, p < 0.01) and the ratio of acceleration time to right ventricular ejection time showed a statistically significant trend from 33 weeks (0.24 ± 0.05 vs. 0.28 ± 0.05, p < 0.05). At 33 weeks, the BPD-PH group showed prolonged isovolumetric contraction time (27.84 ± 5.5 vs. 22.77 ± 4, p < 0.001), prolonged isovolumetric relaxation time (40.3 ± 7.1 vs. 34.9 ± 5.3, p < 0.003), and abnormal myocardial performance index (0.39 ± 0.05 vs. 0.32 ± 0.03, p < 0.001). These differences persisted at 36 weeks after conceptional gestational age.

Conclusions: TDI parameters are sensitive in the early evolution of BPD-PH. Diagnostic accuracy can be increased by combining the TDI parameters with conventional echocardiographic parameters. BPD-PH can be recognizable as early as 33-34 weeks of gestation.

Keywords: bronchopulmonary dysplasia; conventional echocardiogram; extreme prematurity; pulmonary hypertension; tissue Doppler imaging.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Study flow chart.
Figure 2
Figure 2
(A) ROC curve of conventional echocardiographic parameters in predicting BPD-PH. (B) ROC curve of TDI parameters in predicting BPD-PH.
Figure 3
Figure 3
(A) Cluster box plot of LV EI. (B) Cluster box plot of IVCT. (C) Cluster box plot of IVRT. (D) Cluster box plot of MPI.
Figure 4
Figure 4
Echocardiogram images of the study population.
See this image and copyright information in PMC

References

    1. Islam JY, Keller RL, Aschner JL, Hartert TV, Moore PE. Understanding the short- and long-term respiratory outcomes of prematurity and bronchopulmonary dysplasia. Am J Respir Crit Care Med. (2015) 192(2):134–56. 10.1164/rccm.201412-2142PP - DOI - PMC - PubMed
    1. Lignelli E, Palumbo F, Myti D, Morty RE. Recent advances in our understanding of the mechanisms of lung alveolarization and bronchopulmonary dysplasia. Am J Physiol Lung Cell Mol Physiol. (2019) 317(6):L832–87. 10.1152/ajplung.00369.2019 - DOI - PubMed
    1. Baker CD, Abman SH, Mourani PM. Pulmonary hypertension in preterm infants with bronchopulmonary dysplasia. Pediatr Allergy Immunol Pulmonol. (2014) 27(1):8–16. 10.1089/ped.2013.0323 - DOI - PMC - PubMed
    1. Levy PT, Levin J, Leeman KT, Mullen MP, Hansmann G, Kourembanas S. Diagnosis and management of pulmonary hypertension in infants with bronchopulmonary dysplasia. Semin Fetal Neonatal Med. (2022) 27(4):101351. 10.1016/j.siny.2022.101351 - DOI - PubMed
    1. Arjaans S, Zwart EAH, Ploegstra M, Bos AF, Kooi EMW, Hillege HL, et al. Identification of gaps in the current knowledge on pulmonary hypertension in extremely preterm infants: a systematic review and meta-analysis. Paediatr Perinat Epidemiol. (2018) 32(3):258–67. 10.1111/ppe.12444 - DOI - PubMed

LinkOut - more resources