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Nestaas E, Bjarkø L, Kiserud T, Haugen G, Fugelseth D. Heart function by M-mode and tissue Doppler in the early neonatal period in neonates with fetal growth restriction. Early Hum Dev 2023; 183:105809. [PMID: 37331046 DOI: 10.1016/j.earlhumdev.2023.105809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/12/2023] [Accepted: 06/12/2023] [Indexed: 06/20/2023]
Abstract
BACKGROUND Fetal growth restricted (FGR) neonates have increased risk of circulatory compromise due to failure of normal transition of circulation after birth. AIM Echocardiographic assessment of heart function in FGR neonates first three days after birth. STUDY DESIGN Prospective observational study. SUBJECTS FGR- and non-FGR neonates. OUTCOME MEASURES M-mode excursions and pulsed-wave tissue Doppler velocities normalised for heart size and E/e' of the atrioventricular plane day one, two and three after birth. RESULTS Compared with controls (non-FGR of comparable gestational age, n = 41), late-FGR (gestational age ≥ 32 weeks, n = 21) exhibited higher septal excursion (15.9 (0.6) vs. 14.0 (0.4) %, p = 0.021) (mean (SEM)) and left E/e' (17.3 (1.9) vs.11.5 (1.3), p = 0.019). Relative to day three, indexes on day one were higher for left excursion (21 (6) % higher on day one, p = 0.002), right excursion (12 (5) %, p = 0.025), left e' (15 (7) %, p = 0.049), right a' (18 (6) %, p = 0.001), left E/e' (25 (10) %, p = 0.015) and right E/e' (17 (7) %, p = 0.013), whereas no index changed from day two to day three. Late-FGR had no impact on changes from day one and two to day three. No measurements differed between early-FGR (n = 7) and late-FGR. CONCLUSIONS FGR impacted neonatal heart function the early transitional days after birth. Late-FGR hearts had increased septal contraction and reduced left diastolic function compared with controls. The dynamic changes in heart function between first three days were most evident in lateral walls, with similar pattern in late-FGR and non-FGR. Early-FGR and late-FGR exhibited similar heart function.
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Affiliation(s)
- Eirik Nestaas
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Clinic of Paediatrics and Adolescence, Akershus University Hospital, Lørenskog, Norway.
| | - Lisa Bjarkø
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Neonatal Intensive Care, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Torvid Kiserud
- Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Obstetrics and Gynaecology, Haukeland University Hospital, Bergen, Norway
| | - Guttorm Haugen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Fetal Medicine, Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Drude Fugelseth
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Neonatal Intensive Care, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
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Computational Analysis of Cardiac Contractile Function. Curr Cardiol Rep 2022; 24:1983-1994. [PMID: 36301405 PMCID: PMC10091868 DOI: 10.1007/s11886-022-01814-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/14/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE OF REVIEW Heart failure results in the high incidence and mortality all over the world. Mechanical properties of myocardium are critical determinants of cardiac function, with regional variations in myocardial contractility demonstrated within infarcted ventricles. Quantitative assessment of cardiac contractile function is therefore critical to identify myocardial infarction for the early diagnosis and therapeutic intervention. RECENT FINDINGS Current advancement of cardiac functional assessments is in pace with the development of imaging techniques. The methods tailored to advanced imaging have been widely used in cardiac magnetic resonance, echocardiography, and optical microscopy. In this review, we introduce fundamental concepts and applications of representative methods for each imaging modality used in both fundamental research and clinical investigations. All these methods have been designed or developed to quantify time-dependent 2-dimensional (2D) or 3D cardiac mechanics, holding great potential to unravel global or regional myocardial deformation and contractile function from end-systole to end-diastole. Computational methods to assess cardiac contractile function provide a quantitative insight into the analysis of myocardial mechanics during cardiac development, injury, and remodeling.
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Fiorenzano DM, Leal GN, Sawamura KSS, Lianza AC, Carvalho WBD, Krebs VLJ. Respiratory distress syndrome: influence of management on the hemodynamic status of ≤ 32-week preterm infants in the first 24 hours of life. Rev Bras Ter Intensiva 2019; 31:312-317. [PMID: 31618349 PMCID: PMC7005966 DOI: 10.5935/0103-507x.20190056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 03/09/2019] [Indexed: 11/21/2022] Open
Abstract
Objective To investigate the influence of respiratory distress syndrome management on clinical and echocardiographic parameters used for hemodynamic evaluation in ≤ 32- week newborns. Methods Thirty-three ≤ 32-week newborns were prospectively evaluated and subjected to invasive mechanical ventilation. The need for exogenous surfactant and clinical and echocardiographic parameters in the first 24 hours of life was detailed in this group of patients. Results The mean airway pressure was significantly higher in newborn infants who required inotropes [10.8 (8.8 - 23) cmH2O versus 9 (6.2 - 12) cmH2O; p = 0.04]. A negative correlation was found between the mean airway pressure and velocity-time integral of the pulmonary artery (r = -0.39; p = 0.026), right ventricular output (r = -0.43; p = 0.017) and measurements of the tricuspid annular plane excursion (r = -0.37; p = 0.036). A negative correlation was found between the number of doses of exogenous surfactant and the right ventricular output (r = -0.39; p = 0.028) and pulmonary artery velocity-time integral (r = -0.35; p = 0.043). Conclusion In ≤ 32-week newborns under invasive mechanical ventilation, increases in the mean airway pressure and number of surfactant doses are correlated with the worsening of early cardiac function. Therefore, more aggressive management of respiratory distress syndrome may contribute to the hemodynamic instability of these patients.
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Affiliation(s)
- Daniela Matos Fiorenzano
- Disciplina de Neonatologia, Departamento de Pediatria, Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo - São Paulo (SP), Brasil
| | - Gabriela Nunes Leal
- Serviço de Ecocardiografia Neonatal e Pediátrica, Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo - São Paulo (SP), Brasil
| | - Karen Saori Shiraishi Sawamura
- Serviço de Ecocardiografia Neonatal e Pediátrica, Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo - São Paulo (SP), Brasil
| | - Alessandro Cavalcanti Lianza
- Serviço de Ecocardiografia Neonatal e Pediátrica, Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo - São Paulo (SP), Brasil
| | - Werther Brunow de Carvalho
- Disciplina de Neonatologia, Departamento de Pediatria, Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo - São Paulo (SP), Brasil
| | - Vera Lúcia Jornada Krebs
- Disciplina de Neonatologia, Departamento de Pediatria, Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo - São Paulo (SP), Brasil
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Rocha LA, Rolo LC, Araujo Júnior E. How to perform a functional assessment of the fetal heart: a pictorial review. Ultrasonography 2019; 38:365-373. [PMID: 31288508 PMCID: PMC6773963 DOI: 10.14366/usg.18065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 02/07/2019] [Indexed: 11/24/2022] Open
Abstract
The purpose of this pictorial review was to describe various echocardiographic techniques that can be used for the functional assessment of the fetal heart. The systolic and diastolic assessments of the fetal heart are presented separately, with an emphasis on 2-dimensional Doppler methods and an overview of new technologies. The aim of this summary was to review the tools that can be used by the echocardiographer, and on that basis, to systematize the process of performing a functional assessment.
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Affiliation(s)
- Luciane Alves Rocha
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPMUNIFESP), São Paulo, Brazil
| | - Liliam Cristine Rolo
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPMUNIFESP), São Paulo, Brazil
| | - Edward Araujo Júnior
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPMUNIFESP), São Paulo, Brazil
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Terada T, Mori K, Inoue M, Yasunobu H. Mitral annular plane systolic excursion/left ventricular length (MAPSE/L) as a simple index for assessing left ventricular longitudinal function in children. Echocardiography 2016; 33:1703-1709. [PMID: 27545275 DOI: 10.1111/echo.13325] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Assessment of longitudinal left ventricular (LV) function is important for early detection of cardiac dysfunction. Although mitral annular plane systolic excursion (MAPSE) obtained by M-mode echocardiography offers a simple method for assessing longitudinal LV function, normal values of MAPSE for children change according to body size. METHODS To minimize the effects of body size, MAPSE was divided by LV long-axis length (MAPSE/L). MAPSE/L was measured in 210 healthy children from birth to 15 years of age and classified into five subgroups. MAPSE/L was then compared with 10 parameters in 136 children (age, heart rate, mean blood pressure, ejection fraction of the LV (EF), peak atrial flow velocity/peak early diastolic flow velocity of mitral flow, tissue Doppler velocity during systole (s') and early diastole (e'), E/e' ratio, Tei index, and global longitudinal strain (GLS) of the LV by the speckle tracking method). RESULTS MAPSE/L was significantly lower in the neonate group than in the remaining four groups. MAPSE/L then increased with age to peak at 1-5 years and gradually decreased thereafter. In all cases beyond the neonatal period, MAPSE/L was more than 0.17. Among various parameters, GLS, age, EF, Tei index and s' were significantly associated with MAPSE/L in that order. In univariate analysis, GLS was most significantly associated with MAPSE/L (r=.56). CONCLUSIONS We have established normal reference values for MPSE/L in healthy children. MAPSE/L is expected to offer a simple parameter to evaluate LV longitudinal systolic function during daily routine echocardiography in children.
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Affiliation(s)
- Tomomasa Terada
- Department of Pediatrics, Tokushima Prefectural Central Hospital, Tokushima, Japan
| | - Kazuhiro Mori
- Department of Pediatrics, Tokushima Prefectural Central Hospital, Tokushima, Japan
| | - Miki Inoue
- Department of Pediatrics, Tokushima Prefectural Central Hospital, Tokushima, Japan
| | - Hayabuchi Yasunobu
- Department of Pediatrics, Graduate School of Medical Sciences, Tokushima University, Tokushima, Japan
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Murase M. Assessing ventricular function in preterm infants using tissue Doppler imaging. Expert Rev Med Devices 2016; 13:325-38. [DOI: 10.1586/17434440.2016.1153966] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Longitudinal systolic left ventricular function in preterm and term neonates: reference values of the mitral annular plane systolic excursion (MAPSE) and calculation of z-scores. Pediatr Cardiol 2015; 36:20-6. [PMID: 25077661 DOI: 10.1007/s00246-014-0959-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 06/20/2014] [Indexed: 10/25/2022]
Abstract
The mitral annular plane systolic excursion (MAPSE) is a quick and reliable echocardiographic tool for assessing longitudinal left ventricular (LV) systolic function in children and adults. Because this parameter is affected by the LV longitudinal dimension, pediatric and adult normal values are not suitable for preterm and term neonates. A prospective study investigated a large group of preterm and term neonates [gestational age (GA), 26/0-6 to 40/0-6; birth weight (BW), 670-4,140 g]. The growth- and BW-related changes in MAPSE were determined to establish normal z-score values for preterm and term neonates. The MAPSE ranged from a mean of 0.36 ± 0.05 cm in preterm neonates with a GA of 26/0-6 to 0.56 ± 0.08 cm in term neonates with a GA of 40/0-6. The findings showed MAPSE, GA, and BW to be moderately correlated. Pearson's correlation coefficient was 0.56 for GA (MAPSE; p < 0.001) and 0.58 for BW (MAPSE; p < 0.001). The normal MAPSE values did not differ significantly between females and males (p = 0.946). The absolute values and z-scores of normal MAPSE values in healthy preterm and term neonates within the first 48 h of life were calculated, and percentile charts were established. Determination of LV function using MAPSE might be useful for vulnerable infants for whom a prolonged examination is inappropriate and for neonates with suboptimal visualization of the endocardium.
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James AT, Corcoran JD, Jain A, McNamara PJ, Mertens L, Franklin O, El-Khuffash AF. Assessment of myocardial performance in preterm infants less than 29 weeks gestation during the transitional period. Early Hum Dev 2014; 90:829-35. [PMID: 25463828 DOI: 10.1016/j.earlhumdev.2014.09.004] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 09/03/2014] [Accepted: 09/07/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND The transitional circulation and its effect on myocardial performance are poorly understood in preterm infants. AIMS We assessed myocardial performance in infants less than 29 weeks gestation in the first 48 h of life using a comprehensive echocardiographic assessment. DESIGN Infants <29 weeks gestation were prospectively enrolled. Small for gestation, infants on inotropes and/or inhaled nitric oxide and septic infants were excluded. Conventional echocardiography, left ventricular (LV), septal and right ventricular (RV) tissue Doppler imaging (TDI) and tissue Doppler-derived strain and strain rate (SR), tricuspid annular plane systolic excursion (TAPSE) and global RV fractional area change (FAC) were assessed at a median of 10 and 45 h post-delivery. RESULTS Fifty-four infants with a median [IQR] gestation and birth weight of 26.5 weeks [25.8-28.0 weeks] and 915 g [758-1142 g] were included. There was no change in shortening or ejection fraction across the two time points. Systolic and diastolic TDI of the LV, septum and RV increased across the two time points (all p values ≤ 0.01). There was an increase in septal peak systolic and early diastolic SR (p=0.002). Septal systolic strain and late diastolic SR did not change. With the exception of RV strain and early diastolic SR, all RV functional parameters including SR, late diastolic SR, TAPSE, and FAC increased across the two time points (all p values<0.01). CONCLUSION Describing the normal hemodynamic adaptations in stable preterm infants during the transitional period provides the necessary information for the assessment of those parameters in various disease states.
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Affiliation(s)
- Adam T James
- Department of Paediatrics, The Rotunda Hospital, Dublin, Ireland
| | - John D Corcoran
- Department of Paediatrics, The Rotunda Hospital, Dublin, Ireland
| | - Amish Jain
- Department of Paediatrics, Mount Sinai Hospital, Toronto, Canada; Department of Physiology, University of Toronto, Toronto, Canada; Physiology and Experimental Medicine, Hospital for Sick Children, Toronto, Canada
| | - Patrick J McNamara
- Physiology and Experimental Medicine, Hospital for Sick Children, Toronto, Canada; Department of Neonatology, The Hospital for Sick Children, Toronto, Canada
| | - Luc Mertens
- The Labatt Family Heart Centre, The Hospital for Children, Toronto, Canada
| | - Orla Franklin
- Department of Cardiology, Our Lady's Children's Hospital Crumlin, Dublin, Ireland
| | - Afif F El-Khuffash
- Department of Paediatrics, The Rotunda Hospital, Dublin, Ireland; Department of Paediatrics, Royal College of Surgeons in Ireland, Dublin, Ireland.
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Eriksen BH, Nestaas E, Hole T, Liestøl K, Støylen A, Fugelseth D. Myocardial function in term and preterm infants. Influence of heart size, gestational age and postnatal maturation. Early Hum Dev 2014; 90:359-64. [PMID: 24794303 DOI: 10.1016/j.earlhumdev.2014.04.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 03/24/2014] [Accepted: 04/08/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Sparse knowledge exists on the differences in cardiac function between term and preterm infants. This study examines the impact of heart size, gestational age and postnatal maturation on myocardial function. AIM To assess and compare serial echocardiographic indices of myocardial function in term and moderately preterm infants. METHODS Longitudinal, prospective, observational echocardiographic cohort study of 45 healthy term infants examined at day three and at 12-20weeks postnatal age and 53 moderately preterm infants (gestational age 31-35weeks) examined at day three and at term equivalent (4-10weeks postnatal age). OUTCOMES Primary: Systolic mitral and tricuspid annular plane excursions and annular peak systolic pulsed wave tissue Doppler (pwTDI) velocities. Secondary: Indices normalized for heart size. RESULTS On day three, all indices were higher in the term than in the preterm infants whereas normalized systolic pwTDI velocities were lower in the term infants and normalized excursions showed no difference. All indices increased with advanced postnatal age. The indices in term infants on day three were lower than in preterm infants at term equivalent, with and without normalization. After postnatal maturation in both groups, all indices were higher in the term group (except left pwTDI), whereas normalized indices showed no consistent pattern. CONCLUSIONS Myocardial function indices increased with gestational age at birth and more profoundly with postnatal maturation. Serial examinations of non-normalized and normalized myocardial function indices showed no sustained differences between the preterm and the term infants. Normalization by heart size may be of value when assessing myocardial function in infants.
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Affiliation(s)
- Beate Horsberg Eriksen
- Department of Paediatrics, Møre and Romsdal Hospital Trust, NO-6026 Ålesund, Norway; Department of Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Eirik Nestaas
- Department of Paediatrics, Vestfold Hospital Trust, Tønsberg, Norway
| | - Torstein Hole
- Department of Medicine, Møre and Romsdal Hospital Trust, Ålesund, Norway; Institute of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Knut Liestøl
- Institute of Informatics, University of Oslo, Norway
| | - Asbjørn Støylen
- Department of Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Department of Cardiology, St. Olavs Hospital, Trondheim, Norway
| | - Drude Fugelseth
- Department of Neonatal Intensive Care, Oslo University Hospital, Ullevål, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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Saleemi MSH, El-Khuffash A, Franklin O, Corcoran JD. Serial changes in myocardial function in preterm infants over a four week period: the effect of gestational age at birth. Early Hum Dev 2014; 90:349-52. [PMID: 24796208 DOI: 10.1016/j.earlhumdev.2014.04.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 04/07/2014] [Accepted: 04/12/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Myocardial performance is impaired in the first days of life in preterm infants but improves by day 5. Tissue Doppler imaging (TDI) is a novel and reliable means of assessing myocardial performance. OBJECTIVE To investigate myocardial performance using TDI and shortening fraction (SF) in preterm infants of different gestational age groups and serial changes in these parameters in first four weeks of life. Study design Infants less than 36 weeks of gestation were divided into group 1 (24-27 weeks, n=8), group 2 (28-31 weeks, n=12) and group 3 (32-35 weeks, n=13). Infants with severe congenital malformations, a hypoxic insult at birth, and those on inotropic support were excluded. Echocardiograms were performed at 36-48 hours, 2 weeks and 4 weeks of life. Left ventricular (LV) SF, systolic (S'), early diastolic (E') and late diastolic (A') TDI velocities were assessed. We analyzed the data using a repeated-measures ANOVA. RESULTS Thirty three infants underwent serial TDI and SF measurements. There was an increase in LV S' (p=.02) and E' (.01) velocities in group 2 , and in group 3 (p=.03 for S' and p=.04 for E'), but no significant increase in group 1 (p=.48 for S' and .32 for E'). At each study point, there was significant difference in myocardial performance between group 1 and 3 for each of the parameters (p<.05). There was no significant increase in SF over time in any of the groups. CONCLUSION We describe a serial increase in myocardial performance in infants of 28 weeks gestation and above. While there was no change in myocardial performance among the most extremely preterm infants, this may have been the result of small sample size of the group.
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Affiliation(s)
| | | | - Orla Franklin
- Department of Cardiology, Children's University Hospital, Temple Street, Dublin, Ireland
| | - John David Corcoran
- Department of Neonatology, Rotunda Hospital, Dublin, Ireland; Department of Paediatrics, Trinity College University, Dublin, Ireland
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Baker CD, Abman SH, Mourani PM. Pulmonary Hypertension in Preterm Infants with Bronchopulmonary Dysplasia. PEDIATRIC ALLERGY IMMUNOLOGY AND PULMONOLOGY 2014; 27:8-16. [PMID: 24669351 DOI: 10.1089/ped.2013.0323] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 01/16/2014] [Indexed: 01/02/2023]
Abstract
Bronchopulmonary dysplasia (BPD), the chronic lung disease of prematurity, is a significant contributor to perinatal morbidity and mortality. Premature birth disrupts pulmonary vascular growth and initiates a cascade of events that result in impaired gas exchange, abnormal vasoreactivity, and pulmonary vascular remodeling that may ultimately lead to pulmonary hypertension (PH). Even infants who appear to have mild BPD suffer from varying degrees of pulmonary vascular disease (PVD). Although recent studies have enhanced our understanding of the pathobiology of PVD and PH in BPD, much remains unknown with respect to how PH should be properly defined, as well as the most accurate methods for the diagnosis and treatment of PH in infants with BPD. This article will provide neonatologists and primary care providers, as well as pediatric cardiologists and pulmonologists, with a review of the pathophysiology of PH in preterm infants with BPD and a summary of current clinical recommendations for managing PH in this population.
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Affiliation(s)
- Christopher D Baker
- Section of Pulmonary Medicine, University of Colorado School of Medicine , Aurora, Colarado. ; Pediatric Heart Lung Center, University of Colorado School of Medicine , Aurora, Colarado
| | - Steven H Abman
- Section of Pulmonary Medicine, University of Colorado School of Medicine , Aurora, Colarado. ; Pediatric Heart Lung Center, University of Colorado School of Medicine , Aurora, Colarado
| | - Peter M Mourani
- Pediatric Heart Lung Center, University of Colorado School of Medicine , Aurora, Colarado. ; Section of Critical Care Medicine, Department of Pediatrics, University of Colorado School of Medicine , Aurora, Colarado
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