Correlating objective echocardiographic parameters in patients with pulmonary hypertension due to bronchopulmonary dysplasia

OBJECTIVE

Echocardiographic parameters assessing left and right heart function were evaluated in children with established pulmonary hypertension (PH) from bronchopulmonary dysplasia (BPD) to look for correlations with each other, and pulmonary artery pressure (PAPs) from right heart catheterizations (RHC).

STUDY DESIGN

Data were retrospectively collected on patients with BPD and PH and correlations were performed between various objective echocardiographic and RHC measurements.

RESULTS

A total of 31 patients with BPD were found to have PH by echocardiogram and RHC after chart review. Median age of evaluation was 0.58 years. Correlations were noted between measurements of right heart function, indirect measures of pulmonary artery pressures and left ventricular dimensions. A trend was noted between the tricuspid annular plane systolic excursion obtained at echocardiography and systolic pulmonary artery pressure, obtained during RHC.

CONCLUSION

Significant correlations were found between objective echocardiographic measurements of left and right heart function, in patients with PH from BPD.

Echocardiography in pulmonary arterial hypertension

In the context of pulmonary arterial hypertension (PAH), echocardiographic assessment of right ventricular (RV) function is key to determining disease severity and prognosis. Using Doppler echocardiography (ECHO) there are numerous ways that RV function can be measured, either directly or indirectly, to capture the triad of changes in RV geometry, right-to-left interaction, and RV systolic dysfunction in response to high pulmonary vascular resistance states, such as PAH. To fully evaluate and characterize the nature and extent of the impact of PAH on the RV in an individual patient, it is critical to assess a combination of these direct and indirect measures of RV function. In order to predict changes in status and have prognostic significance, the variables used must be easy to measure, reproducible, and clinically relevant. This review assesses the relative value of different ECHO parameters and looks at what the future holds for ECHO imaging of the right heart in PAH.