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

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

JOURNAL=Frontiers in Pediatrics

VOLUME=12

YEAR=2024

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2024.1349175

DOI=10.3389/fped.2024.1349175

ISSN=2296-2360

ABSTRACT=<sec><title>Objectives</title><p>To evaluate serial tissue Doppler cardiac imaging (TDI) in the evolution of bronchopulmonary dysplasia-associated pulmonary hypertension (BPD-PH) among extremely preterm infants.</p></sec><sec><title>Design</title><p>Prospective observational study.</p></sec><sec><title>Setting</title><p>Single-center, tertiary-level neonatal intensive care unit.</p></sec><sec><title>Patients</title><p>Infant born &lt;28 weeks gestation.</p></sec><sec><title>Main outcome measures</title><p>Utility of TDI in the early diagnosis and prediction of BPD-PH and optimal timing for screening of BPD-PH.</p></sec><sec><title>Results</title><p>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%, <italic>p</italic> &lt; 0.018), longer oxygen days (96.16 ± 68.09 vs. 59.35 ± 52.1, <italic>p</italic> &lt; 0.008), and prolonged hospital stay (133.8 ± 45.9 vs. 106.5 ± 37.9 days, <italic>p</italic> &lt; 0.005). The left ventricular eccentricity index (0.99 ± 0.1 vs. 1.1 ± 0.7, <italic>p</italic> &lt; 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, <italic>p</italic> &lt; 0.05). At 33 weeks, the BPD-PH group showed prolonged isovolumetric contraction time (27.84 ± 5.5 vs. 22.77 ± 4, <italic>p</italic> &lt; 0.001), prolonged isovolumetric relaxation time (40.3 ± 7.1 vs. 34.9 ± 5.3, <italic>p</italic> &lt; 0.003), and abnormal myocardial performance index (0.39 ± 0.05 vs. 0.32 ± 0.03, <italic>p</italic> &lt; 0.001). These differences persisted at 36 weeks after conceptional gestational age.</p></sec><sec><title>Conclusions</title><p>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.</p></sec>