Long-Term Outcomes of Pulmonary Hypertension in Preterm Infants with Bronchopulmonary Dysplasia

Neonatology. 2016;110(3):181-9. doi: 10.1159/000445476. Epub 2016 May 13.

Abstract

Background: The long-term cardiovascular outcomes of pulmonary hypertension (PH) in preterm infants with bronchopulmonary dysplasia (BPD) are uncertain.

Objectives: The purpose of this study was to assess outcomes of PH in prematurely born children diagnosed with moderate to severe BPD.

Methods: We retrospectively reviewed the medical records of patients born before 32 weeks of gestation and diagnosed with moderate to severe BPD from June 2004 to April 2008. Patients were recruited for a cross-sectional study from August to October 2014 and underwent echocardiography.

Results: Forty-two children were enrolled. Their mean gestational age and birth weight were 26.2 ± 1.7 weeks and 753.1 ± 172.5 g, respectively. Sixteen patients (38%) were diagnosed with PH at a mean age of 3.3 ± 1.6 months, and the PH improved after a median of 12.3 months (range 0.7-46.6). Cardiovascular function was reassessed at a mean age of 7.7 ± 0.9 years, at which time 1 patient was taking a medication for recurrent PH, and 12 (28.6%) patients exhibited elevated blood pressure. Conventional 2-dimensional and Doppler echocardiography indicated normal ventricular function in all children. However, right ventricular longitudinal strains were decreased in children with previous PH.

Conclusions: Subclinical ventricular dysfunction was detectable using sensitive echocardiographic techniques in children with previous BPD-associated PH. Long-term follow-up and meticulous cardiovascular function assessment are required in this population.

MeSH terms

  • Birth Weight
  • Bronchopulmonary Dysplasia / complications*
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Echocardiography, Doppler
  • Female
  • Gestational Age
  • Humans
  • Hypertension, Pulmonary / diagnostic imaging*
  • Hypertension, Pulmonary / epidemiology*
  • Infant
  • Infant, Newborn
  • Infant, Premature*
  • Infant, Very Low Birth Weight*
  • Logistic Models
  • Male
  • Republic of Korea
  • Retrospective Studies
  • Ventricular Dysfunction / diagnostic imaging*