Pulmonary hypertension in bronchopulmonary dysplasia: Clinical findings, cardiovascular anomalies and outcomes

Maria Jesus del Cerro; Anna Sabaté Rotés; Antonio Cartón; Lucia Deiros; Montserrat Bret; Malaika Cordeiro; Cristina Verdú; Maria Isabel Barrios; Luis Albajara; Federico Gutierrez‐Larraya

doi:10.1002/ppul.22797

journal article Jun 20, 2013

Pulmonary hypertension in bronchopulmonary dysplasia: Clinical findings, cardiovascular anomalies and outcomes

Maria Jesus del Cerro Anna Sabaté Rotés Antonio Cartón Lucia Deiros Montserrat Bret Malaika Cordeiro Cristina Verdú Maria Isabel Barrios Luis Albajara Federico Gutierrez‐Larraya

Pediatric Pulmonology Vol. 49 No. 1 pp. 49-59 · Wiley

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Abstract

AbstractObjectivePulmonary hypertension (PH) worsens the prognosis of bronchopulmonary dysplasia (BPD). The following items have not been fully established for PH in BPD: clinical characterization, incidence of cardiovascular anomalies (CVAs), response to PH treatment, and outcome.Study DesignA review of clinical records, computed tomography (CT) images and catheterization data of 36 patients with PH‐BPD referred to our PH Unit (March 2006 to December 2011) was performed. Twenty‐nine patients without major congenital heart defects and with complete follow‐up data were included.ResultsThe diagnosis of PH was made at a median age of 4.5 months (IQR 2.4–7.8), with an echocardiography estimated median right ventricular pressure/systemic pressure ratio of 70% (IQR 60–80%). CT scanning was performed in 21 patients and catheterization in 14 patients. CVAs were found in 19 patients (65.5%): aortopulmonary collaterals (n = 9), pulmonary vein stenosis (n = 7), ASD (n = 4), and PDA (n = 9). Hemodynamic data: PVRI 4.3 UW m2 (2.7–7); PVRI/SVRI 0.44 (0.32–0.8); and transpulmonary gradient 28 mmHg (19–40). At a median follow‐up of 35 months (IQR 21–91), 6 patients had undergone shunts closure, 22 received specific PH drugs, 3 spontaneously improved of their PH, and 8 (26%) had died.ConclusionPH in BPD is not always a transient condition; it can be diagnosed at later stages and can have a protracted course. The incidence of associated CVAs is high. Prompt diagnosis, detection, and treatment of CVAs, and specific drug therapy can improve the outcome in these patients, although the mortality rate remains high. Pediatr Pulmonol. 2014; 49:49–59. © 2013 Wiley Periodicals, Inc.

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161

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Details

Published: Jun 20, 2013
Vol/Issue: 49(1)
Pages: 49-59
License: View

Authors

M

Maria Jesus del Cerro

Pediatric Cardiology Department La Paz Children's Hospital Madrid Spain

A

Anna Sabaté Rotés

Pediatric Cardiology Department La Paz Children's Hospital Madrid Spain; Autonoma University of Barcelona Pediatrics Department La Paz Children's Hospital Madrid Spain

A

Antonio Cartón

Pediatric Cardiology Department La Paz Children's Hospital Madrid Spain

L

Lucia Deiros

Pediatric Cardiology Department La Paz Children's Hospital Madrid Spain

M

Montserrat Bret

Pediatric Radiology Department La Paz Children's Hospital Madrid Spain

M

Malaika Cordeiro

Neonatology Department La Paz Children's Hospital Madrid Spain

C

Cristina Verdú

Intensive Care Unit La Paz Children's Hospital Madrid Spain

M

Maria Isabel Barrios

Pediatric Neumology Department La Paz Children's Hospital Madrid Spain

L

Luis Albajara

Pediatrics Department La Paz Children's Hospital Madrid Spain

F

Federico Gutierrez‐Larraya

Pediatric Cardiology Department La Paz Children's Hospital Madrid Spain

Funding

none reported

Cite This Article

Maria Jesus del Cerro, Anna Sabaté Rotés, Antonio Cartón, et al. (2013). Pulmonary hypertension in bronchopulmonary dysplasia: Clinical findings, cardiovascular anomalies and outcomes. Pediatric Pulmonology, 49(1), 49-59. https://doi.org/10.1002/ppul.22797

Pulmonary hypertension in bronchopulmonary dysplasia: Clinical findings, cardiovascular anomalies and outcomes

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