Clinical Utility of Echocardiography for the Diagnosis and Prognosis in Children with Bronchopulmonary Dsyplasia
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Background: Bronchopulmonary dysplasia (BPD) may result in chronic pulmonary artery hypertension and right ventricular(RV) dysfunction. Various echocardiographic assessments of RV dysfunction have been used to determine whether echocardiographicmeasurements of premature infants with BPD could provide sensitive measures of RV function that correlates with BPDseverity. Methods: Twenty-eight control subjects without BPD (non BPD group), 28 patients with mild BPD, 11 patients with moderateBPD, and six patients with severe BPD underwent echocardiograms with standard measurement such as ejection fraction byM-mode, tricuspid regurgitation pressure gradient, myocardial performance index (MPI) derived from pulse Doppler, and tissueDoppler imaging (TDI) measurements. BPD severity was classified by the NICHD/NHLBI/ORD workshop rating scale. Twenty-eight control subjects without BPD (non BPD group), 28 patients with mild BPD, 11 patients with moderate BPD, and sixpatients with severe BPD underwent echocardiograms with standard measurement such as ejection fraction by M-mode, tricuspidregurgitation pressure gradient, myocardial performance index (MPI) derived from pulse Doppler, and TDI measurements. BPD severity was classified by the NICHD/NHLBI/ORD workshop rating scale. Results: None of the standard echocardiographic findings was significantly different between the control group and BPDgroups. However, mean septal TDI-MPI of the severe BPD group (0.68 ± 0.06) was significantly (p < 0.01) higher than that of thenon-BPD (0.58 ± 0.10) or the mild BPD group (0.59 ± 0.12). In addition, mean RV TDI-MPI of the severe BPD group (0.71 ±0.13) was significantly (p < 0.05) higher than that of the non-BPD group (0.56 ± 0.08) or the mild BPD group (0.60 ± 0.125). Linear regression showed a good correlation between the severity of BPD and RV TDI-MPI (p = 0.01, R = 0.30) or septal TDIMPI(p = 0.04, R = 0.24). Conclusion: Echocardiographic evaluation of RV function based on an assessment of RV TDI-MPI can provide RV dysfunctionparameter in premature infants with BPD.
Abstract
Background: Bronchopulmonary dysplasia (BPD) may result in chronic pulmonary artery hypertension and right ventricular(RV) dysfunction. Various echocardiographic assessments of RV dysfunction have been used to determine whether echocardiographicmeasurements of premature infants with BPD could provide sensitive measures of RV function that correlates with BPDseverity. Methods: Twenty-eight control subjects without BPD (non BPD group), 28 patients with mild BPD, 11 patients with moderateBPD, and six patients with severe BPD underwent echocardiograms with standard measurement such as ejection fraction byM-mode, tricuspid regurgitation pressure gradient, myocardial performance index (MPI) derived from pulse Doppler, and tissueDoppler imaging (TDI) measurements. BPD severity was classified by the NICHD/NHLBI/ORD workshop rating scale. Twenty-eight control subjects without BPD (non BPD group), 28 patients with mild BPD, 11 patients with moderate BPD, and sixpatients with severe BPD underwent echocardiograms with standard measurement such as ejection fraction by M-mode, tricuspidregurgitation pressure gradient, myocardial performance index (MPI) derived from pulse Doppler, and TDI measurements. BPD severity was classified by the NICHD/NHLBI/ORD workshop rating scale. Results: None of the standard echocardiographic findings was significantly different between the control group and BPDgroups. However, mean septal TDI-MPI of the severe BPD group (0.68 ± 0.06) was significantly (p < 0.01) higher than that of thenon-BPD (0.58 ± 0.10) or the mild BPD group (0.59 ± 0.12). In addition, mean RV TDI-MPI of the severe BPD group (0.71 ±0.13) was significantly (p < 0.05) higher than that of the non-BPD group (0.56 ± 0.08) or the mild BPD group (0.60 ± 0.125). Linear regression showed a good correlation between the severity of BPD and RV TDI-MPI (p = 0.01, R = 0.30) or septal TDIMPI(p = 0.04, R = 0.24). Conclusion: Echocardiographic evaluation of RV function based on an assessment of RV TDI-MPI can provide RV dysfunctionparameter in premature infants with BPD.
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