Changes in pulmonary arterial pressure in preterm infants with chronic lung disease
N V Subhedar, N J Shaw
Neonatal Intensive
Care Unit, Liverpool Women's Hospital, Crown Street, Liverpool L8
7SS, UK
Correspondence to: Dr Subhedar email: n.v.subhedar_lwh{at}yahoo.com
Accepted 29
September 1999
BACKGROUND
Pulmonary
arterial pressure (PAP) is raised in preterm infants with respiratory
distress syndrome who subsequently develop chronic lung disease. The
natural history of pulmonary hypertension in infants with chronic lung
disease is unknown.
OBJECTIVESTo
investigate changes in PAP, assessed non-invasively using Doppler
echocardiography, in infants with chronic lung disease during the 1st
year of life.
METHODSSerial
examinations were performed in infants with chronic lung disease and
healthy preterm infants. The Doppler derived acceleration time to right
ventricular ejection time ratio (AT/RVET) was calculated from
measurements made from the pulmonary artery velocity waveform.
RESULTSA total of 248 examinations were performed in 54 infants with chronic lung disease and
44 healthy preterm infants. The median AT/RVET was significantly lower
in infants with chronic lung disease than in healthy preterm infants
(0.31 v 0.37). AT/RVET significantly correlated with age corrected for prematurity in both infants with
chronic lung disease (r = 0.67) and
healthy infants (r = 0.55). There was no
significant difference between the rate of change in AT/RVET between
the two groups. In infants with chronic lung disease, multivariate
analysis showed that AT/RVET was significantly independently associated
with age and inversely with duration of supplemental oxygen treatment.
Median AT/RVET was significantly lower in infants with chronic lung
disease until 40-52 weeks of age corrected for prematurity.
CONCLUSIONSAlthough
PAP falls with increasing age in both infants with chronic lung disease
and healthy preterm infants, it remains persistently raised in infants
with chronic lung disease until the end of the 1st year of life.
Keywords: pulmonary arterial pressure; chronic lung disease; Doppler echocardiography; acceleration time to right ventricular ejection time ratio; prematurity
© 2000 by Archives of Disease in Childhood
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