D15-08 Persistent Pulmonary Vascular Disease Over the Preschool Age in Children With Bronchopulmonary Dysplasia: A Catheterization-based Study
Abstract
Bronchopulmonary dysplasia-associated pulmonary hypertension (BPD-PH) is a major cause of death in extremely preterm infants. While echocardiography often suggests BPD-PH resolution by age 2, our previous right heart catheterization (RHC) studies indicated that most affected infants still had persistent pulmonary vascular disease (PVD) and mild PH at that time. The long-term hemodynamic status into later childhood is unknown.
To evaluate the longitudinal hemodynamic status of patients with BPD-PH through the preschool years using serial RHC.
We conducted a single-center, prospective observational cohort study enrolling 125 infants born at less than 28 weeks’ gestation (Jan 2018-Dec 2024). Patients developing BPD-PH were managed in a specialized follow-up clinic. The protocol included a planned first RHC around age 2 and a subsequent, follow-up RHC during the preschool years (approx. 4-6 years) for a subset of patients.
Fourteen patients (11.2%) were diagnosed with BPD-PH (median gestation 24 weeks; median birth weight 603 g). Ten (71%) had received sildenafil by 40 weeks postmenstrual age. In most cases, PH resolved on echocardiography during follow-up. Nine of the 14 patients underwent the first RHC at a median age of 25 months. This evaluation revealed persistent, mild PH, with a median mean pulmonary arterial pressure (mPAP) of 20 mmHg and a median pulmonary vascular resistance index (PVRi) of 2.72 WU⋅m2. Pulmonary wedge angiography showed reduced peripheral pulmonary…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 125 participants or records.
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