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Patent ductus arteriosus and the risk of bronchopulmonary dysplasia-associated pulmonary hypertension

BACKGROUND: To determine whether prolonged exposure to a moderate/large patent ductus arteriosus left-to-right shunt (PDA) increases the risk of late (beyond 36 weeks) pulmonary hypertension (BPD-PH) and pulmonary vascular disease (BPD-PVD) during the neonatal hospitalization in preterm infants (<...

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Autores principales: Nawaytou, Hythem, Hills, Nancy K., Clyman, Ronald I.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10403370/
https://www.ncbi.nlm.nih.gov/pubmed/36804505
http://dx.doi.org/10.1038/s41390-023-02522-4
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author Nawaytou, Hythem
Hills, Nancy K.
Clyman, Ronald I.
author_facet Nawaytou, Hythem
Hills, Nancy K.
Clyman, Ronald I.
author_sort Nawaytou, Hythem
collection PubMed
description BACKGROUND: To determine whether prolonged exposure to a moderate/large patent ductus arteriosus left-to-right shunt (PDA) increases the risk of late (beyond 36 weeks) pulmonary hypertension (BPD-PH) and pulmonary vascular disease (BPD-PVD) during the neonatal hospitalization in preterm infants (<28 weeks’ gestation) with bronchopulmonary dysplasia (BPD). METHODS: All infants requiring respiratory support ≥36 weeks had systematic echocardiographic evaluations for BPD-PH at planned intervals. Infants were classified as having either flow-associated BPD-PH (BPD-flow-PH) or BPD-PVD. RESULTS: 256 infants survived ≥36 weeks: 105 had NO BPD (were off respiratory support by 36 weeks); 151 had BPD. 22/151 had BPD-PH (12/22 had BPD-flow-PH from a PDA that persisted beyond 36 weeks; 10/22 had BPD-PVD). Moderate/large PDA shunts that persisted beyond 36 weeks were significantly associated with an increased incidence of BPD-PH due to BPD-flow-PH. We found no association between the duration of PDA exposure and the incidence of BPD-PVD. CONCLUSION: Moderate/large PDA shunts increase the risk of flow-associated BPD-PH when present beyond 36 weeks. Although term infants with PDA-congenital heart disease can develop pulmonary vascular remodeling and PVD after months of PDA exposure, we found no echocardiographic evidence in preterm infants that prolonged PDA exposure increases the incidence of BPD-PVD during the neonatal hospitalization.
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spelling pubmed-104033702023-08-17 Patent ductus arteriosus and the risk of bronchopulmonary dysplasia-associated pulmonary hypertension Nawaytou, Hythem Hills, Nancy K. Clyman, Ronald I. Pediatr Res Article BACKGROUND: To determine whether prolonged exposure to a moderate/large patent ductus arteriosus left-to-right shunt (PDA) increases the risk of late (beyond 36 weeks) pulmonary hypertension (BPD-PH) and pulmonary vascular disease (BPD-PVD) during the neonatal hospitalization in preterm infants (<28 weeks’ gestation) with bronchopulmonary dysplasia (BPD). METHODS: All infants requiring respiratory support ≥36 weeks had systematic echocardiographic evaluations for BPD-PH at planned intervals. Infants were classified as having either flow-associated BPD-PH (BPD-flow-PH) or BPD-PVD. RESULTS: 256 infants survived ≥36 weeks: 105 had NO BPD (were off respiratory support by 36 weeks); 151 had BPD. 22/151 had BPD-PH (12/22 had BPD-flow-PH from a PDA that persisted beyond 36 weeks; 10/22 had BPD-PVD). Moderate/large PDA shunts that persisted beyond 36 weeks were significantly associated with an increased incidence of BPD-PH due to BPD-flow-PH. We found no association between the duration of PDA exposure and the incidence of BPD-PVD. CONCLUSION: Moderate/large PDA shunts increase the risk of flow-associated BPD-PH when present beyond 36 weeks. Although term infants with PDA-congenital heart disease can develop pulmonary vascular remodeling and PVD after months of PDA exposure, we found no echocardiographic evidence in preterm infants that prolonged PDA exposure increases the incidence of BPD-PVD during the neonatal hospitalization. 2023-08 2023-02-17 /pmc/articles/PMC10403370/ /pubmed/36804505 http://dx.doi.org/10.1038/s41390-023-02522-4 Text en http://www.nature.com/authors/editorial_policies/license.html#termsUsers may view, print, copy, and download text and data-mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use:http://www.nature.com/authors/editorial_policies/license.html#terms
spellingShingle Article
Nawaytou, Hythem
Hills, Nancy K.
Clyman, Ronald I.
Patent ductus arteriosus and the risk of bronchopulmonary dysplasia-associated pulmonary hypertension
title Patent ductus arteriosus and the risk of bronchopulmonary dysplasia-associated pulmonary hypertension
title_full Patent ductus arteriosus and the risk of bronchopulmonary dysplasia-associated pulmonary hypertension
title_fullStr Patent ductus arteriosus and the risk of bronchopulmonary dysplasia-associated pulmonary hypertension
title_full_unstemmed Patent ductus arteriosus and the risk of bronchopulmonary dysplasia-associated pulmonary hypertension
title_short Patent ductus arteriosus and the risk of bronchopulmonary dysplasia-associated pulmonary hypertension
title_sort patent ductus arteriosus and the risk of bronchopulmonary dysplasia-associated pulmonary hypertension
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10403370/
https://www.ncbi.nlm.nih.gov/pubmed/36804505
http://dx.doi.org/10.1038/s41390-023-02522-4
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