J Cardiovasc Ultrasound.  2016 Dec;24(4):278-284. 10.4250/jcu.2016.24.4.278.

Clinical Utility of Echocardiography for the Diagnosis and Prognosis in Children with Bronchopulmonary Dsyplasia

• Choi YE
• Cho HJ
• Song ES
• Jeong IS
• Yoon N
• Choi YY
• Ma JS
• Cho YK

• KMID: 2364645
• DOI: http://doi.org/10.4250/jcu.2016.24.4.278

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 echocardiographic measurements of premature infants with BPD could provide sensitive measures of RV function that correlates with BPD severity.
METHODS
Twenty-eight control subjects without BPD (non BPD group), 28 patients with mild BPD, 11 patients with moderate BPD, and six patients with severe BPD underwent echocardiograms with standard measurement such as ejection fraction by M-mode, tricuspid regurgitation pressure gradient, myocardial performance index (MPI) derived from pulse Doppler, and tissue Doppler 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 six patients with severe BPD underwent echocardiograms with standard measurement such as ejection fraction by M-mode, tricuspid regurgitation 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 BPD groups. However, mean septal TDI-MPI of the severe BPD group (0.68 ± 0.06) was significantly (p < 0.01) higher than that of the non-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 TDI-MPI (p = 0.04, R = 0.24).
CONCLUSION
Echocardiographic evaluation of RV function based on an assessment of RV TDI-MPI can provide RV dysfunction parameter in premature infants with BPD.

Keyword

Right ventricular function; Bronchopulmonary dysplasia; Echocardiography

MeSH Terms

Bronchopulmonary Dysplasia
Child*
Diagnosis*
Echocardiography*
Education
Humans
Hypertension
Infant, Newborn
Infant, Premature
Linear Models
Prognosis*
Pulmonary Artery
Tricuspid Valve Insufficiency
Ventricular Function, Right

Figure

• 

  Fig. 1 The representative echocardiographic images of tissue Doppler imaging (TDI)-derived myocardial performance index (MPI) obtained from the interventricular septum (septal TDI-MPI) and the right ventricular (RV) free wall at the level of tricuspid annulus (RV TDI-MPI) in patients without bronchopulmonary dysplasia (BPD) or with mild, moderate, or severe BPD.

• 

  Fig. 2 The representative echocardiographic images of tissue Doppler imaging (TDI)-derived myocardial performance index (MPI) obtained from the interventricular septum (septal TDI-MPI, A) and the right ventricular (RV) free wall at the level of tricuspid annulus (RV TDI-MPI, B) in patients without bronchopulmonary dysplasia (BPD) or with mild, moderate, or severe BPD. Dots represent actual values. Lines represents linear regression.

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