Value of echocardiography in assessing the outcome of bronchopulmonary dysplasia of the newborn
Fouron, J.C.; Le Guennec, J.C.; Villemant, D.; Perreault, G.; Davignon, A.
Pediatrics 65(3): 529-535
1980
ISSN/ISBN: 0031-4005 PMID: 7360540 Document Number: 165431
Cardiac catheterization of infants with bronchopulmonary dysplasia shows right ventricular hypertrophy and pulmonary hypertension in the majority of survivors. To determine if serial echocardiographic assessments of the pulmonary vascular bed help establish short-term prognosis of bronchopulmonary dysplasia and to evaluate myocardial function of the survivors, ten preterm infants were studied. They were classified according to 4 radiologic stages. Echocardiographs (50) were recorded allowing serial measurements of the right systolic time intervals. All infants that eventually expired had a ratio of the preejection period to the ejection time of the right ventricle above 0.3 prior to death (5 patients). Infants with normal right preejection period to right ejection time ratio had a good outcome despite persistence of abnormal lung X-rays (4 patients). Persistence of O2 dependence with abnormal right systolic time intervals after 3 mo. of life eventually led to death (2 patients) or serious pulmonary insufficiency (1 patient). The lungs as seen on chest X-rays of this patient remained unchanged (moderate stage IV) during 6 mo.; the echocardiograph showed a progressive increase in right preejection period to right ejection time ratio. This infant developed cor pulmonale. Myocardial function evaluated on the last echocardiograph of the 4 infants considered cured was within normal limits. Indirect assessment of pulmonary pressure by echocardiography can be used for clinical evaluation and ultimate prognosis of bronchopulmonary dysplasia and should be part of the follow-up evaluation of infants with this disease.