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The biventricular contribution to chronic pulmonary hypertension of the extremely premature infant

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Abstract

Objective

Evaluate factors associated with significant pulmonary hypertension [PH] (≥2/3 systemic) and its impact on ventricular function at 36 weeks postmenstrual age (PMA).

Study design

Retrospective cohort of infants born at <29 weeks who survived to their echocardiography screening for PH at 36 weeks PMA. Masked experts extracted conventional and speckle-tracking echocardiography [STE] data.

Results

Of 387 infants, 222 were included and 24 (11%) categorized as significant PH. Significant PH was associated with a decrease in tricuspid annular plane systolic excursion (0.79 vs 0.87 cm, p = 0.03), right peak longitudinal strain [pLS] by STE (−19.6 vs −23.1%, p = 0.003) and left pLS (−25.0 vs −22.7%, p = 0.02). The association between biventricular altered function by STE and significant PH persisted after adjustment for potential confounders – LV-pLS (p = 0.007) and RV-pLS (p = 0.01).

Conclusion

Our findings are suggestive that premature newborns with significant PH at 36 weeks PMA have a biventricular cardiac involvement to their pathophysiology.

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Fig. 1: Flowchart for patient inclusion.

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Acknowledgements

We acknowledge the support of the Canadian Neonatal Network who provided some of data for our center.

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Authors and Affiliations

  1. McGill University Health Centre—Montreal Children’s Hospital, Quebec, QC, Canada

    Gabriela de Carvalho Nunes, Punnanee Wutthigate, Jessica Simoneau, Adrian Dancea, Marc Beltempo, Claudia Renaud & Gabriel Altit

  2. Division of Neonatology, McGill University Health Centre—Montreal Children’s Hospital, Quebec, QC, Canada

    Gabriela de Carvalho Nunes, Punnanee Wutthigate, Jessica Simoneau, Marc Beltempo & Gabriel Altit

  3. Division of Neonatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand

    Punnanee Wutthigate

  4. Division of Pediatric Cardiology, McGill University Health Centre—Montreal Children’s Hospital, Quebec, QC, Canada

    Adrian Dancea & Claudia Renaud

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  1. Gabriela de Carvalho Nunes
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Contributions

GCN conceptualized and designed the study, collected the data, analyzed the data, drafted the manuscript, and adjusted the manuscript according to the comments of co-authors; PW collected the data and revised the manuscript; JS collected the data and revised the manuscript; CR and AD reviewed and revised the manuscript; MB conceptualized and designed the study, collected the data, critically appraised the analysis of the data and reviewed and revised the manuscript; GA conceptualized and designed the study, supervised data collection, critically appraised the analysis of the data, wrote and critically reviewed the manuscript for important intellectual content.

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Correspondence to Gabriel Altit.

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de Carvalho Nunes, G., Wutthigate, P., Simoneau, J. et al. The biventricular contribution to chronic pulmonary hypertension of the extremely premature infant. J Perinatol 43, 174–180 (2023). https://doi.org/10.1038/s41372-022-01497-0

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