Clinical utility of echocardiography in bronchopulmonary dysplasia: a retrospective cohort study

TL;DR

This study shows that echocardiography can detect heart function differences in preterm infants with and without BPD, suggesting its potential for identifying BPD.

Contribution

The study demonstrates echocardiography's potential as a tool for identifying BPD in preterm infants through cardiac function differences.

Findings

BPD infants showed reduced left and right ventricular systolic and diastolic function compared to non-BPD infants.

Echocardiographic parameters like LVEF, TAPSE, and TDI were significantly different between BPD and non-BPD groups.

Cardiac dysfunction was more pronounced in BPD infants despite similar gestational age and birth weight.

Abstract

Bronchopulmonary dysplasia (BPD) is a common chronic lung complication in preterm infants, often complicated by cardiopulmonary dysfunction and poor outcomes. This study aimed to evaluate echocardiographic parameter differences at 36 weeks postmenstrual age (PMA) between preterm infants with and without BPD, and explore echocardiography’s utility for BPD identification.

A retrospective cohort study included 94 preterm infants (gestational age < 32 weeks) admitted to the NICU (2019–2023). They were grouped by 2018 NICHD criteria: Non-BPD (n = 50, no/mild respiratory support) and BPD (n = 44, requiring prolonged oxygen/mechanical ventilation). Standard transthoracic echocardiography (TTE) at 36 weeks PMA assessed left ventricular (LV), right ventricular (RV), and tissue Doppler imaging (TDI) parameters.

Gestational age and birth weight were comparable between the two groups (p < 0.01), but BPD infants had longer mechanical ventilation duration (p < 0.01). BPD infants showed significant cardiac dysfunction: reduced LV ejection fraction (LVEF), mitral valve E velocity (MV-E), and MV-E/A ratio; decreased RV tricuspid annular plane systolic excursion (TAPSE) and fractional area change (FAC); and abnormal TDI (lower TV-S′/E′/A′, higher TV-E/E′ ratio) (all p < 0.01).

Echocardiographic parameters reflecting biventricular systolic/diastolic dysfunction differ significantly between BPD and non-BPD preterm infants, indicating potential for BPD identification.

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