Differences in Eccentricity Index and Systolic–Diastolic Ratio in Extremely Low-Birth-Weight Infants with Bronchopulmonary Dysplasia at Risk of Pulmonary Hypertension

Abstract

Objective To compare the left ventricular eccentricity index (EI) and tricuspid valve systolic–diastolic (SD) ratio in infants at risk of bronchopulmonary dysplasia (BPD) and pulmonary hypertension (PH).

Study Design Review of echocardiograms performed on infants born at ≤ 28 weeks' postmenstrual age, categorized into the following three cohorts: BPD and PH (n = 13); BPD only (n = 16); and controls (n = 59). EI was measured from a parasternal short axis 2D image. The SD ratio was measured from the continuous wave Doppler tracing. Groups were compared using Kruskal–Wallis and Wilcoxon rank sum tests.

Result EI and SD ratios were successfully measured in all infants. There were no differences between controls and BPD cohort. In contrast, the BPD and PH cohort had increased systolic EI (1.46 vs. 1.00–1.01), diastolic EI (1.47 vs. 1.00), and SD ratio (1.12 vs. 0.97–1.00) compared with controls and BPD only cohort (p ≤ 0.01 for all).

Conclusion The EI and SD ratio may be useful as a screening tool for PH in this population.

Keywords

bronchopulmonary dysplasia - pulmonary hypertension - extremely low birth weight infants - eccentricity index - echocardiogram

Authors' Contribution

A. M. designed the study, collected and performed preliminary analysis of the data, prepared the figures, and wrote the main manuscript text. J. M., C. C., and G. T. performed additional data collection (neonatology and cardiology) and analysis of the data. C. H. performed detailed statistical analysis of the final data. K. H. performed additional data collection (cardiac catheterization) and analysis of the data. P. B. designed the study, obtained institutional review board approval, performed analysis of the data, and assisted in manuscript preparation. All authors reviewed, edited, and approved the article.

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