WIP 52 - Diagnosis of Pulmonary Hypertension in Preterm Neonates: Echocardiography Findings and Diagnosis of Bronchopulmonary Dysplasia

Publication Number: WIP 52.7693

Erin D. Myers, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States; Rowena Cayabyab, Los Angeles General Medical Center, Los Angeles, CA, United States; Smeeta Sardesai, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States; Rangasamy Ramanathan, Cedars Sinai Guerin Children's, Los Angeles, CA, United States; Shazia Bhombal, Children's Healthcare of Atlanta/Emory University, Atlanta, GA, United States

Background: Bronchopulmonary dysplasia (BPD) remains a large source of morbidity in preterm infants. It is established that there is abnormal development of the pulmonary vasculature in BPD with a portion of patients with developing pulmonary hypertension (PH). While literature suggests early echocardiography (ECHO) with evidence of PH may correlate with later diagnosis of PH in the BPD population, further delineation of specific ECHO markers demonstrating elevated pulmonary vascular resistance including signs of decreased RV compliance may further identify patients at risk for developing BPD and BPD with PH.

Objective: As PH can be diagnosed via ECHO, we hypothesized that review of ECHOs in high-risk patients could show early signs of abnormal hemodynamics suggestive of PH. We also hypothesize that these abnormal hemodynamic findings could be predictive of later complications of premature lung disease including BPD with PH.

Design/Methods: Retrospective cohort study of all preterm infants less than 32 gestational age (GA) at birth admitted to Los Angeles General Hospital neonatal intensive care unit (NICU) from May 2015 to December 2023 who were diagnosed with PH and had ECHO performed within the first week of life and at 36 weeks post menstrual age or before discharge . Groups will be classified as no BPD or PH, BPD with PH, and BPD without PH. Data will be collected from electronic medical records and NICU database. ECHOs will be reviewed for estimated right ventricular systolic pressure, septal flattening, and presence of any shunting to assess for evidence of PH in both time periods. ECHOs will be reviewed between December and January, and analysis should be completed by March 2025. Continuous variables will be analyzed with Kruskal wallis or ANOVA and Chi square test for categorical variables. Multinomial logistic regression will be used to determine if early PH can predict BPD with PH. We are anticipating 150 VLBW infants with echocardiograms performed at the first week of life and at 36 weeks postmenstrual age. Data analysis will be completed in March 2025.