Bronchopulmonary dysplasia-associated pulmonary hypertension

Sahni, Mitali; Bhandari, Vineet

doi:10.21037/pm.2019.02.01

Cited by 10 publications

(17 citation statements)

References 46 publications

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“…Bronchopulmonary dysplasia, on the other hand, happens predominately in premature babies and newborns beyond 30 days of life that have been managed for respiratory disease, following prolonged use of oxygen and ventilator therapy [ 35 ]. BPD is said to cause 50% of deaths in the setting of pulmonary hypertension [ 3 , 36 ].…”

Section: Epidemiologymentioning

confidence: 99%

“…BPD results from inadequate vascular growth of the lung parenchyma, which in turn reduces the surface area for gaseous exchange [ 35 ]. Consequently, this chronic hypoxia results in lung hyperreactivity, inflammation, fibrosis, and remodeling that causes poor growth of pulmonary vessels.…”

Section: Epidemiologymentioning

confidence: 99%

“…Consequently, this chronic hypoxia results in lung hyperreactivity, inflammation, fibrosis, and remodeling that causes poor growth of pulmonary vessels. Risk factors include oligohydramnios, fetal growth restriction due to chronic placental insufficiency, and preeclampsia [ 3 , 35 ].…”

Section: Epidemiologymentioning

confidence: 99%

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Pulmonary Hypertension in Children across Africa: The Silent Threat

Namuyonga

Mocumbi

2021

International Journal of Pediatrics

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Pulmonary hypertension (PH) is a complex puzzle in Africa, especially among children who present with a cocktail of issues including recurrent pulmonary infections, unoperated congenital heart disease, and advanced rheumatic heart disease. Sickle cell anemia and neonatal complications of transiting from fetal circulation also contribute to the burden of pulmonary hypertension. Mortality from pulmonary arterial hypertension (PAH) remains high in Africa (18-21%), claiming sufferers in the first 6 months after diagnosis. Unfortunately, PH remains underreported in sub-Saharan Africa since many centers lack the capacity to diagnose and confirm it by the recommended gold standard, right heart catheterization. The unresolved burden of unoperated congenital heart lesions and rheumatic heart disease, among other preventable causes, stand out as major causes of PH in African children. This paper highlights pediatric PAH as a result of major gaps in care and illustrates the need for its prevention as well as for the promotion of research into the most important drivers, to prevent premature mortality in the continent.

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Section: Epidemiologymentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 99%

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Pulmonary Hypertension in Children across Africa: The Silent Threat

Namuyonga

Mocumbi

2021

International Journal of Pediatrics

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“…The decreased vessel density throughout the pulmonary microcapillary network leads to decreased cross sectional area for pulmonary blood flow and increased pulmonary vascular resistance [ 169 , 171 ]. Risk factors for BPD-PH are low birth weight, maternal abnormalities such as oligohydramnion, pre-eclampsia and postnatal injuries, including hyperoxia, hypoxia and infection, all of which lead to endothelial injury, disruption of growth factor expression and the activation of signalling pathways promoting vascular remodelling [ 169 , 172 , 173 , 174 , 175 ]. Genetic susceptibility appears to play a further role in this process.…”

Section: Group 3 Ph ( Table 1 )mentioning

confidence: 99%

Focused Update on Pulmonary Hypertension in Children—Selected Topics of Interest for the Adult Cardiologist

2020

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Pulmonary hypertensive vascular disease (PHVD), and pulmonary hypertension (PH), which is a broader term, are severe conditions associated with high morbidity and mortality at all ages. Treatment guidelines in childhood are widely adopted from adult data and experience, though big differences may exist regarding aetiology, concomitant conditions and presentation. Over the past few years, paediatric aspects have been incorporated into the common guidelines, which currently address both children and adults with pulmonary hypertension (PH). There are multiple facets of PH in the context of cardiac conditions in childhood. Apart from Eisenmenger syndrome (ES), the broad spectrum of congenital heart disease (CHD) comprises PH in failing Fontan physiology, as well as segmental PH. In this review we provide current data and novel aspects on the pathophysiological background and individual management concepts of these conditions. Moreover, we focus on paediatric left heart failure with PH and its challenging issues, including end stage treatment options, such as mechanical support and paediatric transplantation. PH in the context of rare congenital disorders, such as Scimitar Syndrome and sickle cell disease is discussed. Based on current data, we provide an overview on multiple underlying mechanisms of PH involved in these conditions, and different management strategies in children and adulthood. In addition, we summarize the paediatric aspects and the pros and cons of the recently updated definitions of PH. This review provides deeper insights into some challenging conditions of paediatric PH in order to improve current knowledge and care for children and young adults.

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“…The strongest predictor of BPD is infant’s GA at birth [ 11 ]. The most commonly accepted mechanism of BPD development is ascribed to lung injury and inflammation in immature lungs occurring after post-natal exposure to hyperoxia and IMV, in the presence of placental insufficiency and other predisposing antenatal factors [ 12 ]. Recent advances in BPD show that it may occur even after minimal exposure to these post-natal therapies [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Patho-mechanisms of the origins of bronchopulmonary dysplasia

Sahni

Bhandari

2021

Mol Cell Pediatr

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Bronchopulmonary dysplasia (BPD) continues to be one of the most common complications of prematurity, despite significant advancement in neonatology over the last couple of decades. The new BPD is characterized histopathologically by impaired lung alveolarization and dysregulated vascularization. With the increased survival of extremely preterm infants, the risk for the development of BPD remains high, emphasizing the continued need to understand the patho-mechanisms that play a role in the development of this disease. This brief review summarizes recent advances in our understanding of the maldevelopment of the premature lung, highlighting recent research in pathways of oxidative stress-related lung injury, the role of placental insufficiency, growth factor signaling, the extracellular matrix, and microRNAs.

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Bronchopulmonary dysplasia-associated pulmonary hypertension

Cited by 10 publications

References 46 publications

Pulmonary Hypertension in Children across Africa: The Silent Threat

Pulmonary Hypertension in Children across Africa: The Silent Threat

Focused Update on Pulmonary Hypertension in Children—Selected Topics of Interest for the Adult Cardiologist

Patho-mechanisms of the origins of bronchopulmonary dysplasia

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