Pulmonary hypertension in bronchopulmonary dysplasia

Ambalavanan, Namasivayam; Mourani, Peter M.

doi:10.1002/bdra.23241

Cited by 67 publications

(41 citation statements)

References 44 publications

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“…Recently, a retrospective cohort study identified peak BNP levels as a prognostic marker for all-cause mortality in extremely-low-BW infants with BPD-associated PH [11]. It has been suggested that serial BNP may be useful for following the course of PH in this population [1]. However, this is the first prospective study to propose BNP levels >1,000 pg/ml as a screening tool for PH in infants with BPD.…”

Section: Discussionmentioning

confidence: 99%

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Biochemical Screening for Pulmonary Hypertension in Preterm Infants with Bronchopulmonary Dysplasia

et al. 2016

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Background: Pulmonary hypertension (PH) in infants with bronchopulmonary dysplasia (BPD) is associated with increased morbidity and mortality. Elevated levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and decreased levels of amino acid precursors of nitric oxide (NO) have been associated with PH, but have not been studied in infants with PH secondary to BPD. Objective: The aim of this study was to identify a biochemical marker for PH in infants with BPD. Methods: Twenty infants, born at <27 weeks' gestational age (GA) and/or with a birth weight (BW) ≤750 g, who met the criteria for BPD at 36 weeks' corrected GA (CGA) were enrolled in this cross-sectional pilot study. A screening echocardiogram was conducted at 36-38 weeks' CGA and plasma NT-proBNP and amino acid levels were obtained within 1 week of the screening echocardiogram. Results: Five infants (25%) had echocardiographic evidence of PH. GA and BW were not significantly different between the 2 groups (a PH group and a No PH group). NT-proBNP was significantly elevated in the PH group (median 1,650 vs. 520 pg/ml; p = 0.001) but citrulline levels were significantly lower (median 21 vs. 36 μmol/l; p = 0.005). Arginine levels were not significantly different between the groups (median 78 vs. 79 μmol/l; p = 1). Conclusion: NT-proBNP and the NO precursor citrulline may be cost-effective biochemical markers for screening for the presence of PH in preterm infants who have BPD. If validated in a larger study, such biochemical markers may, in part, replace PH screening echocardiograms in these patients.

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Section: Discussionmentioning

confidence: 99%

“…Pulmonary hypertension (PH) occurs in approximately 14-37% of prematurely born infants with bronchopulmonary dysplasia (BPD) [1]. It is associated with a significant mortality risk, as high as 38%.…”

Section: Introductionmentioning

confidence: 99%

Biochemical Screening for Pulmonary Hypertension in Preterm Infants with Bronchopulmonary Dysplasia

et al. 2016

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“…Wistar rats 2,3 were selected at random on days 3, 7 and 14 after the experiment had commenced. pentobarbital sodium (3%) was injected intraperitoneally (1 mL/100 g body weight) to sacrifice the rats.…”

Section: Isolation Culture and Identification Of Lfs In Vitromentioning

confidence: 99%

Expression dynamics of caveolin-1 in fibroblasts of newborn rats with chronic lung disease and its impact on lung fibroblast proliferation

Wang

Xue

2017

Acta Cir. Bras.

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Purpose: To evaluate the changes of caveolin-1 in lung fibroblasts in newborn Wistar rats when exposed to hyperoxic conditions, as well as lung fibroblasts cell cycle. Methods: One hundred newborn Wistar rats were randomly divided (50 rats/group) into experimental and control groups, exposed to hyperoxic conditions or normal air, respectively. The fraction of inspired oxygen (FiO 2 ) in the experimental group was 90%, whereas this value was 21% in the control group. Lung fibroblasts were collected on days 3, 7, and 14 of the experiment. Caveolin-1 expression dynamics in lung fibroblasts was assayed in each group by immunofluorescence and Western blot analyses. Flow cytometry (FCM) was used to assess the proportions of lung fibroblasts at different stages of the cell cycle. Results: On day 3, no significant difference in caveolin-1 expression was observed between the hyperoxic and control groups; however, on days 7 and 14, caveolin-1 expression was significantly lower in the hyperoxic group than in the control (P<0.05). No apparent differences were observed in caveolin-1 expression in the control group at the different time points. Using FCM analysis, we showed that the proportion of lung fibroblasts in G0/G1 phase in the hyperoxic group decreased compared to that of the control group on day 7, while the proportion of S-phase cells increased (P<0.05). These differences were more significant when the groups were compared on day 14 (P<0.01). Conclusion: After seven days the exposure to hyperoxic conditions, lung fibroblasts proliferated and caveolin-1 expression decreased.

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“…En nuestro centro empleamos habitualmente inicio de tratamiento con sildenafil como primera lí-nea cuando los pacientes presentan HP secundaria a DBP severa, luego de haber evaluado y tratado pertinentemente otras posibles etiologías subyacentes. En caso de no responder, se podría agregar bosentán o iloprost según la experiencia del equipo tratante y las características del paciente específico 8,21 .…”

Section: Terapias Específicasunclassified

El rol de la hipertensión pulmonar en la displasia broncopulmonar

Valenzuela

Moya

Luco

et al. 2017

Rev. chil. pediatr.

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Palabras clave: Displasia broncopulmonar, Hipertensión pulmonar, enfermedad pulmonar crónica, recién nacido prematuro ResumenHace 50 años Northway describió la Displasia Broncopulmonar (DBP), en nacidos de pretérmino expuestos a ventilación mecánica. Desde entonces, ha aumentado la sobrevida de ellos; sin embargo, ha aparecido una "nueva DBP" y la incidencia de esta no ha disminuido. Una de las características de esta patología es la remodelación vascular anómala, que en su expresión más severa se conoce como Hipertensión Pulmonar (HP); con una incidencia de 17%, que es proporcional a la severidad de la DBP (33% en DBP severa); y como un factor de mortalidad (hasta un 48% mortalidad a 2 años con HP por DBP). Debido a esto resulta importante conocer los métodos diagnósticos y alternativas terapéuticas, tema que se discute en esta revisión. Considerando la alta mortalidad de la asociación HP-DBP, adquiere importancia una estrategia de tamizaje en la población de riesgo. El gold standard para el diagnóstico de HP es el cateterismo cardíaco, sin embargo, el ecocardiograma transtorácico es una herramienta útil para el tamizaje y diagnóstico de HP en pacientes displásicos, con mediciones cuantitativas y cambios cualitativos en la evaluación diagnóstica. A nivel sanguíneo el péptido natriurético tipo B (BNP), ha mostrado ser útil en el seguimiento; en cuanto a imágenes, la tomografía computarizada se utiliza en casos severos. En cuanto a las terapias, se han propuesto el óxido nítrico inhalado como vasodilatador pulmonar, los inhibidores de la fosfodiesterasas -sildenafil-, los antagonistas de la endotelina -bosentán-y los análogos de prostaciclinas -iloprost-. Aún no se cuenta con evidencia de alta calidad para su uso, dosis y duración del tratamiento, pero hay variadas experiencias clínicas. Además, es relevante el cuidado interdisciplinario, destacando optimizar la nutrición. El desafío es lograr una prevención efectiva de la DBP y de sus complicaciones. Un protocolo de tamizaje de HP debe asociarse a una estratificación de riesgo y directrices de tratamiento.

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Pulmonary hypertension in bronchopulmonary dysplasia

Cited by 67 publications

References 44 publications

Biochemical Screening for Pulmonary Hypertension in Preterm Infants with Bronchopulmonary Dysplasia

Biochemical Screening for Pulmonary Hypertension in Preterm Infants with Bronchopulmonary Dysplasia

Expression dynamics of caveolin-1 in fibroblasts of newborn rats with chronic lung disease and its impact on lung fibroblast proliferation

El rol de la hipertensión pulmonar en la displasia broncopulmonar

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