Philip T. Levy, Jonathan Levin, Kristen T. Leeman, Mary P. Mullen, Georg Hansmann, Stella Kourembanas
Harvard Medical School and Boston Children’s Hospital. Hannover Medical School.
United States and Germany
Seminars in Fetal and Neonatal Medicine
Semin Fetal Neonatal Med 2022; 27:
DOI: 10.1016/j.siny.2022.101351
Abstract
Chronic pulmonary hypertension of infancy (cPHi) is a heterogeneous disease process that contributes to morbidity and mortality in preterm infants. cPHi is most commonly associated with chronic lung disease of prematurity and represents a unique phenotype of bronchopulmonary dysplasia. It is characterized by persistently elevated or newly rising pulmonary vascular resistance and pulmonary artery pressure beyond the first weeks of age. The high-pressure afterload on the right ventricle may or may not be tolerated, depending upon additional cardiovascular shunting and co-morbidities. A comprehensive clinical evaluation combined with advanced hemodynamic assessment by echocardiography and other cardiac imaging modalities help decipher the etiopathologies of disease, identify cardiopulmonary compromise earlier and guide individualized therapeutic intervention tailored by the phenotype. This review summarizes the underlying etiologies, risk factors for development, hemodynamic assessment, management, and follow-up of cPHi in preterm infants. We offer an algorithm for early detection of cPHi and outline research priorities.
Category
Review Articles Concerning Pulmonary Vascular Disease
Class 3. Pulmonary Vascular Disease Associated with Lung Disease.
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Filed (PHiled). Greater than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: No