Digital Subtraction Pulmonary Angiography: A Useful Tool to Evaluate Pediatric Pulmonary Hypertension

Josue Maldonado Custodio, Nathan Rodgers, Varun Aggarwal
University of Minnesota.
United States

Pediatric Cardiology
Pediatr Cardiol 2026;
DOI: 10.1007/s00246-026-04311-2

Abstract
Pulmonary arterial hypertension causes significant morbidity and mortality in pediatric patients. Current guidelines speak about the need for new strategies to diagnose and monitor pulmonary hypertension in pediatrics. Digital subtraction pulmonary angiography is a useful tool to assess lung vasculature and parenchymal perfusion deficits. A Pulmonary Vascular Underperfusion Score has been previously published and used to assess pulmonary vasoreactivity testing response in premature infants with bronchopulmonary dysplasia and pulmonary hypertension. By adopting this Pulmonary Vascular Underperfusion Score, we performed a retrospective review for evaluating children with pulmonary arterial hypertension. Our study demonstrates that the Pulmonary Vascular Underperfusion Score is strongly associated with pulmonary vascular resistance in pediatric patients with pulmonary arterial hypertension. Specifically, a score of ≥ 1.5 reliably identified patients with elevated pulmonary vascular resistance, both at baseline and during vasodilator testing, with high sensitivity and specificity. These findings suggest that Pulmonary Vascular Underperfusion Score may be a useful tool in risk stratification of children with pediatric pulmonary artery hypertension.

Category
Diagnostic Testing for Pulmonary Vascular Disease. Non-invasive Testing
Diagnostic Testing for Pulmonary Vascular Disease. Risk Stratification

Age Focus: Pediatric Pulmonary Vascular Disease

Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication

Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: Yes

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