Maria Lucia Rossi, Maria Clara Escobar-Diaz, Stephanie Marie Hadley, Paula Cecilia Randanne, Joan Sanchez-de-Toledo, Iolanda Jordan
Sant Joan de Deu Hospital. Sant Joan de Déu Research Institute. Boston Children’s Hospital. University of Pittsburgh. University of Barcelona. Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP)
Spain and United States
Pediatric Cardiology
Pediatr Cardiol 2023; 44: 237-244
DOI: 10.1007/s00246-022-03043-3
Abstract
Pulmonary hypertension has been reported as a crucial factor in the pathophysiology of severe bronchiolitis. The aim of this study was to evaluate pulmonary artery pressure (PAP) in patients with bronchiolitis and to analyze their correlation with clinical outcomes. This prospective cohort study examined children admitted for bronchiolitis. PAP was assessed by right ventricle (RV) acceleration/ejection time ratio (AT/ET), isovolumic relaxation time, eccentricity index, and the presence of a pulmonary systolic notch. Pulmonary hypertension (PH) was considered if at least two altered parameters were present. Severity of clinical course was established by higher N-terminal (NT)-prohormone BNP (NT-proBNP) values, the need for positive pressure respiratory support (PPRS), and the duration of hospital admission. One hundred sixty-nine children were included in analysis. Sixty-eight patients (40%) required PPRS, and those patients had increased NT-proBNP values and worse tricuspid annular systolic excursion (TAPSE) compared to mild cases (p < 0.001and p < 0.001, respectively). Twenty-two (13%) cases had at least two altered parameters of PAP and met criteria for presumed PH, with no differences in NT-proBNP values, TAPSE, need for PPRS or hospital length of stay compared to normal PAP group (p = 0.98, p = 0.07, p = 0.94 and p = 0.64, respectively). We found no correlation between altered RV AT/ET and worse cardiac function, NT-proBNP values or hospital length of stay. In our cohort, the presence of echocardiographic findings of PH were not associated with worse clinical outcomes. Patients with severe bronchiolitis had higher values of NT-proBNP but, interestingly, no clear association with PH.
Category
Class III. Pulmonary Hypertension Associated with Lung Disease
Diagnostic Testing for Pulmonary Vascular Disease. Non-invasive Testing
Right Heart Dysfunction Associated with Pulmonary Vascular Disease
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Filed (PHiled). Greater than 1-2 years since publication
Article Access
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