RESUMO
Pulmonary hypertension (PH) is a complication of bronchopulmonary dysplasia (BPD). The underlying pathophysiology of BPD-associated PH is complex and poorly understood. Echocardiogram may underestimate the severity of pulmonary hypertensive vascular disease in severe BPD. Digital subtraction pulmonary angiography (DSPA) is a potentially useful imaging modality for evaluating changes in the pulmonary vasculature of BPD-associated PH. In this study, we objectively quantified the pulmonary hypertensive vascular changes demonstrated by DSPA using a novel pulmonary vascular underperfusion score (PVUS) and correlated the scoring system with echocardiography parameters and cardiac hemodynamics by right heart catheterization.
Assuntos
Displasia Broncopulmonar/classificação , Hipertensão Pulmonar/classificação , Recém-Nascido Prematuro/fisiologia , Angiografia Digital/métodos , Displasia Broncopulmonar/complicações , Estudos Transversais , Ecocardiografia/métodos , Humanos , Hipertensão Pulmonar/complicações , Recém-Nascido , Recém-Nascido Prematuro/crescimento & desenvolvimento , Escala de Gravidade do Ferimento , Pulmão/anormalidades , Pulmão/fisiopatologiaRESUMO
Bronchopulmonary dysplasia (BPD) is the most common respiratory sequelae of prematurity and histopathologically features fewer, dysmorphic, pulmonary arteries. We present our experience with the digital subtraction pulmonary angiography (DSPA) findings of a segmental vascular filling abnormality in three children who were born at extreme prematurity and have pulmonary hypertension due to severe BPD. Our preliminary data suggest that DSPA may be useful in evaluating the severity of pulmonary vascular disease in children with BPD.