Spectrum of clinical and cardiac dysfunction in bronchopulmonary dysplasia: early prediction of long-term morbidity.
OBJECTIVE
The objective of this study was to correlate the severity of bronchopulmonary dysplasia (BPD) in infants < or = 28 weeks' gestation with clinical and radiologic scoring and cardiac function as measured by echocardiography.


METHODS
Twenty-five infants with a mean birth weight of 909 gm and gestational age 26 weeks were studied. All infants were categorized with a clinical and radiologic scoring system at 1 and 3 months. All infants were studied with two-dimensional, M-mode, and Doppler echocardiography.


RESULTS
A significant correlation was found between clinical and radiologic scores at 1 month (r = 0.42) and between radiologic scorings at 1 and 3 months (r = 0.67). Severe BPD is directly related with mean airway pressure on day 7 of life (p < 0.05), use of intralipids (p < 0.05), and average oxygen exposure (p < 0.05). Left ventricular posterior wall thickness is directly correlated to severity of BPD (p < 0.05), and transmitral flow velocities and early diastolic/atrial contraction flow velocity ratio are inversely related to severity of BPD (p < 0.05).


CONCLUSIONS
Severe BPD can be predicted at an early age, and certain subtle cardiac dysfunctions can be used as early markers of BPD.
Shekhawat
P S
PS
Newborn Services, Monash Medical Center, Clayton, Melbourne, Australia.
Fong
L V
LV
Mitvalsky
J
J
Yu
V Y
VY
D000704:Analysis of Variance; D001997:Bronchopulmonary Dysplasia / Q000145:classification* / Q000150:complications* / Q000453:epidemiology; D006332:Cardiomegaly / Q000175:diagnosis* / Q000209:etiology; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D008297:Male; D009017:Morbidity; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index