Cardiac Mechanics in Children with Bronchopulmonary Dysplasia.
BACKGROUND
Disruption of pulmonary vasculogenesis occurs in bronchopulmonary dysplasia (BPD). Increased impedance to pulmonary flow secondary to abnormal vascular development may affect ventricular mechanics.


OBJECTIVE
We aimed to test the hypothesis that cardiac mechanics are altered in prematurely born children with BPD.


METHODS
A cohort of 47 children was studied: 22 aged 48.9 ± 6.4 months born preterm with BPD (group I), 13 aged 46.3 ± 8.1 months born preterm without BPD (group II), and 12 healthy children aged 53.4 ± 12.2 months born at term (group III). Left (LV) and right ventricular (RV) strain and strain rate were assessed by speckle-tracking echocardiography.


RESULTS
The global RV systolic strain rate (p = 0.022) was significantly lower, while RV systolic strain (p = 0.05) and early diastolic strain rate (p = 0.05) and LV longitudinal systolic strain rate (p = 0.06) also tended to be lower in group I than group III. Group I also tended to have lower RV systolic strain (p = 0.09) and early diastolic strain rate (p = 0.049) and LV longitudinal systolic strain rate (p = 0.08) than group II. An increasing trend from group I to III was observed for RV lateral wall and septal systolic strain and strain rate (all p < 0.05). The LV but not RV size was significantly smaller in group I compared with group III (p < 0.05). Multiple regression identified duration of invasive ventilation (β = -0.66, p = 0.032) as an independent determinant of RV systolic strain after adjustment for perinatal risk factors.


CONCLUSIONS
Impairment of RV myocardial deformation occurs in children with BPD, the magnitude of which is associated negatively with the duration of invasive ventilation.
Shanghai Children's Hospital, Shanghai Jiaotong University, Shanghai, SAR, China.
Lijian
L
Xie
Yuet-Yee
YY
Chee
Kar-Yin
KY
Wong
Yiu-Fai
YF
Cheung
D001997:Bronchopulmonary Dysplasia / Q000503:physiopathology*; D016022:Case-Control Studies; D002675:Child, Preschool; D003971:Diastole; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D012044:Regression Analysis; D013599:Systole; D018497:Ventricular Dysfunction, Right / Q000503:physiopathology*