title: Systemic arterial stiffness in infants with bronchopulmonary dysplasia: potential cause of systemic hypertension.
abstract: Systemic hypertension is common among preterm infants with severe bronchopulmonary dysplasia (BPD); the exact cause is unknown. The objective of this preliminary hypothesis generating study was to examine systemic arterial structure and vasomotor function in a cohort of preterm infants with severe BPD, using a cohort of preterm infants without BPD and a cohort of term infants for comparison.
  
  
  
  After obtaining informed consent, we measured aortic wall thickness and vasomotor function by ultrasonography in 20 infants with severe BPD, 7 infants with no BPD, and compared them with 20 healthy term infants.
  
  
  
  Maximum aortic thickness was significantly higher in infants with BPD (827±163 μm) compared to those with no BPD (674±22 μm) and term infants (657±67 μm) (unadjusted P<0.0001). The input impedance was similarly elevated in the infants with BPD (574±127 dynes s( )cm(-5)) compared to those with no BPD (325±24 dynes s cm(-)(5)) or term infants (328±113 dynes s cm(-)(5)) (unadjusted P<0.0001). Stiffness index was significantly higher in the infants with BPD (3.4±0.6) compared to those with no BPD (2.6±0.3) or term infants (2.3±0.4) (unadjusted P<0.0001). Systemic vascular resistance was also significantly elevated in the infants with BPD. The results remained significant even after adjusting for gestational age and birth weight. Measures of vasomotor function significantly correlated with blood pressure.
  
  
  
  The aortic wall thickness and vasomotor function are significantly altered in preterm infants with severe BPD. These findings may explain the higher incidence of systemic hypertension in this population.
authors.affiliation: Monash Newborn, Monash Children's Hospital, Monash Health, Melbourne, VIC, Australia.|Department of Pediatrics, Monash University, Melbourne, VIC, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Sehgal
authors.affiliation: Monash Newborn, Monash Children's Hospital, Monash Health, Melbourne, VIC, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Malikiwi
authors.affiliation: Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.|Department of Clinical Haematology, Alfred Hospital, Melbourne, VIC, Australia.
authors.forename: E
authors.initials: E
authors.lastname: Paul
authors.affiliation: Monash Newborn, Monash Children's Hospital, Monash Health, Melbourne, VIC, Australia.|Department of Pediatrics, Monash University, Melbourne, VIC, Australia.
authors.forename: K
authors.identifier: 0000-0002-1931-0549
authors.initials: K
authors.lastname: Tan
authors.affiliation: Department of Pediatrics, Monash University, Melbourne, VIC, Australia.|Paediatric and Fetal Cardiac Units, Monash Medical Centre, Monash Health, Melbourne, VIC, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Menahem
mesh_terms: D001011:Aorta / Q000000981:diagnostic imaging*; D001315:Australia; D001794:Blood Pressure / Q000502:physiology; D001997:Bronchopulmonary Dysplasia / Q000150:complications / Q000503:physiopathology*; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000503:physiopathology*; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D016014:Linear Models; D008297:Male; D012307:Risk Factors; D016216:Ultrasonography, Prenatal; D059289:Vascular Stiffness; D014666:Vasomotor System / Q000000981:diagnostic imaging*