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Pulmonary hypertension in the premature infant population: Analysis of echocardiographic findings and biomarkers
Author(s) -
O'Connor Michael G.,
Suthar Divya,
Vera Kimberly,
Slaughter James C.,
Maitre Natalie L.,
Steele Steven,
Beller Amy,
Fike Candice D.,
Aschner Judy L.,
Moore Paul E.,
Austin Eric D.
Publication year - 2018
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.23913
Subject(s) - medicine , nitric oxide , pulmonary hypertension , gestational age , exhaled nitric oxide , bronchopulmonary dysplasia , odds ratio , respiratory system , population , citrulline , demographics , cardiology , asthma , pediatrics , arginine , pregnancy , spirometry , biochemistry , genetics , chemistry , demography , environmental health , amino acid , sociology , biology
Objective Extremely low gestational age neonates (ELGANs) are at risk for pulmonary hypertension (PH). We hypothesized that PH, defined by echocardiogram at 36 weeks gestational age (GA), would associate with respiratory morbidity, increased oxidant stress, and reduced nitric oxide production. Study Design ELGANs in the Vanderbilt fraction of the Prematurity and Respiratory Outcomes Program (PROP) who had echocardiograms at 36 ± 1 weeks GA were studied. Echocardiogram features of PH were compared with clinical characteristics as well as markers of oxidant stress and components of the nitric oxide pathway. Biomarkers were obtained at enrollment (median day 3), 7, 14, and 28 days of life. Results Sixty of 172 infants had an echocardiogram at 36 weeks; 11 had evidence of PH. Infants did not differ by PH status in regards to demographics, respiratory morbidity, or oxidant stress. However, odds of more severe PH were significantly higher in infants with higher nitric oxide metabolites (NOx) at enrollment and with a lower citrulline level at day 7. Conclusions Respiratory morbidity may not always associate with PH at 36 weeks among ELGANs. However, components of nitric oxide metabolism are potential biologic markers of PH in need of further study.