{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T15:19:04Z","timestamp":1780759144373,"version":"3.54.1"},"reference-count":27,"publisher":"Georg Thieme Verlag KG","issue":"16","funder":[{"DOI":"10.13039\/100000016","name":"U.S. Department of Health and Human Services","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000016","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:p>\n            Objective\u2003Bronchopulmonary dysplasia (BPD) is the most common complication of preterm birth. Infants with BPD are at increased risk for pulmonary hypertension (PH). Cardiac catheterization is the gold standard for diagnosing PH, but cardiac catheterization is challenging to perform in small, sick, premature infants. The utility of echocardiography for diagnosing PH and predicting outcomes in extremely premature infants has not been clearly defined. Therefore, we sought to use predefined criteria to diagnose PH by echocardiogram and relate PH severity to mortality in extremely premature infants with BPD.<\/jats:p><jats:p>\n            Study Design\u2003Echocardiograms from 46 infants born \u226428 weeks' postmenstrual age with a diagnosis of BPD were assessed for PH by three pediatric cardiologists using predefined criteria, and survival times among categories of PH patients were compared. A total of 458 echocardiograms were reviewed, and 15 (33%) patients were found to have at least moderate PH. Patients with at least moderate PH had similar demographic characteristics to those with no\/mild PH.<\/jats:p><jats:p>\n            Results\u2003Ninety percent of infants without moderate to severe PH survived to hospital discharge, compared with 67% of infants with at least moderate PH (p\u2009=\u20090.048). Patients with severe PH had decreased survival to hospital discharge (38%) compared with moderate (100%) and no\/mild PH (90%) groups. Kaplan\u2013Meier survival curves also differed among PH severity groups (Wilcoxon p\u2009&lt;\u20090.001).<\/jats:p><jats:p>\n            Conclusion\u2003Using predefined criteria for PH, premature infants with BPD can be stratified into PH severity categories. Patients diagnosed with severe PH by echocardiogram have significantly reduced survival.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0044-1786544","type":"journal-article","created":{"date-parts":[[2024,5,3]],"date-time":"2024-05-03T05:08:16Z","timestamp":1714712896000},"page":"2206-2213","source":"Crossref","is-referenced-by-count":6,"title":["Correlating Severity of Pulmonary Hypertension by Echocardiogram with Mortality in Premature Infants with Bronchopulmonary Dysplasia"],"prefix":"10.1055","volume":"41","author":[{"given":"Rachel D.","family":"Torok","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Gardner","sequence":"additional","affiliation":[{"name":"Division of Pediatric Pulmonology, Department of Pediatrics, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piers C.A.","family":"Barker","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew W.","family":"McCrary","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer S.","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina"},{"name":"Department of Pediatrics, Duke Clinical Research Institute, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph P.","family":"Hornik","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Duke Clinical Research Institute, Durham, North Carolina"},{"name":"Division of Pediatric Critical Care, Duke University Medical Center, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew M.","family":"Laughon","sequence":"additional","affiliation":[{"name":"Division of Neonatal-Perinatal Medicine, Department of Pediatrics, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9403-381X","authenticated-orcid":false,"given":"Wesley M.","family":"Jackson","sequence":"additional","affiliation":[{"name":"Division of Neonatal-Perinatal Medicine, Department of Pediatrics, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,5,2]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.jpeds.2017.05.029","article-title":"Evaluation and management of pulmonary hypertension in children with bronchopulmonary dysplasia","volume":"188","author":"U Krishnan","year":"2017","journal-title":"J Pediatr"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1542\/peds.2009-2959","article-title":"Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network","volume":"126","author":"B J Stoll","year":"2010","journal-title":"Pediatrics"},{"issue":"07","key":"ref3","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1164\/rccm.201606-1183ST","article-title":"Executive Summary of the American Heart Association and American Thoracic Society Joint Guidelines for Pediatric Pulmonary Hypertension","volume":"194","author":"S H Abman","year":"2016","journal-title":"Am J Respir Crit Care Med"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"e148","DOI":"10.3928\/19382359-20190325-03","article-title":"Bronchopulmonary dysplasia and pulmonary outcomes of prematurity","volume":"48","author":"M K Tracy","year":"2019","journal-title":"Pediatr Ann"},{"issue":"11","key":"ref5","doi-asserted-by":"crossref","first-page":"1398","DOI":"10.1164\/rccm.201907-1342OC","article-title":"Characterization of disease phenotype in very preterm infants with severe bronchopulmonary dysplasia","volume":"201","author":"K Y Wu","year":"2020","journal-title":"Am J Respir Crit Care Med"},{"issue":"05","key":"ref6","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1038\/jp.2016.255","article-title":"Pulmonary hypertension in preterm infants: results of a prospective screening program","volume":"37","author":"C G Weismann","year":"2017","journal-title":"J Perinatol"},{"issue":"03","key":"ref7","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1038\/s41390-020-0993-4","article-title":"Pulmonary hypertension in bronchopulmonary dysplasia","volume":"89","author":"G Hansmann","year":"2021","journal-title":"Pediatr Res"},{"issue":"21","key":"ref8","doi-asserted-by":"crossref","first-page":"2037","DOI":"10.1161\/CIR.0000000000000329","article-title":"Pediatric pulmonary hypertension: Guidelines From the American Heart Association and American Thoracic Society","volume":"132","author":"S H Abman","year":"2015","journal-title":"Circulation"},{"issue":"03","key":"ref9","doi-asserted-by":"crossref","first-page":"e682","DOI":"10.1542\/peds.2011-1827","article-title":"Prospective analysis of pulmonary hypertension in extremely low birth weight infants","volume":"129","author":"R Bhat","year":"2012","journal-title":"Pediatrics"},{"issue":"05","key":"ref10","doi-asserted-by":"crossref","first-page":"e008142","DOI":"10.1161\/JAHA.117.008142","article-title":"Risk factors for major early adverse events related to cardiac catheterization in children and young adults with pulmonary hypertension: an analysis of data from the IMPACT (Improving Adult and Congenital Treatment) Registry","volume":"7","author":"M L O'Byrne","year":"2018","journal-title":"J Am Heart Assoc"},{"issue":"02","key":"ref11","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1038\/s41372-018-0277-6","article-title":"Agreement of an echocardiogram-based diagnosis of pulmonary hypertension in infants at risk for bronchopulmonary dysplasia among masked reviewers","volume":"39","author":"A W McCrary","year":"2019","journal-title":"J Perinatol"},{"issue":"04","key":"ref12","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1016\/S0735-1097(85)80433-2","article-title":"An echocardiographic index for separation of right ventricular volume and pressure overload","volume":"5","author":"T Ryan","year":"1985","journal-title":"J Am Coll Cardiol"},{"issue":"05","key":"ref13","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/j.echo.2010.03.019","article-title":"Recommendations for quantification methods during the performance of a pediatric echocardiogram: a report from the Pediatric Measurements Writing Group of the American Society of Echocardiography Pediatric and Congenital Heart Disease Council","volume":"23","author":"L Lopez","year":"2010","journal-title":"J Am Soc Echocardiogr"},{"issue":"05","key":"ref14","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1016\/j.echo.2015.01.014","article-title":"The reproducibility and absolute values of echocardiographic measurements of left ventricular size and function in children are algorithm dependent","volume":"28","author":"R Margossian","year":"2015","journal-title":"J Am Soc Echocardiogr"},{"issue":"09","key":"ref15","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1016\/j.healun.2019.06.022","article-title":"2019 updated consensus statement on the diagnosis and treatment of pediatric pulmonary hypertension: The European Pediatric Pulmonary Vascular Disease Network (EPPVDN), endorsed by AEPC, ESPR and ISHLT","volume":"38","author":"G Hansmann","year":"2019","journal-title":"J Heart Lung Transplant"},{"issue":"05","key":"ref16","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1016\/j.jpeds.2014.07.040","article-title":"Pulmonary hypertension in preterm infants: prevalence and association with bronchopulmonary dysplasia","volume":"165","author":"H Mirza","year":"2014","journal-title":"J Pediatr"},{"issue":"09","key":"ref17","doi-asserted-by":"crossref","first-page":"704","DOI":"10.2459\/JCM.0b013e328332e745","article-title":"Severe pulmonary arterial hypertension in a very premature baby with bronchopulmonary dysplasia: normalization with long-term sildenafil","volume":"11","author":"S Caputo","year":"2010","journal-title":"J Cardiovasc Med (Hagerstown)"},{"issue":"02","key":"ref18","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1159\/000085646","article-title":"Oral sildenafil for treatment of severe pulmonary hypertension in an infant","volume":"88","author":"K L Hon","year":"2005","journal-title":"Biol Neonate"},{"issue":"02","key":"ref19","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1542\/peds.2007-1583","article-title":"Clinical utility of echocardiography for the diagnosis and management of pulmonary vascular disease in young children with chronic lung disease","volume":"121","author":"P M Mourani","year":"2008","journal-title":"Pediatrics"},{"issue":"01","key":"ref20","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.echo.2017.09.009","article-title":"Echocardiographic estimation of mean pulmonary artery pressure: a comparison of different approaches to assign the likelihood of pulmonary hypertension","volume":"31","author":"K Hellenkamp","year":"2018","journal-title":"J Am Soc Echocardiogr"},{"key":"ref21","first-page":"16","article-title":"Pathophysiology, screening and diagnosis of pulmonary hypertension in infants with bronchopulmonary dysplasia - a review of the literature","volume":"23","author":"G Altit","year":"2017","journal-title":"Paediatr Respir Rev"},{"issue":"01","key":"ref22","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1161\/01.CIR.68.1.68","article-title":"Interventricular septal configuration as a predictor of right ventricular systolic hypertension in children: a cross-sectional echocardiographic study","volume":"68","author":"M E King","year":"1983","journal-title":"Circulation"},{"issue":"01","key":"ref23","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1055\/s-0035-1556757","article-title":"Differences in eccentricity index and systolic-diastolic ratio in extremely low-birth-weight infants with bronchopulmonary dysplasia at risk of pulmonary hypertension","volume":"33","author":"A W McCrary","year":"2016","journal-title":"Am J Perinatol"},{"issue":"06","key":"ref24","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1542\/peds.2007-0971","article-title":"Pulmonary artery hypertension in formerly premature infants with bronchopulmonary dysplasia: clinical features and outcomes in the surfactant era","volume":"120","author":"E Khemani","year":"2007","journal-title":"Pediatrics"},{"issue":"03","key":"ref25","doi-asserted-by":"crossref","first-page":"2045894019878598","DOI":"10.1177\/2045894019878598","article-title":"Diminished right ventricular function at diagnosis of pulmonary hypertension is associated with mortality in bronchopulmonary dysplasia","volume":"9","author":"G Altit","year":"2019","journal-title":"Pulm Circ"},{"issue":"08","key":"ref26","doi-asserted-by":"crossref","first-page":"2399","DOI":"10.1002\/ppul.25444","article-title":"Sildenafil for pulmonary hypertension in neonates: An updated systematic review and meta-analysis","volume":"56","author":"Z He","year":"2021","journal-title":"Pediatr Pulmonol"},{"issue":"08","key":"ref27","first-page":"CD005494","article-title":"Sildenafil for pulmonary hypertension in neonates","volume":"8","author":"L E Kelly","year":"2017","journal-title":"Cochrane Database Syst Rev"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0044-1786544.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T13:25:50Z","timestamp":1730813150000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0044-1786544"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,2]]},"references-count":27,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2024,11,4]]},"published-print":{"date-parts":[[2024,12]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0044-1786544","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,2]]}}}