{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T03:13:01Z","timestamp":1773371581217,"version":"3.50.1"},"reference-count":56,"publisher":"Wiley","issue":"19","license":[{"start":{"date-parts":[[2022,9,6]],"date-time":"2022-09-06T00:00:00Z","timestamp":1662422400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Physiology"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:sec><jats:title>Abstract<\/jats:title><jats:p>The cardiovascular impact of dexamethasone (Dex) is not well understood. Most data are obtained from a 6\u00a0week, high\u2010dose regimen, and are limited to findings of hypertension and cardiac hypertrophy. The present study ascertained the impact of low\u2010dose Dex on cardiac indices when administered to extremely preterm infants for lung disease. A pre\u2013post intervention prospective echocardiographic (Echo) study was undertaken, with cardiac assessments performed before and within 24\u00a0h after completion of first course of therapy (10\u00a0day regimen, cumulative 0.89\u00a0mg\u00a0kg<jats:sup>\u20131<\/jats:sup>). Thirty infants with a gestational age of 24.6\u00a0\u00b1\u00a01.1\u00a0weeks and birthweight of 612\u00a0\u00b1\u00a0125\u00a0g, respectively, were studied. The age at Dex administration was 20\u00a0\u00b1\u00a09\u00a0days. Fractional inspired oxygen decreased from 0.7\u00a0\u00b1\u00a00.23 to 0.35\u00a0\u00b1\u00a00.14 (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Patent ductus arteriosus was noted in 20 infants at Echo1. At Echo2, the ductal diameter decreased from 2.16\u00a0\u00b1\u00a00.8 to 1.1\u00a0\u00b1\u00a00.8\u00a0mm (<jats:italic>P\u00a0=<\/jats:italic> 0.0003), with complete closure in 7\/20 (35%). A reduction in left pulmonary artery end\u2010diastolic velocity was noted (17\u00a0\u00b1\u00a012 to 9\u00a0\u00b1\u00a010\u00a0cm\u00a0s<jats:sup>\u20131<\/jats:sup>, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Pulmonary vascular resistance decreased (increased time to peak velocity\/right ventricular ejection time, 0.2\u00a0\u00b1\u00a00.03 to 0.23 \u00a0\u00b1\u00a00.03, <jats:italic>P\u00a0=<\/jats:italic> 0.0001) and right ventricular systolic performance improved (tricuspid annular plane systolic excursion, 4.9\u00a0\u00b1\u00a00.8 to 5.5\u00a0\u00b1\u00a00.9\u00a0mm, <jats:italic>P\u00a0=<\/jats:italic> 0.02). No significant changes in fractional shortening and left ventricular mass were noted. A significant increase in blood pressure was noted. As a percentage of pre\u2010treatment baseline, the mean increase for systolic blood pressure was 20.3% (95% confidence interval\u00a0=\u00a014\u201326) on day 2 (<jats:italic>P\u00a0=<\/jats:italic> 0.008). Low\u2010dose Dex influenced cardiovascular parameters related to pulmonary circulation.\n<jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/tjp15211-gra-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec><jats:sec><jats:title>Key points<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Corticosteroid therapy is frequently used in preterm infants who are dependent on ventilator support.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Echocardiographic studies in infants administered a 6\u00a0week course of steroids have noted left ventricular hypertrophy, outlet obstruction and hypertension, but no information is available on right heart indices.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>The cardiopulmonary effects of the current, significantly lesser cumulative dose (10\u00a0day regimen, commonly described as \u2018DART\u2019) have not been evaluated.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>The present study noted a significant influence on ductal and pulmonary circulation indices. Left heart architecture and function was maintained, whereas a significant but transient increase in blood pressure was noted.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec>","DOI":"10.1113\/jp282973","type":"journal-article","created":{"date-parts":[[2022,9,7]],"date-time":"2022-09-07T04:38:40Z","timestamp":1662525520000},"page":"4361-4373","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Cardiorespiratory adaptation to low\u2010dose dexamethasone for lung disease in extremely preterm infants: A prospective echocardiographic study"],"prefix":"10.1113","volume":"600","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2600-7529","authenticated-orcid":false,"given":"Arvind","family":"Sehgal","sequence":"first","affiliation":[{"name":"Monash Newborn Monash Children's Hospital  Melbourne VIC Australia"},{"name":"Department of Paediatrics Monash University  Melbourne VIC Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcel F.","family":"Nold","sequence":"additional","affiliation":[{"name":"Monash Newborn Monash Children's Hospital  Melbourne VIC Australia"},{"name":"Department of Paediatrics Monash University  Melbourne VIC Australia"},{"name":"Ritchie Centre Hudson Institute of Medical Research  Melbourne VIC Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9111-5027","authenticated-orcid":false,"given":"Calum T.","family":"Roberts","sequence":"additional","affiliation":[{"name":"Monash Newborn Monash Children's Hospital  Melbourne VIC Australia"},{"name":"Department of Paediatrics Monash University  Melbourne VIC Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Menahem","sequence":"additional","affiliation":[{"name":"Emeritus Head, Paediatric and Fetal Cardiac Units Monash Medical Centre, Monash Health  Melbourne VIC Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,9,6]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.75.1.106"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00202-6"},{"key":"e_1_2_6_4_1","first-page":"41","article-title":"Dexamethasone therapy in severe bronchopulmonary dysplasia","volume":"24","author":"Bourchier D.","year":"1988","journal-title":"Australian Paediatric Journal"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(80)80862-6"},{"key":"e_1_2_6_6_1","first-page":"1225","article-title":"Disproportionate septal hypertrophy associated with erythroblastosis fetalis","volume":"144","author":"Carter B. 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