{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T20:35:05Z","timestamp":1765485305470,"version":"3.44.0"},"reference-count":25,"publisher":"BMJ","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"published-print":{"date-parts":[[1996,1]]},"abstract":"<jats:p>Thirty four newborns presenting with persistent hypoxaemia in the first three days of life underwent detailed haemodynamic assessment using Doppler echocardiography, including measurements of pulmonary arterial pressure (PAP), left ventricular (LV) function, and left ventricular output (LVO). Results were compared with values from 51 healthy babies, and those of survivors were compared with non-survivors. Four of the 34 babies were excluded from this analysis because one was found to have transposed great arteries, one had a large left-to-right shunt with no evidence of persistent pulmonary hypertension, and two had diffuse skeletal myopathy. Tricuspid regurgitation was present in 70%, permitting systolic PAP estimation. The pulmonary:systemic arterial pressure ratio range was 0.7:1 to 1.83:1 (mean 1.02:1). A patent duct was present in 83%, and flow patterns indicated PAP approaching, or above, systemic pressure in all. Systolic time interval ratio TPV\/RVET (time to peak velocity at the pulmonary valve\/right ventricular ejection time) was mostly (65%) in the normal range, and did not correlate with other PAP measurements. LV function was below the 10th centile in only 11%, but values for LVO lay below the 10th centile in 41%, and for left ventricular stroke volume index (LSVI) in 66%. Results of 18 survivors were compared with 10 non-survivors (excluding two premature babies who died early with pulmonary interstitial emphysema). There were no significant differences for any parameter of PAP or LV function, but LVO and LSVI were significantly lower in non-survivors: LVO survivors (mean (SD)), 205 (57), non-survivors 138 (63) ml\/kg\/minute (P &lt; 0.01); LSVI survivors, 1.29 (0.51), non-survivors 0.86 (0.31) ml\/kg (P &lt; 0.05). All four babies with LVO &lt; 100 ml\/kg\/minute died, and 6\/7 babies with LSVI &lt; 1 ml\/kg died. Detailed echocardiographic evaluation shows that the haemodynamic features of persistent pulmonary hypertension are diverse and that clinical diagnosis can be incorrect. Low LV output and stroke volume, usually with normal LV function, were the only Doppler echocardiographic parameters to predict subsequent death. This correlation with outcome requires further prospective evaluation.<\/jats:p>","DOI":"10.1136\/fn.74.1.f26","type":"journal-article","created":{"date-parts":[[2008,10,31]],"date-time":"2008-10-31T17:55:51Z","timestamp":1225475751000},"page":"F26-F32","source":"Crossref","is-referenced-by-count":54,"title":["Haemodynamic features at presentation in persistent pulmonary hypertension of the newborn and outcome."],"prefix":"10.1136","volume":"74","author":[{"given":"J. R.","family":"Skinner","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Hunter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. N.","family":"Hey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1996,1,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1002\/ppul.1950050103","article-title":"Predicting survival in infants with persistent pulmonary hypertension of the newborn","volume":"5","author":"Davis, J.M.; Spitzer, A.E.; Cox, C.; Fox, W.W.","year":"1988","unstructured":"Davis JM, Spitzer AE, Cox C, Fox WW. Predicting survival in infants with persistent pulmonary hypertension of the newborn. Pediatr Pulmonol 1988; 5: 6-9.","journal-title":"Pediatr Pulmonol"},{"issue":"39","key":"ref_2","first-page":"87","article-title":"'PFC' syndrome (persistence of the fetal circulation)","volume":"1969","author":"Gersony, W.M.; Duc, G.V.; Sinclair, J.C.","unstructured":"Gersony WM, Duc GV, Sinclair JC. 'PFC' syndrome (persistence of the fetal circulation). Circulation 1969; 39 (suppl 3): 87.","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1016\/S0022-3476(76)80404-0","article-title":"Disturbances of the transitional circulation: Spectrum of pulmonary hypertension and myocardial dysfunction","volume":"89","author":"Reimenschneider, T.A.; Nielsen, H.C.; Ruttenberg, M.D.; Jaffe, R.B.","year":"1976","unstructured":"Reimenschneider TA, Nielsen HC, Ruttenberg MD, Jaffe RB. Disturbances of the transitional circulation: Spectrum of pulmonary hypertension and myocardial dysfunction. Jf Pediatr 1976; 89: 622-5.","journal-title":"Jf Pediatr"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/S0095-5108(18)30899-6","article-title":"Neonatal pulmonary hypertension: pathophysiology, classification and etiology","volume":"11","author":"Gersony, W.M.","year":"1984","unstructured":"Gersony WM. Neonatal pulmonary hypertension: pathophysiology, classification and etiology. Clin Perinatol 1984; 11: 517-24.","journal-title":"Clin Perinatol"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1016\/S0735-1097(85)80477-0","article-title":"Continuous wave Doppler determination of right ventricular pressure: a simultaneous Doppler-catheterization study in 127 patients","volume":"6","author":"Currie, P.J.; Seward, J.B.; Chan, K.L.; Fyfe, D.A.; Hagler, D.H.; Mair, D.D.","year":"1985","unstructured":"Currie PJ, Seward JB, Chan KL, Fyfe DA, Hagler DH, Mair DD, et al. Continuous wave Doppler determination of right ventricular pressure: a simultaneous Doppler-catheterization study in 127 patients. Jf Am Coil Cardiol 1985; 6: 750-6.","journal-title":"Jf Am Coil Cardiol"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1136\/adc.69.2.216","article-title":"Validation of right heart pressure determination by Doppler in infants with tricuspid regurgitation","volume":"69","author":"Skinner, JR, Stuart; AGS, O.'Sullivan; J, Heads; A, Boys; RJ, Hunter; S.","year":"1993","unstructured":"Skinner JR, Stuart AGS, O'Sullivan J, Heads A, Boys RJ, Hunter S. Validation of right heart pressure determination by Doppler in infants with tricuspid regurgitation. Arch Dis Child 1993; 69: F216-20.","journal-title":"Arch Dis Child"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1136\/adc.66.4_Spec_No.386","article-title":"Non-invasive determination of pulmonary arterial pressure in healthy neonates","volume":"66","author":"Skinner, JR, Boys; RJ, Hunter; S, Hey; E.N.","year":"1991","unstructured":"Skinner JR, Boys RJ, Hunter S, Hey EN. Non-invasive determination of pulmonary arterial pressure in healthy neonates. Arch Dis Child 1991; 66: F386-90.","journal-title":"Arch Dis Child"},{"key":"ref_8","first-page":"284","article-title":"Doppler flow characteristics in the assessment of pulmonary artery pressure in ductus arteriosus","volume":"62","author":"Houston, A.B.; Lim, M.K.; Doig, W.B.; Gnanapragasam, J.; Coleman, E.N.; Jamieson, M.P.G.","year":"1989","unstructured":"Houston AB, Lim MK, Doig WB, Gnanapragasam J, Coleman EN, Jamieson MPG, et al. Doppler flow characteristics in the assessment of pulmonary artery pressure in ductus arteriosus. BrHeartJ 1989; 62: 284-90.","journal-title":"BrHeartJ"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1016\/S0735-1097(10)80076-2","article-title":"Doppler echocardiographic measurement of pulmonary artery pressure from ductal Doppler velocities in the newborn","volume":"15","author":"Musewe, N.N.; Poppe, D.; Smallhorn, J.F.; Hellman, J.; Whyte, H.; Smith, B.","year":"1990","unstructured":"Musewe NN, Poppe D, Smallhorn JF, Hellman J, Whyte H, Smith B, et al. Doppler echocardiographic measurement of pulmonary artery pressure from ductal Doppler velocities in the newborn. JAm Coil Cardiol 1990; 15: 446-56.","journal-title":"JAm Coil Cardiol"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1016\/0002-9149(84)90646-5","article-title":"Doppler echocardiographic prediction of pulmonary arterial hypertension in congenital heart disease","volume":"53","author":"Kosturakis, D.; Goldberg, S.J.; Allen, H.D.; Loeber, C.","year":"1984","unstructured":"Kosturakis D, Goldberg SJ, Allen HD, Loeber C. Doppler echocardiographic prediction of pulmonary arterial hypertension in congenital heart disease. Am _J Cardiol 1984; 53: 1110-5.","journal-title":"Am _J Cardiol"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1136\/adc.65.1_Spec_No.24","article-title":"Postnatal circulatory adaptation in healthy term and preterm neonates","volume":"65","author":"Evans, N.J.; Archer, L.N.J.","year":"1990","unstructured":"Evans NJ, Archer LNJ. Postnatal circulatory adaptation in healthy term and preterm neonates. Arch Dis Child 1990; 65: 24-6.","journal-title":"Arch Dis Child"},{"key":"ref_12","first-page":"939","article-title":"Assessment of the pulmonary vascular bed by echocardiographic right ventricular systolic time intervals","volume":"5","author":"Riggs, T.; Hirschfeld, S.; Borkat, G.; Knoke, J.; Liebman, J.","year":"1977","unstructured":"Riggs T, Hirschfeld S, Borkat G, Knoke J, Liebman J. Assessment of the pulmonary vascular bed by echocardiographic right ventricular systolic time intervals. Circulation 1977; 5: 939-47.","journal-title":"Circulation"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1016\/S0022-3476(77)80521-0","article-title":"Persistence of fetal circulation syndrome: An echocardiographic study","volume":"91","author":"Riggs, T.; Hirschfeld, S.; Fanaroff, A.; Liebman, J.","year":"1977","unstructured":"Riggs T, Hirschfeld S, Fanaroff A, Liebman J. Persistence of fetal circulation syndrome: An echocardiographic study. _J Pediatr 1977; 91: 626-31.","journal-title":"_J Pediatr"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1016\/S0022-3476(80)80752-9","article-title":"Echocardiography in hypoxemic neonatal pulmonary disease","volume":"96","author":"Johnson, G.L.; Cunningham, M.D.; Desai, N.S.; Cottrill, C.M.; Noonan, J.A.","year":"1980","unstructured":"Johnson GL, Cunningham MD, Desai NS, Cottrill CM, Noonan JA. Echocardiography in hypoxemic neonatal pulmonary disease. JPediatr 1980; 96: 716-20.","journal-title":"JPediatr"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1542\/peds.60.4.444","article-title":"Respiratory distress syndrome: echocardiographic assessment of cardiovascular function and pulmonary vascular resistance","volume":"60","author":"Halliday, H.; Hirschfeld, S.; Riggs, T.; Liebman, J.; Fanaroff, A.; Bormuth, C.","year":"1977","unstructured":"Halliday H, Hirschfeld S, Riggs T, Liebman J, Fanaroff A, Bormuth C. Respiratory distress syndrome: echocardiographic assessment of cardiovascular function and pulmonary vascular resistance. Pediatrics 1977; 60: 444-9.","journal-title":"Pediatrics"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/S0022-3476(82)80178-9","article-title":"Noninvasive pulsed Doppler determination of cardiac output in neonates and children","volume":"101","author":"Alverson, D.; Eldridge, M.; Dillon, T.; Yabek, S.; Berman, W.","year":"1982","unstructured":"Alverson D, Eldridge M, Dillon T, Yabek S, Berman W. Noninvasive pulsed Doppler determination of cardiac output in neonates and children. Jf Pediatr 1982; 101: 46-50.","journal-title":"Jf Pediatr"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1136\/adc.65.1_Spec_No.15","article-title":"Reproducibility of measurements of cardiac output in newborn infants by Doppler ultrasound","volume":"65","author":"Hudson, I.; Houston, A.; Aitchison, T.; Holland, B.; Turner, T.","year":"1990","unstructured":"Hudson I, Houston A, Aitchison T, Holland B, Turner T. Reproducibility of measurements of cardiac output in newborn infants by Doppler ultrasound. Arch Dis Child 1990; 65: F15-19.","journal-title":"Arch Dis Child"},{"key":"ref_18","first-page":"1072","article-title":"Recommendations regarding quantitation in m-mode echocardiography: results of a survey of echocardiographic measurements","volume":"6","author":"Sahn, D.J.; DeMaria, A.; Kisslo, J.; Weyman, A.","year":"1978","unstructured":"Sahn DJ, DeMaria A, Kisslo J, Weyman A. Recommendations regarding quantitation in m-mode echocardiography: results of a survey of echocardiographic measurements. Circulation 1978; 6: 1072-83.","journal-title":"Circulation"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1136\/adc.67.4_Spec_No.374","article-title":"Central venous pressure in the ventilated neonate","volume":"67","author":"Skinner, JR, Milligan; DWA, Hunter; S, Hey; E.N.","year":"1992","unstructured":"Skinner JR, Milligan DWA, Hunter S, Hey EN. Central venous pressure in the ventilated neonate. Arch Dis Child 1992; 67: 374-7.","journal-title":"Arch Dis Child"},{"key":"ref_20","first-page":"41","article-title":"Interatrial shunt flow profiles in newborn infants: a colour flow and pulsed Doppler echocardiographic study","volume":"65","author":"Hiraishi, S.; Agata, Y.; Saito, K.; Oguchi, K.; Misawa, H.; Fujino, N.","year":"1991","unstructured":"Hiraishi S, Agata Y, Saito K, Oguchi K, Misawa H, Fujino N, et al. Interatrial shunt flow profiles in newborn infants: a colour flow and pulsed Doppler echocardiographic study. BrHeartJ 1991; 65: 41-5.","journal-title":"BrHeartJ"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1016\/0002-9149(83)90426-5","article-title":"Noninvasive diagnosis of persistent fetal circulation versus congenital cardiovascular defects","volume":"52","author":"Linday, L.A.; Ehlers, K.H.; O'Loughlin, J.E.; LaGamma, E.F.; Engle, M.A.","year":"1983","unstructured":"Linday LA, Ehlers KH, O'Loughlin JE, LaGamma EF, Engle MA. Noninvasive diagnosis of persistent fetal circulation versus congenital cardiovascular defects. Am Jf Cardiol 1983; 52: 847-51.","journal-title":"Am Jf Cardiol"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/S0894-7317(89)80053-7","article-title":"Comparison of several non-invasive methods for estimation of pulmonary artery pressure","volume":"2","author":"Stevenson, G.S.","year":"1989","unstructured":"Stevenson GS. Comparison of several non-invasive methods for estimation of pulmonary artery pressure. JAm Soc Echocardiogr 1989; 2: 157-71.","journal-title":"JAm Soc Echocardiogr"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1136\/adc.67.4_Spec_No.366","article-title":"Pulmonary and systemic arterial pressure in hyaline membrane disease","volume":"67","author":"Skinner, JR, Boys; RJ, Hunter; S, Hey; E.N.","year":"1992","unstructured":"Skinner JR, Boys RJ, Hunter S, Hey EN. Pulmonary and systemic arterial pressure in hyaline membrane disease. Arch Dis Child 1992; 67: F366-73.","journal-title":"Arch Dis Child"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1542\/peds.90.6.899","article-title":"Persistent pulmonary hypertension in premature neonates with severe respiratory distress syndrome","volume":"90","author":"Walther, F.J.; Benders, M.J.; Leighton, J.O.","year":"1992","unstructured":"Walther FJ, Benders MJ, Leighton JO. Persistent pulmonary hypertension in premature neonates with severe respiratory distress syndrome. Pediatrics 1992; 90: 899-904.","journal-title":"Pediatrics"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/S0022-3476(80)80832-8","article-title":"Papillary muscle necrosis in a neonatal autopsy population: incidence and associated clinical manifestations","volume":"96","author":"Setzer, E.; Ermocilla, R.; Tonkin, I.; John, E.; Sansa, M.; Cassady, G.","year":"1980","unstructured":"Setzer E, Ermocilla R, Tonkin I, John E, Sansa M, Cassady G. Papillary muscle necrosis in a neonatal autopsy population: incidence and associated clinical manifestations. JPediatr 1980; 96: 289-94.","journal-title":"JPediatr"}],"container-title":["Archives of Disease in Childhood - Fetal and Neonatal Edition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/fn.74.1.F26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T19:30:02Z","timestamp":1757100602000},"score":1,"resource":{"primary":{"URL":"https:\/\/fn.bmj.com\/lookup\/doi\/10.1136\/fn.74.1.F26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1996,1]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[1996,1,1]]},"published-print":{"date-parts":[[1996,1]]}},"alternative-id":["10.1136\/fn.74.1.F26"],"URL":"https:\/\/doi.org\/10.1136\/fn.74.1.f26","relation":{},"ISSN":["1359-2998","1468-2052"],"issn-type":[{"type":"print","value":"1359-2998"},{"type":"electronic","value":"1468-2052"}],"subject":[],"published":{"date-parts":[[1996,1]]}}}