{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:44:38Z","timestamp":1790750678068,"version":"4.1.0"},"reference-count":76,"publisher":"European Respiratory Society (ERS)","issue":"6","license":[{"start":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T00:00:00Z","timestamp":1694044800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2023,7,24]]},"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Pulmonary vascular disease (PVD) affects the majority of preterm neonates with bronchopulmonary dysplasia (BPD) and significantly determines long-term mortality through undetected progression into pulmonary hypertension. Our objectives were to associate characteristics of pulmonary artery (PA) flow and cardiac function with BPD-associated PVD near term using advanced magnetic resonance imaging (MRI) for improved risk stratification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Preterms &lt;32\u2005weeks postmenstrual age (PMA) with\/without BPD were clinically monitored including standard echocardiography and prospectively enrolled for 3\u2005T MRI in spontaneous sleep near term (AIRR (Attention to Infants at Respiratory Risks) study). Semi-manual PA flow quantification (phase-contrast MRI; no BPD n=28, mild BPD n=35 and moderate\/severe BPD n=25) was complemented by cardiac function assessment (cine MRI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified abnormalities in PA flow and cardiac function,<jats:italic>i.e.<\/jats:italic>increased net forward volume right\/left ratio, decreased mean relative area change and pathological right end-diastolic volume, to sensitively detect BPD-associated PVD while correcting for PMA (leave-one-out area under the curve 0.88, sensitivity 0.80 and specificity 0.81). We linked these changes to increased right ventricular (RV) afterload (RV\u2013arterial coupling (p=0.02), PA mid-systolic notching (t2; p=0.015) and cardiac index (p=1.67\u00d710<jats:sup>\u22128<\/jats:sup>)) and correlated echocardiographic findings. Identified in moderate\/severe BPD, we successfully applied the PA flow model in heterogeneous mild BPD cases, demonstrating strong correlation of PVD probability with indicators of BPD severity,<jats:italic>i.e.<\/jats:italic>duration of mechanical ventilation (r<jats:sub>s<\/jats:sub>=0.63, p=2.20\u00d710<jats:sup>\u22124<\/jats:sup>) and oxygen supplementation (r<jats:sub>s<\/jats:sub>=0.60, p=6.00\u00d710<jats:sup>\u22124<\/jats:sup>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Abnormalities in MRI PA flow and cardiac function exhibit significant, synergistic potential to detect BPD-associated PVD, advancing the possibilities of risk-adapted monitoring.<\/jats:p><\/jats:sec>","DOI":"10.1183\/13993003.02445-2022","type":"journal-article","created":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T15:15:46Z","timestamp":1694099746000},"page":"2202445","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":12,"title":["MRI pulmonary artery flow detects lung vascular pathology in preterms with lung 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