Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Pediatrics, Division of Neonatology, Development Research Center, Child Growth, Isfahan University of Medical Sciences, Isfahan, Iran.
Pediatr Cardiol. 2024 Dec;45(8):1816-1822. doi: 10.1007/s00246-023-03295-7. Epub 2023 Sep 10.
Preterm infants with bronchopulmonary dysplasia (BPD) frequently encounter systemic hypertension, yet the underlying cause remains elusive. Given the absence of prior investigations concerning the correlation between systemic hypertension and aortic thickness, we undertook this study to assess and juxtapose diverse vascular indices amidst preterm neonates with BPD, preterm neonates lacking BPD, and healthy neonates, utilizing abdominal aorta ultrasonography. This cross-sectional study encompassed 20 preterm neonates, 20 preterm neonates with BPD, and 20 healthy neonates, meticulously matched for sex and postnatal age. Comprehensive demographic, anthropometric, and clinical evaluation data were documented. The neonates underwent abdominal aortic ultrasonography for comparative evaluation of aortic wall thickness and vasomotor function across the three groups. The study revealed that neonates with BPD exhibited a notably higher average systolic blood pressure than preterm and term neonates (P < 0.05). Conversely, echocardiographic parameters such as input impedance, and arterial wall stiffness index displayed no substantial variance among the three groups (P > 0.05). The mean (SD) aortic intima-media thickness (aIMT) for preterm neonates with BPD, preterm neonates, and term neonates were 814 (193.59) μm, 497.50 (172.19) μm, and 574.00 (113.20) μm, correspondingly (P < 0.05). Furthermore, the mean (SD) pulsatile diameter for preterm neonates with BPD, preterm neonates, and term neonates were 1.52 (0.81) mm, 0.91 (0.55) mm, and 1.34 (0.51) mm, respectively (P < 0.05). Following adjustment for birth weight, sex, and gestational age at birth, the study identified a noteworthy correlation between aIMT and BPD. The investigation concluded that the mean aortic intima-media thickness (aIMT) was significantly elevated in preterm neonates with BPD, signifying a potential early indicator of atherosclerosis and predisposition to future heightened blood pressure and cardiovascular ailments. Consequently, the study postulates that aIMT could be a consistent and well-tolerated marker for identifying BPD patients at risk of developing these health complications.
患有支气管肺发育不良 (BPD) 的早产儿经常会出现全身性高血压,但根本原因仍不清楚。鉴于之前没有研究过全身性高血压与主动脉厚度之间的相关性,我们进行了这项研究,旨在使用腹部主动脉超声评估和比较患有 BPD 的早产儿、没有 BPD 的早产儿和健康新生儿之间的不同血管指数。这项横断面研究纳入了 20 名早产儿、20 名患有 BPD 的早产儿和 20 名健康新生儿,他们在性别和出生后年龄方面进行了精细匹配。记录了全面的人口统计学、人体测量学和临床评估数据。对新生儿进行了腹部主动脉超声检查,以比较三组新生儿的主动脉壁厚度和血管舒缩功能。研究结果显示,患有 BPD 的早产儿的平均收缩压明显高于早产儿和足月儿(P < 0.05)。相反,三组之间的超声心动图参数,如输入阻抗和动脉壁僵硬指数没有显著差异(P > 0.05)。患有 BPD 的早产儿、早产儿和足月儿的平均(标准差)主动脉内膜中层厚度(aIMT)分别为 814(193.59)μm、497.50(172.19)μm 和 574.00(113.20)μm(P < 0.05)。此外,患有 BPD 的早产儿、早产儿和足月儿的平均(标准差)脉动直径分别为 1.52(0.81)mm、0.91(0.55)mm 和 1.34(0.51)mm(P < 0.05)。在调整出生体重、性别和出生时的胎龄后,研究发现 aIMT 与 BPD 之间存在显著相关性。该研究得出结论,患有 BPD 的早产儿的平均主动脉内膜中层厚度(aIMT)显著升高,这表明动脉粥样硬化的潜在早期指标以及未来血压升高和心血管疾病的易感性增加。因此,该研究假设 aIMT 可能是一种一致且耐受性良好的标志物,可用于识别患有 BPD 并有可能出现这些健康并发症的患者。