van Genuchten Wouter J, Steenhorst Jarno J, van Tussenbroek Gabrielle M J W, van der Velde Nikki, Kamphuis Lieke S, Reiss Irwin K M, Merkus Daphne, Helbing Willem A, Hirsch Alexander
Division of Pediatric Cardiology, Department of Pediatrics, Cardiovascular Institute, Erasmus MC, Rotterdam, The Netherlands (W.J.v.G., J.J.S., G.M.J.W.v.T., W.A.H.).
Department of Cardiology, Cardiovascular Institute, Thorax Center, Erasmus MC, Rotterdam, The Netherlands (J.J.S., N.v.d.V., D.M., A.H.).
Circ Cardiovasc Imaging. 2025 Apr;18(4):e017791. doi: 10.1161/CIRCIMAGING.124.017791. Epub 2025 Mar 13.
Very preterm-born infants are at risk for developing bronchopulmonary dysplasia (BPD), a chronic lung disease. Nowadays, the majority of these infants reach adulthood. Very preterm-born young adults are at risk for developing pulmonary arterial (PA) hypertension later in life. An early sign of PA hypertension is increased PA stiffness. This study aims to use cardiovascular magnetic resonance to compare PA stiffness using PA relative area change (RAC) and pulse wave velocity (PWV) to identify early signs for PA hypertension in young adults born very premature, with and without BPD.
Twenty preterm-born young adults with and 20 without BPD underwent cardiovascular magnetic resonance and were compared with 20 at-term-born young adults. RAC was calculated as the percentage change between the maximal and minimal areas of the PA. PWV was calculated using a method that simultaneously compares flow and area increase in the pulmonary artery during early systole.
In 57 of 60 patients, PWV and RAC measurements could be performed. Preterm-born young adults with BPD showed increased PWV compared with preterm-born young adults without BPD (median [25th-75th percentile] 2.07 m/s [1.45-3.05] versus 1.61 m/s [1.18-1.85]; =0.04) and at-term-born young adults (1.35 m/s [1.08-2.23]; =0.04). RAC was decreased in both preterm-born young adults with (62% [56-82]; <0.01) and without BPD (78% [67-93]; <0.01), compared with at-term-born young adults (101% [87-122]).
Preterm-born young adults with BPD show increased PA stiffness as measured by PWV compared with preterm-born young adults without BPD and at-term-born young adults; RAC was decreased in both preterm-born groups compared with at-term controls. This noninvasive method of measuring PA stiffness might be a valuable tool to identify individuals at risk for early signs of PA hypertension in this population.
极早早产儿有患支气管肺发育不良（BPD）这一慢性肺部疾病的风险。如今，这些婴儿中的大多数已成年。极早早产的年轻成年人在以后的生活中有患肺动脉（PA）高压的风险。PA高压的一个早期迹象是PA僵硬度增加。本研究旨在使用心血管磁共振成像，通过PA相对面积变化（RAC）和脉搏波速度（PWV）来比较PA僵硬度，以识别极早早产且有或无BPD的年轻成年人中PA高压的早期迹象。
20名患有BPD的极早早产年轻成年人和20名无BPD的极早早产年轻成年人接受了心血管磁共振成像检查，并与20名足月出生的年轻成年人进行比较。RAC计算为PA最大和最小面积之间的百分比变化。PWV使用一种在早期收缩期同时比较肺动脉血流和面积增加的方法进行计算。
60例患者中有57例可进行PWV和RAC测量。与无BPD的极早早产年轻成年人（中位数[第25 - 75百分位数]2.07 m/s[1.45 - 3.05]）和足月出生的年轻成年人（1.35 m/s[1.08 - 2.23]）相比，患有BPD的极早早产年轻成年人的PWV增加（P = 0.04）。与足月出生的年轻成年人（101%[87 - 122]）相比，患有（62%[56 - 82]；P < 0.01）和无BPD（78%[67 - 93]；P < 0.01）的极早早产年轻成年人的RAC均降低。
与无BPD的极早早产年轻成年人和足月出生的年轻成年人相比，患有BPD的极早早产年轻成年人经PWV测量显示PA僵硬度增加；与足月对照组相比，两个极早早产组的RAC均降低。这种测量PA僵硬度的非侵入性方法可能是识别该人群中PA高压早期迹象风险个体的有价值工具。
