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Published on: January 16, 2013
[Bronchiolitis and pulmonary hypertension]
Luiza Bardi-Peti1, Eugen Pascal Ciofu
1Universitatea de Medicină si Farmacie "Carol Davila", S.C.U.C. "Grigore Alexandrescu", Bucureşti. luizabardi@yahoo.com
Insights
Previously healthy infants with bronchiolitis can develop elevated pulmonary artery pressures (PAP), indicating potential pulmonary hypertension. This finding suggests PAP may be a useful indicator for disease severity and prognosis in infants with bronchiolitis.
Area of Science:
- Pediatric Cardiology
- Pulmonology
- Neonatal Medicine
Background:
- Bronchiolitis is a common respiratory infection in infants.
- Pulmonary hypertension (PHT) is a serious condition that can arise from respiratory illnesses.
- The relationship between bronchiolitis and elevated pulmonary artery pressures (PAP) in previously healthy infants requires further investigation.
Purpose of the Study:
- To determine if previously healthy infants diagnosed with bronchiolitis exhibit increased pulmonary artery pressures.
- To evaluate the potential link between bronchiolitis and the development of pulmonary hypertension.
Main Methods:
- Echocardiography (2D and Doppler) was used to measure pulmonary arterial pressure (PAP) in 94 infants (47 with bronchiolitis, 47 controls) aged 2-12 months.
- Infants with congenital heart disease or other causes of pulmonary hypertension were excluded.
- Pulmonary arterial pressure was estimated using time to peak velocity corrected for heart rate; Student's t-test was used for comparisons.
Main Results:
- 13 infants with bronchiolitis showed elevated mean PAP (> 25 mmHg), categorized as mild-moderate pulmonary hypertension.
- Mean PAP was significantly higher in infants with bronchiolitis compared to controls (p = 0.001).
- Infants with bronchiolitis and pulmonary hypertension had significantly longer hospitalizations (p = 0.006) and higher PAP with moderate/severe wheezing (p = 0.001).
Conclusions:
- Echocardiography provides valuable insights into pulmonary hypertension in infants with bronchiolitis.
- Pulmonary hypertension may serve as a criterion for assessing disease severity, a prognostic factor, and a guide for therapeutic interventions in bronchiolitis.
Objectives:
The study was undertaken to assess whether previously healthy infants with bronchiolitis develop elevated pulmonary artery pressures.
Material And Methods:
We performed 2D and Doppler echocardiography in 94 infants, aged between 2 and 12 months, from November 2007 to December 2009. 47 infants had bronchiolitis and 47 were in the control group. We excluded children with congenital heart diseases and other conditions associated with pulmonary hypertension. The method of time to peak velocity corrected for heart rate was used to estimate pulmonary arterial pressure (PAP). A Student's t-test for independent samples was used to compare the mean values of variables.
Outcomes:
Increased mean pulmonary pressures (> 25 mmHg) were measured in 13 infants with bronchiolitis. The values were categorized as mild-moderate pulmonary hypertension. Mean PAP were significantly increased in subjects with bronchiolitis, vs. control (p = 0.001). In infants with bronchiolitis, hospitalisation was significantly longer at patients with pulmonary hypertension vs. normal PAP (p = 0.006). Mean PAP were significantly increased in subjects with a moderate/severe episode of wheezing at admission vs. a mild episode (p = 0.001).
Conclusion:
Echocardiography brings valuable informations regarding pulmonary hypertension in bronchiolitis. PHT could be a criterion in establishing the severity of disease, a prognosis factor and an element of therapeutic guidance.
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