Myocardial performance index by tissue Doppler in bronchopulmonary dysplasia survivors
Ebru Kazanci1, Tevfik Karagöz, Gülsevin Tekinalp
1Department of Pediatrics, Gazi University Faculty of Medicine, Ankara, Turkey.
Insights
Survivors of bronchopulmonary dysplasia (BPD) show subclinical ventricular dysfunction. Myocardial performance index (MPI) via tissue Doppler echocardiography (TDE) revealed higher values in BPD patients, indicating early cardiac changes.
Area of Science:
- Pediatric Cardiology
- Neonatal Medicine
- Cardiovascular Physiology
Background:
- Bronchopulmonary dysplasia (BPD) survivors often undergo echocardiography, but previous studies found no significant cardiac differences compared to healthy children.
- Conventional echocardiography may not detect subtle cardiac changes in BPD survivors.
Purpose of the Study:
- To investigate subclinical ventricular dysfunction in BPD survivors using myocardial performance index (MPI) with tissue Doppler echocardiography (TDE).
- To compare cardiac function between BPD survivors and healthy controls.
Main Methods:
- Fifteen asymptomatic BPD survivors and age/sex-matched controls underwent M-mode, 2D, and TDE echocardiography.
- Pulmonary artery systolic pressures (PAPs) and ventricular MPI were measured.
- Data were compared between BPD survivors and controls.
Main Results:
- No significant differences were found using conventional M-mode and 2D echocardiography.
- Both right and left ventricular MPI were significantly higher in the BPD group compared to controls.
- Mean PAPs were elevated in BPD survivors, with a positive correlation between PAPs and right ventricular MPI.
Conclusions:
- MPI measured by TDE is a sensitive tool for detecting subclinical ventricular dysfunction in BPD survivors.
- BPD survivors may have underlying cardiac abnormalities not detected by routine echocardiography.
- This study is the first to demonstrate subclinical ventricular dysfunction in BPD survivors.
Abstract:
Bronchopulmonary dysplasia (BPD) survivors from the surfactant era were evaluated by echocardiography in a few studies and no significant differences were found between BPD and non-BPD children. In this study, we evaluated these children with myocardial performance index (MPI), which was obtained by tissue Doppler echocardiography (TDE) in addition to the conventional methods. Fifteen children with BPD who did not have any cardiopulmonary symptoms at the time of the study were examined. All children were studied with M-mode, two-dimensional and DE. Pulmonary artery systolic pressures (PAPs) were estimated from tricuspid regurgitant velocity, and MPI for both ventricles were obtained by TDE. Results were compared with those of term-born, age- and sex-matched control children. While the variables obtained by M-mode and DE did not differ between the groups, the right and left ventricular MPI were found to be significantly higher in the BPD group compared with the control group (mean right ventricular MPI 0.48 +/- 0.04 vs. 0.41 +/- 0.05; mean left ventricular MPI 0.47 +/- 0.05 vs. 0.39 +/- 0.06). In addition, mean PAPs values of the patients were found to be significantly higher than those of the controls (30.4 +/- 6.9 mmHg vs. 23.3 +/- 5.3 mmHg), and there was a positive correlation between PAPs and right ventricular MPI values in the BPD group (r = 0.5). While routine echocardiographic examinations revealed no difference between the groups, MPI measurements by TDE technique yielded significantly higher values in the BPD group. To this extent, our study is the first to show that survivors of BPD may, in fact, have a subclinical ventricular dysfunction.
