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Pulmonary Hypertension and Pulmonary Vasodilators

Roberta L Keller1

  • 1Neonatology, Department of Pediatrics, UCSF Benioff Children's Hospital, University of California San Francisco, Box 0734, 550 16th Street, 5th Floor, San Francisco, CA 94143, USA.

Clinics in Perinatology
|February 16, 2016
PubMed

Insights

Diagnosing chronic pulmonary hypertension in infants with lung disease requires better echocardiographic criteria. Current methods lack validation for identifying infants needing treatment for cardiovascular comorbidities.

Area of Science:

  • Pediatric Cardiology
  • Neonatology
  • Pulmonology

Background:

  • Pulmonary hypertension presents acutely (persistent pulmonary hypertension of the newborn) or chronically in the perinatal period.
  • While acute pulmonary hypertension diagnosis is established, validated echocardiographic criteria for chronic forms are lacking.
  • Infants with lung disease are at risk for chronic pulmonary hypertension and associated cardiovascular issues.

Purpose of the Study:

  • To highlight the need for validated echocardiographic criteria for diagnosing chronic pulmonary hypertension in infants.
  • To emphasize the importance of evaluating cardiovascular comorbidities in these infants.
  • To address the uncertainty in treatment decisions without confirmed pulmonary vascular disease.

Main Methods:

  • Review of current diagnostic standards for pulmonary hypertension in neonates.
  • Analysis of echocardiographic utility in identifying chronic pulmonary hypertension.
  • Discussion of the role of cardiac catheterization in diagnosis and comorbidity assessment.

Main Results:

  • Existing echocardiographic criteria are insufficient for diagnosing chronic pulmonary hypertension in infants with lung disease.
  • Cardiovascular comorbidities frequently accompany pulmonary hypertension and lung disease in infants.
  • Confirmation of pulmonary vascular disease via cardiac catheterization is crucial for guiding treatment.

Conclusions:

  • Validated echocardiographic criteria are urgently needed for chronic pulmonary hypertension in at-risk infants.
  • Comprehensive evaluation including cardiac catheterization is essential for accurate diagnosis and management.
  • Further research should focus on developing reliable diagnostic tools for this population.

Keywords:
Bronchopulmonary dysplasiaCongenital diaphragmatic herniaEchocardiographyPersistent pulmonary hypertension of the newbornPulmonary vascular diseasePulmonary vascular resistance

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