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Differences in Pulmonary Artery Stiffness Measured by CMR in Preterm-Born Young Adults With and Without
Wouter J van Genuchten1, Jarno J Steenhorst1,2,3, Gabrielle M J W van Tussenbroek1
1Division 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.).
Insights
Young adults born very preterm with bronchopulmonary dysplasia (BPD) exhibit increased pulmonary artery stiffness. This study used cardiovascular magnetic resonance to detect early signs of pulmonary arterial hypertension in this population.
Area of Science:
- Cardiology
- Pulmonology
- Medical Imaging
Background:
- Very preterm infants face risks for bronchopulmonary dysplasia (BPD), a chronic lung condition.
- Adults born very preterm are susceptible to developing pulmonary arterial (PA) hypertension.
- Increased PA stiffness is an early indicator of PA hypertension.
Purpose of the Study:
- To compare PA stiffness using cardiovascular magnetic resonance (CMR) in very preterm-born young adults with and without BPD.
- To identify early signs of PA hypertension in this population.
- To assess PA relative area change (RAC) and pulse wave velocity (PWV) as measures of PA stiffness.
Main Methods:
- Cardiovascular magnetic resonance imaging was performed on 60 young adults (20 preterm with BPD, 20 preterm without BPD, 20 at-term controls).
- Pulmonary artery relative area change (RAC) and pulse wave velocity (PWV) were calculated.
- PWV measured using simultaneous flow and area increase in the pulmonary artery during early systole.
Main Results:
- Increased PWV was observed in preterm adults with BPD compared to those without BPD and at-term controls (P=0.04).
- Decreased RAC was found in both preterm groups (with and without BPD) compared to at-term controls (P<0.01).
- Measurements were successful in 57 out of 60 participants.
Conclusions:
- Preterm-born young adults with BPD demonstrate increased PA stiffness, indicated by higher PWV.
- Both preterm groups showed reduced RAC compared to controls, suggesting altered PA mechanics.
- Noninvasive CMR assessment of PA stiffness may aid in identifying individuals at risk for early PA hypertension.
Background:
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.
Methods:
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.
Results:
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]; P=0.04) and at-term-born young adults (1.35 m/s [1.08-2.23]; P=0.04). RAC was decreased in both preterm-born young adults with (62% [56-82]; P<0.01) and without BPD (78% [67-93]; P<0.01), compared with at-term-born young adults (101% [87-122]).
Conclusions:
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.
