気管支肺異形成症における心エコー検査の臨床的有用性：後向きコホート研究

Bronchopulmonary dysplasia (BPD) is a common chronic lung complication in preterm infants, often complicated by cardiopulmonary dysfunction and poor outcomes. This study aimed to evaluate echocardiographic parameter differences at 36 weeks postmenstrual age (PMA) between preterm infants with and without BPD, and explore echocardiography's utility for BPD identification.

A retrospective cohort study included 94 preterm infants (gestational age < 32 weeks) admitted to the NICU (2019-2023). They were grouped by 2018 NICHD criteria: Non-BPD (n = 50, no/mild respiratory support) and BPD (n = 44, requiring prolonged oxygen/mechanical ventilation). Standard transthoracic echocardiography (TTE) at 36 weeks PMA assessed left ventricular (LV), right ventricular (RV), and tissue Doppler imaging (TDI) parameters.

Gestational age and birth weight were comparable between groups (p < 0.01), but BPD infants had longer mechanical ventilation duration (p < 0.01). BPD infants showed significant cardiac dysfunction: reduced LV ejection fraction (LVEF), mitral valve E velocity (MV-E), and MV-E/A ratio; decreased RV tricuspid annular plane systolic excursion (TAPSE) and fractional area change (FAC); and abnormal TDI (lower TV-S'/E'/A', higher TV-E/E' ratio) (all p < 0.01).

Echocardiographic parameters reflecting biventricular systolic/diastolic dysfunction differ significantly between BPD and non-BPD preterm infants, indicating potential for BPD identification.