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Cardiovascular findings in very low birthweight schoolchildren with and without bronchopulmonary dysplasia
Authors:Korhonen P  Hyödynmaa E  Lautamatti V  Iivainen T  Tammela O
Institution:Paediatric Research Centre, Tampere University Hospital, PO Box 2000, Fin-33521 Tampere, Finland.
Abstract:BACKGROUND: With the introduction of new therapies in peri- and neonatology, the clinical picture of bronchopulmonary dysplasia (BPD) seems to alter. The consequences of this "new BPD" are of interest. AIM: To evaluate cardiovascular findings during the surfactant era in very low birthweight (VLBW, birth weight < 1500 g) schoolchildren with and without BPD. METHODS: At 7-8 years of age, 34 VLBW children with BPD born in one hospital underwent blood pressure (BP) measurement, electrocardiography (ECG), two-dimensional Doppler and M-mode echocardiography, flow-volume spirometry and whole-body plethysmography. The age- and sex-matched control groups comprised 34 VLBW children without BPD (no-BPD group) and 34 term children (term group). RESULTS: The mean(SD) diastolic BP was significantly higher in the no-BPD than in the BPD group (65(9) vs. 59(8) mm Hg, p < 0.05). No clinically significant tricuspid regurgitations were found. The groups did not differ with respect to right ventricular systolic time intervals corrected for heart rate. The results of all M-mode measurements were within normal range. Compared to term controls, the BPD cases had lower mean(SD) forced expiratory flow in 1 s (90(14)% vs. 99(11)% of ref., p < 0.05) and more often high ratio of residual volume to total lung capacity (15(52%) vs. 4(13%), p < 0.01). No clinically significant correlations were found between current lung function and echocardiographic findings. CONCLUSION: In the surfactant era, school-aged VLBW survivors with and without BPD do not seem to evince indirect signs of elevated pulmonary pressure. The increased pulmonary vascular resistance associated with BPD appears to resolve with time more rapidly than abnormalities in respiratory function.
Keywords:AoD  aortic diameter  AT  right ventricular acceleration time  BMI  body mass index  BP  blood pressure  BPD  bronchopulmonary dysplasia  CI  confidence interval  CP  cerebral palsy  CS  corticosteroid  ECG  electrocardiography  ET  right ventricular ejection time  FEV1  forced expiratory volume in 1 s  FVC  forced vital capacity  IVSd  thickness of interventricular septum at end diastole  LVEDD  left ventricular end diastolic dimension  LVESD  left ventricular end systolic dimension  LVH  left ventricular hypertrophy  LVPWd  left ventricular posterior wall thickness at end diastole  LVSF  left ventricular shortening fraction  O2  oxygen  PAD  pulmonary artery diameter  PDA  patent ductus arteriosus  PEP  right ventricular preejection period  RDS  respiratory distress syndrome  SD  standard deviation  SGA  small for gestational age  VLBW  very low birth weight
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