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10-09-2023 | Hypertension | Research

Assessment of Vascular Indices by Abdominal Aortic Ultrasonography in Preterm Neonates with Bronchopulmonary Dysplasia

Authors: Mehdi Ghaderian, Behzad Barekatain, Mohammad Reza Sabri, Silva Hovsepian, Alireza Ahmadi, Bahar Dehghan, Chehreh Mahdavi, Davood Ramezani Nezhad, Mostafa Arezoo

Published in: Pediatric Cardiology

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Abstract

Preterm infants with bronchopulmonary dysplasia (BPD) frequently encounter systemic hypertension, yet the underlying cause remains elusive. Given the absence of prior investigations concerning the correlation between systemic hypertension and aortic thickness, we undertook this study to assess and juxtapose diverse vascular indices amidst preterm neonates with BPD, preterm neonates lacking BPD, and healthy neonates, utilizing abdominal aorta ultrasonography. This cross-sectional study encompassed 20 preterm neonates, 20 preterm neonates with BPD, and 20 healthy neonates, meticulously matched for sex and postnatal age. Comprehensive demographic, anthropometric, and clinical evaluation data were documented. The neonates underwent abdominal aortic ultrasonography for comparative evaluation of aortic wall thickness and vasomotor function across the three groups. The study revealed that neonates with BPD exhibited a notably higher average systolic blood pressure than preterm and term neonates (P < 0.05). Conversely, echocardiographic parameters such as input impedance, and arterial wall stiffness index displayed no substantial variance among the three groups (P > 0.05). The mean (SD) aortic intima-media thickness (aIMT) for preterm neonates with BPD, preterm neonates, and term neonates were 814 (193.59) μm, 497.50 (172.19) μm, and 574.00 (113.20) μm, correspondingly (P < 0.05). Furthermore, the mean (SD) pulsatile diameter for preterm neonates with BPD, preterm neonates, and term neonates were 1.52 (0.81) mm, 0.91 (0.55) mm, and 1.34 (0.51) mm, respectively (P < 0.05). Following adjustment for birth weight, sex, and gestational age at birth, the study identified a noteworthy correlation between aIMT and BPD. The investigation concluded that the mean aortic intima-media thickness (aIMT) was significantly elevated in preterm neonates with BPD, signifying a potential early indicator of atherosclerosis and predisposition to future heightened blood pressure and cardiovascular ailments. Consequently, the study postulates that aIMT could be a consistent and well-tolerated marker for identifying BPD patients at risk of developing these health complications.
Literature
1.
go back to reference Sehgal A, Krishnamurthy MB, Clark M, Menahem S (2018) ACE inhibition for severe bronchopulmonary dysplasia—an approach based on physiology. Physiol Rep 6(17):e13821CrossRefPubMedPubMedCentral Sehgal A, Krishnamurthy MB, Clark M, Menahem S (2018) ACE inhibition for severe bronchopulmonary dysplasia—an approach based on physiology. Physiol Rep 6(17):e13821CrossRefPubMedPubMedCentral
2.
go back to reference Sahni M, Bhandari V (2019) Bronchopulmonary dysplasia-associated pulmonary hypertension. Pediatr Med 2(4):4CrossRef Sahni M, Bhandari V (2019) Bronchopulmonary dysplasia-associated pulmonary hypertension. Pediatr Med 2(4):4CrossRef
3.
go back to reference Sheth S et al (2020) Factors associated with development of early and late pulmonary hypertension in preterm infants with bronchopulmonary dysplasia. J Perinatol 40(1):138–148CrossRefPubMed Sheth S et al (2020) Factors associated with development of early and late pulmonary hypertension in preterm infants with bronchopulmonary dysplasia. J Perinatol 40(1):138–148CrossRefPubMed
4.
go back to reference Sehgal A et al (2016) Systemic arterial stiffness in infants with bronchopulmonary dysplasia: potential cause of systemic hypertension. J Perinatol 36(7):564–569CrossRefPubMed Sehgal A et al (2016) Systemic arterial stiffness in infants with bronchopulmonary dysplasia: potential cause of systemic hypertension. J Perinatol 36(7):564–569CrossRefPubMed
5.
go back to reference Hébert A et al (2020) Management of chronic pulmonary hypertension in neonates with bronchopulmonary dysplasia: perspectives of neonatologists with hemodynamic expertise and pediatric cardiologists. J Perinatol 40(11):1726–1728CrossRefPubMed Hébert A et al (2020) Management of chronic pulmonary hypertension in neonates with bronchopulmonary dysplasia: perspectives of neonatologists with hemodynamic expertise and pediatric cardiologists. J Perinatol 40(11):1726–1728CrossRefPubMed
6.
go back to reference Abman SH, Warady BA, Lum GM, Koops BL (1984) Systemic hypertension in infants with bronchopulmonary dysplasia. J Pediatr 104(6):928–931CrossRefPubMed Abman SH, Warady BA, Lum GM, Koops BL (1984) Systemic hypertension in infants with bronchopulmonary dysplasia. J Pediatr 104(6):928–931CrossRefPubMed
7.
go back to reference Starr MC, Wilson AC (2022) Systemic hypertension in infants with bronchopulmonary dysplasia. Curr Hypertens Rep 24(6):193–203CrossRefPubMed Starr MC, Wilson AC (2022) Systemic hypertension in infants with bronchopulmonary dysplasia. Curr Hypertens Rep 24(6):193–203CrossRefPubMed
8.
go back to reference Flahault A et al (2020) Arterial structure and stiffness are altered in young adults born preterm. Arterioscler Thromb Vasc Biol 40(10):2548–2556CrossRefPubMed Flahault A et al (2020) Arterial structure and stiffness are altered in young adults born preterm. Arterioscler Thromb Vasc Biol 40(10):2548–2556CrossRefPubMed
10.
go back to reference Malayeri AA et al (2008) Relation of aortic wall thickness and distensibility to cardiovascular risk factors (from the Multi-Ethnic Study of Atherosclerosis [MESA]). Am J Cardiol 102(4):491–496CrossRefPubMedPubMedCentral Malayeri AA et al (2008) Relation of aortic wall thickness and distensibility to cardiovascular risk factors (from the Multi-Ethnic Study of Atherosclerosis [MESA]). Am J Cardiol 102(4):491–496CrossRefPubMedPubMedCentral
11.
go back to reference Shah AB et al (2015) Characteristics of systemic hypertension in preterm children. J Clin Hypertens (Greenwich) 17(5):364–370CrossRefPubMed Shah AB et al (2015) Characteristics of systemic hypertension in preterm children. J Clin Hypertens (Greenwich) 17(5):364–370CrossRefPubMed
12.
go back to reference Sehgal A, Elsayed K, Nugent M, Varma S (2022) Sequelae associated with systemic hypertension in infants with severe bronchopulmonary dysplasia. J Perinatol 42(6):775–780CrossRefPubMedPubMedCentral Sehgal A, Elsayed K, Nugent M, Varma S (2022) Sequelae associated with systemic hypertension in infants with severe bronchopulmonary dysplasia. J Perinatol 42(6):775–780CrossRefPubMedPubMedCentral
13.
go back to reference Anderson AH et al (1993) Systemic hypertension in infants with severe bronchopulmonary dysplasia: associated clinical factors. Am J Perinatol 10(03):190–193CrossRefPubMed Anderson AH et al (1993) Systemic hypertension in infants with severe bronchopulmonary dysplasia: associated clinical factors. Am J Perinatol 10(03):190–193CrossRefPubMed
14.
go back to reference Sabri MR et al (2021) The associations of low birth weight with primary hypertension in later life: a systematic review and meta-analysis. J Res Med Sci 26:33CrossRefPubMedPubMedCentral Sabri MR et al (2021) The associations of low birth weight with primary hypertension in later life: a systematic review and meta-analysis. J Res Med Sci 26:33CrossRefPubMedPubMedCentral
15.
go back to reference Kwon HW et al (2016) Long-term outcomes of pulmonary hypertension in preterm infants with bronchopulmonary dysplasia. Neonatology 110(3):181–189CrossRefPubMed Kwon HW et al (2016) Long-term outcomes of pulmonary hypertension in preterm infants with bronchopulmonary dysplasia. Neonatology 110(3):181–189CrossRefPubMed
16.
17.
go back to reference McCloskey K et al (2014) Aortic intima-media thickness measured by trans-abdominal ultrasound as an early life marker of subclinical atherosclerosis. Acta Paediatr 103(2):124–130CrossRefPubMed McCloskey K et al (2014) Aortic intima-media thickness measured by trans-abdominal ultrasound as an early life marker of subclinical atherosclerosis. Acta Paediatr 103(2):124–130CrossRefPubMed
18.
go back to reference Oikonomou N et al (2020) Aortic intima-media thickness in neonates exposed to early-onset preeclampsia. Early Hum Dev 151:105166CrossRefPubMed Oikonomou N et al (2020) Aortic intima-media thickness in neonates exposed to early-onset preeclampsia. Early Hum Dev 151:105166CrossRefPubMed
19.
go back to reference Skilton MR et al (2019) Natural history of atherosclerosis and abdominal aortic intima-media thickness: rationale, evidence, and best practice for detection of atherosclerosis in the young. J Clin Med 8(8):1201CrossRefPubMedPubMedCentral Skilton MR et al (2019) Natural history of atherosclerosis and abdominal aortic intima-media thickness: rationale, evidence, and best practice for detection of atherosclerosis in the young. J Clin Med 8(8):1201CrossRefPubMedPubMedCentral
20.
go back to reference Flahault A et al (2020) Increased incidence but lack of association between cardiovascular risk factors in adults born preterm. Hypertension 75(3):796–805CrossRefPubMed Flahault A et al (2020) Increased incidence but lack of association between cardiovascular risk factors in adults born preterm. Hypertension 75(3):796–805CrossRefPubMed
21.
go back to reference Nascimento AMMdAd et al. (2017) Endothelial dysfunction in children with type 1 diabetes mellitus. Arch Endocrinol Metabol 61: 476–483 Nascimento AMMdAd et al. (2017) Endothelial dysfunction in children with type 1 diabetes mellitus. Arch Endocrinol Metabol 61: 476–483
22.
go back to reference Skilton MR, Raitakari OT, Celermajer DS (2013) High intake of dietary long-chain ω-3 fatty acids is associated with lower blood pressure in children born with low birth weight: NHANES 2003–2008. Hypertension 61(5):972–976CrossRefPubMed Skilton MR, Raitakari OT, Celermajer DS (2013) High intake of dietary long-chain ω-3 fatty acids is associated with lower blood pressure in children born with low birth weight: NHANES 2003–2008. Hypertension 61(5):972–976CrossRefPubMed
23.
go back to reference Oh YS (2018) Arterial stiffness and hypertension. Clin Hypertension 24(1):17CrossRef Oh YS (2018) Arterial stiffness and hypertension. Clin Hypertension 24(1):17CrossRef
24.
go back to reference Merillon JP et al (1982) Aortic input impedance in normal man and arterial hypertension: its modification during changes in aortic pressure. Cardiovasc Res 16(11):646–656CrossRefPubMed Merillon JP et al (1982) Aortic input impedance in normal man and arterial hypertension: its modification during changes in aortic pressure. Cardiovasc Res 16(11):646–656CrossRefPubMed
25.
go back to reference Kotur-Stevuljević J et al (2013) Hyperlipidemia, oxidative stress, and intima media thickness in children with chronic kidney disease. Pediatr Nephrol 28:295–303CrossRefPubMed Kotur-Stevuljević J et al (2013) Hyperlipidemia, oxidative stress, and intima media thickness in children with chronic kidney disease. Pediatr Nephrol 28:295–303CrossRefPubMed
26.
go back to reference Liu M-L et al (2004) Circulating oxidized low-density lipoprotein and its association with carotid intima-media thickness in asymptomatic members of familial combined hyperlipidemia families. Arterioscler Thromb Vasc Biol 24(8):1492–1497CrossRefPubMed Liu M-L et al (2004) Circulating oxidized low-density lipoprotein and its association with carotid intima-media thickness in asymptomatic members of familial combined hyperlipidemia families. Arterioscler Thromb Vasc Biol 24(8):1492–1497CrossRefPubMed
Metadata
Title
Assessment of Vascular Indices by Abdominal Aortic Ultrasonography in Preterm Neonates with Bronchopulmonary Dysplasia
Authors
Mehdi Ghaderian
Behzad Barekatain
Mohammad Reza Sabri
Silva Hovsepian
Alireza Ahmadi
Bahar Dehghan
Chehreh Mahdavi
Davood Ramezani Nezhad
Mostafa Arezoo
Publication date
10-09-2023
Publisher
Springer US
Published in
Pediatric Cardiology
Print ISSN: 0172-0643
Electronic ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-023-03295-7