ArticlePhysiological reports2018
ACE inhibition for severe bronchopulmonary dysplasia - an approach based on physiology.
Article in Physiological reports, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 34 citations in OpenAlex.
- Diastolic function in newborn infants: understanding pathophysiology, diagnosis and clinical relevance.Pediatric research · 2026Review
- Tailoring Therapy to Bronchopulmonary Dysplasia Phenotype: A Ten-Year Experience in Precision Medicine.Children (Basel, Switzerland) · 2026Article
- Targeted Neonatal Echocardiography in Bronchopulmonary Dysplasia: A Framework for Screening and Management of Chronic Pulmonary Hypertension.Journal of clinical medicine · 2025Review
- Diagnostic and therapeutic precision in cardiovascular diseases in the neonatal intensive care.Journal of perinatology : official journal of the California Perinatal Association · 2025Review
- The rationale of using angiotensin receptor blocker instead of pulmonary vasodilators to treat pulmonary hypertension in bronchopulmonary dysplasia: a case report and literature review.Frontiers in pediatrics · 2025Article
- Assessment of Vascular Indices by Abdominal Aortic Ultrasonography in Preterm Neonates with Bronchopulmonary Dysplasia.Pediatric cardiology · 2024Article
- Patent Ductus Arteriosus and Lung Magnetic Resonance Imaging Phenotype in Moderate and Severe Bronchopulmonary Dysplasia-Pulmonary Hypertension.American journal of respiratory and critical care medicine · 2024Article
- Systemic hemodynamics and pediatric lung disease: mechanistic links and therapeutic relevance.American journal of physiology. Heart and circulatory physiology · 2024Review
- Cardiovascular Sequelae of Bronchopulmonary Dysplasia in Preterm Neonates Born before 32 Weeks of Gestational Age: Impact of Associated Pulmonary and Systemic Hypertension.Journal of cardiovascular development and disease · 2024Review
- Left ventricular diastolic function and respiratory outcomes in preterm infants: a retrospective study.Pediatric research · 2023Article
- Targeting vasculature to reduce fetal growth restriction associated bronchopulmonary dysplasia.Respirology (Carlton, Vic.) · 2022Article
- Hemodynamic consequences of respiratory interventions in preterm infants.Journal of perinatology : official journal of the California Perinatal Association · 2022Review
- Sequelae associated with systemic hypertension in infants with severe bronchopulmonary dysplasia.Journal of perinatology : official journal of the California Perinatal Association · 2022Article
- Safety, Feasibility, and Impact of Enalapril on Cardiorespiratory Physiology and Health in Preterm Infants with Systemic Hypertension and Left Ventricular Diastolic Dysfunction.Journal of clinical medicine · 2021Article
- Fetal Growth Restriction and Hypertension in the Offspring: Mechanistic Links and Therapeutic Directions.The Journal of pediatrics · 2020Review
- Cardiovascular response and sequelae after minimally invasive surfactant therapy in growth-restricted preterm infants.Journal of perinatology : official journal of the California Perinatal Association · 2020Article
- ACE inhibition for severe bronchopulmonary dysplasia - an approach based on physiology.Physiological reports · 2018Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Premature infants have a high incidence of bronchopulmonary dysplasia (BPD). Systemic hypertension, arterial thickness and stiffness, and increased systemic afterload may all contribute to BPD pathophysiology by altering left ventricular (LV) function and increasing pulmonary venous congestion by lowering end-diastolic compliance. This case series studied the usefulness of angiotensin-converting enzyme (ACE) inhibition by measuring clinical and echocardiographic improvements in six consecutive infants with "severe" BPD unresponsive to conventional therapy. The range of gestation and birthweight were 23-29 weeks and 505-814 g, respectively. All required mechanical ventilation (including high-frequency oscillation) and all but one were administered postnatal corticosteroids. Other treatments including sildenafil and diuretics made no clinical improvements. Captopril was started for systemic hypertension after cardiac and vascular ultrasounds which were repeated 5 weeks later. A significant reduction in oxygen (55 ± 25 to 29 ± 3%, two-tailed P = 0.03) and ventilator requirements, and improved cardiovascular parameters were noted. This included a trend toward reduction in aorta intima media thickness [840 ± 94 to 740 ± 83 μm, P = 0.07] and an increased pulsatile diameter [36 ± 14 to 63 ± 25 μm, P = 0.04]). Improvements were observed for both systolic (increased LV output, 188 ± 13 to 208 ± 13 mL/kg/min, P = 0.046 and mean velocity of circumferential fiber shortening, 1.6 ± 0.2 to 2.5 ± 0.3 [circ/sec], P = 0.0004) and diastolic (decreased isovolumic relaxation time, 69.6 ± 8.2 to 59.4 ± 5 msec, P = 0.044) function which was accompanied by increased pulmonary vein flow. Right ventricular output increased accompanied by a significant lowering of pulmonary vascular resistance. These findings suggest that improving respiratory and cardiac indices (especially diastolic function) warrants further exploration of ACE inhibition in BPD infants unresponsive to conventional therapy.
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