ArticleJournal of the American Society of Echocardiography : official publication of the American Society of Echocardiography2019
Echocardiographic Assessment of Right Ventricular Afterload in Preterm Infants: Maturational Patterns of Pulmonary Artery Acceleration Time Over the First Year of Age and Implications for Pulmonary Hypertension.
Article in Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers.
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Who cites it
39 citing papers in PubMed, 60 citations in OpenAlex.
- Early Echocardiographic Indicators of Pulmonary Vascular Disease in Preterm Infants at Risk for Bronchopulmonary Dysplasia.Pediatric cardiology · 2026Article
- Novel echocardiographic markers for the assessment of pulmonary hypertension in infants.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Tissue Doppler Imaging, Pulmonary Haemodynamics and Conventional Echocardiographic Indices for Early Bronchopulmonary Dysplasia Prediction in Preterm Infants: A Prospective Observational Feasibility Study.Children (Basel, Switzerland) · 2026Article
- Echocardiographic Detection of Pulmonary Hypertension and Right Ventricular Failure in Infants with Bronchopulmonary Dysplasia: A Survey of the BPD Collaborative.Children (Basel, Switzerland) · 2026Article
- Fetal Ductal Constriction, Pulmonary Hypertension and Atrial Septum Mobility: A Correlation Study.Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine · 2026Article
- MicroRNA profiles in preterm children with regard to BPD and echocardiographic findings.Frontiers in medicine · 2026Article
- Hemodynamic phenotyping of bronchopulmonary dysplasia: from transitional circulation to precision cardiopulmonary care.Frontiers in pediatrics · 2026Review
- Neonatologist-Performed Echocardiography in Neonatal Pulmonary Hypertension: A Narrative Review of the Literature.Diagnostics (Basel, Switzerland) · 2025Review
- Omic-signature of bronchopulmonary dysplasia associated pulmonary hypertension in <1500g-birth-weight-infants with hemodynamically significant intracardiac shunt.Pediatric research · 2025Article
- Persistence of right ventricular dysfunction in infants after perinatal asphyxia treated with therapeutic hypothermia.Pediatric research · 2025Article
- Unique Patterns of Circulating Extracellular Vesicles in Preterm Infants During Adaptation to Extra-Uterine Life.Journal of extracellular vesicles · 2025Observational
- The Diagnostic Value of Transthoracic Echocardiography Parameters Under the New Diagnostic Criteria for Pulmonary Hypertension.Canadian respiratory journal · 2025Article
- Longitudinal evaluation of hemodynamic blood and echocardiographic biomarkers for the prediction of BPD and BPD-related pulmonary hypertension in very-low-birth-weight preterm infants.European journal of pediatrics · 2024Observational
- Impact of cord clamping on haemodynamic transition in term newborn infants.Archives of disease in childhood. Fetal and neonatal edition · 2024Article
- Cardiopulmonary physiological effects of diuretic therapy in preterm infants with chronic pulmonary hypertension.Journal of perinatology : official journal of the California Perinatal Association · 2023Article
- Bronchopulmonary dysplasia - associated pulmonary hypertension: An updated review.Seminars in perinatology · 2023Review
- Patent ductus arteriosus, bronchopulmonary dysplasia and pulmonary hypertension-a complex conundrum with many phenotypes?Pediatric research · 2023Article
- Multiomics endotyping of preterm infants with bronchopulmonary dysplasia and pulmonary hypertension-A pilot study.Pulmonary circulation · 2023Article
- A scoping review of echocardiographic and lung ultrasound biomarkers of bronchopulmonary dysplasia in preterm infants.Frontiers in pediatrics · 2023Article
- Targeted neonatal echocardiography and lung ultrasound in preterm infants with chronic lung disease with and without pulmonary hypertension, screened using a standardized algorithm.Frontiers in pediatrics · 2023Article
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Authors and funding
12 authors at 8 institutions in 3 countries.
Funding
Abstract
backgroundAssessment of pulmonary hemodynamics is critical in the diagnosis and management of cardiopulmonary disease of premature infants, but reliable noninvasive indices of pulmonary hemodynamics in preterm infants are lacking. Because pulmonary artery acceleration time (PAAT) is a validated noninvasive method to assess right ventricular (RV) afterload in infants and children, the aim of this study was to investigate the maturational changes of PAAT measures in preterm infants over the first year of age and to discern the impact of typical cardiopulmonary abnormalities on these measures.
methodsIn a prospective multicenter study of 239 preterm infants (<29 weeks at birth), PAAT was assessed at days 1, 2, and 5 to 7, at 32 and 36 weeks' postmenstrual age, and at 1-year corrected age. To account for heart rate variability, PAAT was adjusted for RV ejection time. Premature infants who developed bronchopulmonary dysplasia or had echocardiographic findings of pulmonary hypertension were analyzed separately. Intra- and interobserver reproducibility analysis was performed.
resultsPAAT was feasible in 95% of the image acquisitions, and there was high intra- and interobserver agreement (intraclass correlation coefficients > 0.9 and coefficients of variation < 6%). In uncomplicated preterm infants (n = 103 [48%]) PAAT and PAAT adjusted for RV ejection time increased longitudinally from birth to 1-year corrected age (P < .001) and were linearly associated with gestational age at birth (r = 0.81 and r = 0.82, P < .001) and increasing postnatal weight and postnatal age (r > 0.81, P < .001). PAAT measures were significantly reduced (P < .001) in infants with bronchopulmonary dysplasia and/or pulmonary hypertension (n = 119 [51%]) beyond 1 week of age.
conclusionsPAAT measures increase in preterm infants from birth to 1-year corrected age, reflective of the physiologic postnatal drop in RV afterload. Bronchopulmonary dysplasia and pulmonary hypertension have a negative impact on PAAT measures. By demonstrating excellent reliability and establishing reference patterns of PAAT in preterm infants, this study suggests that PAAT and PAAT adjusted for RV ejection time can be used as complementary parameters to assess physiologic and pathologic changes in pulmonary hemodynamics in neonates.
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