Pulmonary Hypertension in Newborns Might Be Treated at Early Stage Using Echocardiography

Pulmonary hypertension (PH) can be detected using echocardiography earlier than previously thought, according to a study conducted on newborn mice that may considerably aid the treatment of premature infants. Being able to detect PH early means that the disease — with bronchopulmonary dysplasia, a common ailment in such babies — can be tackled sooner, preventing or decreasing both its severity and the risk of later complications.

In adults, pulmonary hypertension is a known cause in the development of serious lung ailments that include chronic obstructive pulmonary disease (COPD).

Researchers at Baylor College of Medicine in Houston, Texas, induced oxidative stress and inflammation, the two main factors contributing to PH development, in a group of newborn mice by exposing them to very high levels of oxygen (70%) for 14 days. A control group was exposed to 21% oxygen or regular air.

They then performed echocardiography tests, and saw that the young mice exposed to hyperoxia (high oxygen levels) developed oxidative stress in the lungs, inflammation, and PH. In addition, their lungs highly resembled those of infants with bronchopulmonary dysplasia and PH.

Developing new treatments for these two conditions has been limited partly due to a lack of advanced imaging techniques. Echocardiography tests have typically been used in four-week-old mice to detect PH and lung damage. But by that time, the damage to the lungs can be too advanced to effectively treat it. Earlier use of echocardiograms will allow researchers to not only better understand how PH develops but also to test potential new therapies.

“It’s important to understand not only the pathology, but also the functional aspect of pulmonary hypertension,” said Dr. Binoy Shivanna, assistant professor of pediatrics and neonatology at Baylor and Texas Children’s Hospital, in a press release. “This is where the echocardiography test, a non-invasive test that uses high frequency sound waves to take pictures of the heart, comes in.”

The new mouse model developed for the study replicates many of the PH features seen in infants.

Bronchopulmonary dysplasia is a chronic lung disease affecting infants and children. It can be caused by inflammation, infection and oxidative stress, which damages cells and have detrimental effects on lung development. This can lead to PH, which is characterized by an increased pressure in the blood vessels of the lungs. PH is commonly seen in premature infants, and can result in long-term problems and increased mortality.

Early diagnosis can be extremely important in preventing the negative effects of PH in a child’s health in the long-term.

The study, “Phenotypic assessment of pulmonary hypertension using high-resolution echocardiography is feasible in neonatal mice with experimental bronchopulmonary dysplasia and pulmonary hypertension: a step toward preventing chronic obstructive pulmonary disease,” was published in the International Journal of Chronic Obstructive Pulmonary Disease.